87R24267 KKR-F
 
  By: Raymond, Guillen H.B. No. 4047
 
  Substitute the following for H.B. No. 4047:
 
  By:  Frank C.S.H.B. No. 4047
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to allowing health care providers to enter certain claims
  and other information into the Medicaid electronic visit
  verification system.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 531.024172(d), Government Code, is
  amended to read as follows:
         (d)  In implementing the electronic visit verification
  system:
               (1)  subject to Subsection (e), the executive
  commissioner shall adopt compliance standards for health care
  providers; and
               (2)  the commission shall ensure that:
                     (A)  the information required to be reported by
  health care providers is standardized across managed care
  organizations that contract with the commission to provide health
  care services to Medicaid recipients and across commission
  programs;
                     (B)  processes required by managed care
  organizations to retrospectively correct data are standardized and
  publicly accessible to health care providers; [and]
                     (C)  standardized processes are established for
  addressing the failure of a managed care organization to provide a
  timely authorization for delivering services necessary to ensure
  continuity of care; and
                     (D)  a health care provider is allowed to:
                           (i)  enter a variable schedule into the
  electronic visit verification system;
                           (ii)  complete electronic visit
  verification system data maintenance within the 95-day period
  following the date of a service delivery visit; and
                           (iii)  submit a claim to be reimbursed for an
  amount of time that:
                                 (a)  does not exceed the amount of
  authorized hours unless the additional hours are approved by the
  commission or the managed care organization; and
                                 (b)  is equal to or less than the
  appropriately verified amount of time.
         SECTION 2.  If before implementing any provision of this Act
  a state agency determines that a waiver or authorization from a
  federal agency is necessary for implementation of that provision,
  the agency affected by the provision shall request the waiver or
  authorization and may delay implementing that provision until the
  waiver or authorization is granted.
         SECTION 3.  This Act takes effect September 1, 2021.