| |
| |
|
|
A BILL TO BE ENTITLED
|
|
|
AN ACT
|
|
|
relating to the process for recovering overpayments under Medicaid. |
|
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
|
SECTION 1. Section 531.1131(f), Government Code, is amended |
|
|
to read as follows: |
|
|
(f) In adopting rules establishing due process procedures |
|
|
under Subsection (e), the executive commissioner shall require that |
|
|
a managed care organization or an entity with which the managed care |
|
|
organization contracts under Section 531.113(a)(2) that engages in |
|
|
payment recovery efforts in accordance with this section and |
|
|
Section 531.1135 provide: |
|
|
(1) written notice to a provider required to use |
|
|
electronic visit verification of the organization's intent to |
|
|
recoup overpayments in accordance with Section 531.1135; and |
|
|
(2) any [a] provider [described by Subdivision (1)] at |
|
|
least 60 days after the provider has exhausted all rights to an |
|
|
appeal to cure any defect in a claim, including by submitting |
|
|
necessary documentation for the claim or resubmitting the claim, |
|
|
before the organization may begin any efforts to collect |
|
|
overpayments. |
|
|
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, 2023. |