| |
| |
|
|
A BILL TO BE ENTITLED
|
|
|
AN ACT
|
|
|
relating to the award of health plan provider contracts under the |
|
|
Medicaid managed care program. |
|
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
|
SECTION 1. Section 533.004(a), Government Code, is amended |
|
|
to read as follows: |
|
|
(a) In providing health care services through Medicaid |
|
|
managed care to recipients in a health care service region, the |
|
|
commission shall contract with a managed care organization in that |
|
|
region that is licensed under Chapter 843, Insurance Code, if |
|
|
subject to that chapter, to provide health care in that region and |
|
|
that is: |
|
|
(1) wholly owned and operated by a hospital district |
|
|
in that region; |
|
|
(2) created by a nonprofit corporation that: |
|
|
(A) has a contract, agreement, or other |
|
|
arrangement with a hospital district in that region or with a |
|
|
municipality in that region that owns a hospital licensed under |
|
|
Chapter 241, Health and Safety Code, and has an obligation to |
|
|
provide health care to indigent patients; and |
|
|
(B) under the contract, agreement, or other |
|
|
arrangement, assumes the obligation to provide health care to |
|
|
indigent patients and leases, manages, or operates a hospital |
|
|
facility owned by the hospital district or municipality; [or] |
|
|
(3) created by a nonprofit corporation that has a |
|
|
contract, agreement, or other arrangement with a hospital district |
|
|
in that region under which the nonprofit corporation acts as an |
|
|
agent of the district and assumes the district's obligation to |
|
|
arrange for services under the Medicaid expansion for children as |
|
|
authorized by Chapter 444, Acts of the 74th Legislature, Regular |
|
|
Session, 1995; or |
|
|
(4) a provider-sponsored health organization |
|
|
affiliated with two trauma facilities designated as level I trauma |
|
|
facilities by the Department of State Health Services under Section |
|
|
773.115, Health and Safety Code, provided the commission does not |
|
|
have an existing contract with a managed care organization under |
|
|
Subdivision (1). |
|
|
SECTION 2. The changes in law made by this Act apply only to |
|
|
the award of a contract by the Health and Human Services Commission |
|
|
on or after the effective date of this Act. |
|
|
SECTION 3. 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 4. This Act takes effect immediately if it receives |
|
|
a vote of two-thirds of all the members elected to each house, as |
|
|
provided by Section 39, Article III, Texas Constitution. If this |
|
|
Act does not receive the vote necessary for immediate effect, this |
|
|
Act takes effect September 1, 2021. |