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A BILL TO BE ENTITLED
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AN ACT
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relating to Medicaid reimbursement for certain costs incurred while |
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a chronically ill Medicaid recipient who is a child receives |
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hospital care. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter B, Chapter 32, Human Resources Code, |
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is amended by adding Section 32.0318 to read as follows: |
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Sec. 32.0318. REIMBURSEMENT FOR CERTAIN COSTS RELATED TO |
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HOSPITAL CARE FOR CHRONICALLY ILL CHILDREN. (a) In this section: |
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(1) "Hospital" means a hospital licensed under Chapter |
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241, Health and Safety Code. |
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(2) "Medicaid managed care organization" has the |
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meaning assigned by Section 521.0001, Government Code. |
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(3) "Recipient" means a recipient of medical |
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assistance regardless of whether that assistance is provided |
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through a fee-for-service or managed care model or through another |
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payment model or arrangement. |
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(b) Subject to the requirements of this subsection, the |
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commission shall ensure that medical assistance reimbursement is |
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provided for the costs of food purchased from and parking at a |
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hospital at which a recipient is hospitalized or otherwise |
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receiving health care services. To be eligible for medical |
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assistance reimbursement: |
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(1) the costs must be incurred and paid during the |
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recipient's period of hospitalization or receipt of health care |
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services by a parent, guardian, or caretaker of the recipient; and |
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(2) the recipient must: |
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(A) be younger than 18 years of age; |
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(B) have been diagnosed with a chronic illness |
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designated by the executive commissioner; and |
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(C) be hospitalized or receiving health care |
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services at the hospital for that chronic illness. |
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(c) The executive commissioner may require that a Medicaid |
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managed care organization provide reimbursement under this section |
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to a recipient who is enrolled in a Medicaid managed care plan |
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offered by the organization. |
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(d) The executive commissioner shall adopt rules necessary |
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to implement this section, including rules: |
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(1) designating the diagnoses considered chronic |
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illnesses for purposes of reimbursement under this section; and |
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(2) establishing reasonable limits on reimbursement |
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amounts. |
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SECTION 2. 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 3. This Act takes effect September 1, 2025. |