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A BILL TO BE ENTITLED
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AN ACT
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relating to certain contracting requirements under the Medicaid |
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managed care delivery model. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 533.003(a), Government Code, is amended |
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to read as follows: |
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(a) In awarding contracts to managed care organizations, |
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the commission shall: |
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(1) give preference to organizations that have |
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significant participation in the organization's provider network |
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from each health care provider in the region who has traditionally |
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provided care to Medicaid and charity care patients; |
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(2) give extra consideration to organizations that |
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agree to assure continuity of care for at least three months beyond |
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the period of Medicaid eligibility for recipients; |
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(3) consider the need to use different managed care |
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plans to meet the needs of different populations; |
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(4) consider the ability of organizations to process |
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Medicaid claims electronically; [and] |
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(5) in the initial implementation of managed care in |
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the South Texas service region, give extra consideration to an |
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organization that [either: |
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[(A)] is locally owned, managed, and operated, if |
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one exists; and |
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(6) consider the potential benefit to the Medicaid |
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managed care program implemented under this chapter that may be |
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derived from awarding a contract to provide health care services to |
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recipients in a service delivery area to an organization that is |
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licensed under Chapter 843, Insurance Code, and is: |
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(A) wholly owned and operated by a hospital |
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district in the service delivery area; or |
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(B) created by a nonprofit organization that has |
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a contract, agreement, or other arrangement with a hospital |
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district in that service delivery area or with a municipality in |
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that service delivery area that owns a hospital licensed under |
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Chapter 241, Health and Safety Code, and has an obligation to |
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provide health care to indigent patients [is in compliance with the |
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requirements of Section 533.004]. |
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SECTION 2. Section 533.004, Government Code, is repealed. |
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SECTION 3. (a) Except as provided by Subsection (b) of this |
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section, the changes in law made by this Act apply only after the |
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next operational start date of the Health and Human Services |
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Commission's STAR and STAR+PLUS procurements. A procurement before |
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the next operational start date for the Health and Human Services |
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Commission's STAR and STAR+PLUS procurements is governed by the law |
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in effect before the effective date of this Act and the former law |
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is continued in effect for that purpose. |
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(b) The changes in law made by this Act apply to any STAR |
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Kids procurement on or after the effective date of this Act. |
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SECTION 4. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 5. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2023. |