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By: Hull, et al. (Senate Sponsor - Cook, et al.) |
H.B. No. 3151 |
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(In the Senate - Received from the House May 14, 2025; |
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May 14, 2025, read first time and referred to Committee on Health & |
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Human Services; May 23, 2025, reported favorably by the following |
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vote: Yeas 9, Nays 0; May 23, 2025, sent to printer.) |
Click here to see the committee vote |
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A BILL TO BE ENTITLED
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AN ACT
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relating to expedited credentialing of certain federally qualified |
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health center providers by Medicaid managed care organizations. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Sections 540.0656(a) and (d), Government Code, |
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are amended to read as follows: |
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(a) In this section, "applicant provider" means a physician |
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or other health care provider, including a federally qualified |
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health center as defined by 42 U.S.C. Section 1396d(l)(2)(B) or a |
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health care provider for the federally qualified health center, |
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applying for expedited credentialing. |
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(d) To qualify for expedited credentialing and payment |
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under Subsection (e), an applicant provider must: |
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(1) have a current contract with a Medicaid managed |
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care organization or be a member of or a health care provider for |
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one of the following that has a current contract with a Medicaid |
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managed care organization: |
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(A) an established health care provider group; or |
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(B) a federally qualified health center as |
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defined by 42 U.S.C. Section 1396d(l)(2)(B) [an established health |
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care provider group that has a current contract with a Medicaid |
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managed care organization]; |
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(2) be a Medicaid-enrolled provider; |
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(3) agree to comply with the terms of the contract |
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described by Subdivision (1); and |
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(4) submit all documentation and other information the |
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Medicaid managed care organization requires as necessary to enable |
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the organization to begin the credentialing process the |
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organization requires to include a provider in the organization's |
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provider network. |
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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. |
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