89R16032 AB-D

By: Longoria H.B. No. 4410

A BILL TO BE ENTITLED

AN ACT

relating to Medicaid reimbursement rates for certain ground ambulance services.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 32.028, Human Resources Code, is amended by adding Subsection (o) to read as follows:

(o) The executive commissioner shall ensure that the rules governing the determination of medical assistance reimbursement base rates paid to a provider for providing ground ambulance services are at least equal to 40 percent of the rate paid under Medicare for providing ground ambulance services originating in a rural area.

SECTION 2. Subchapter F, Chapter 540, Government Code, as effective April 1, 2025, is amended by adding Section 540.0281 to read as follows:

Sec. 540.0281. REIMBURSEMENT RATE FOR CERTAIN GROUND AMBULANCE SERVICE PROVIDERS. A contract to which this subchapter applies must require the contracting Medicaid managed care organization to:

(1) reimburse a provider who is in the organization's provider network and who provides ground ambulance services at a rate that is at least equal to the rate paid under Medicare for the provision of ground ambulance services originating in a rural area; and

(2) annually increase the reimbursement rate by three percent.

SECTION 3. (a) The Health and Human Services Commission shall, in a contract between the commission and a managed care organization under Chapter 540, Government Code, as effective April 1, 2025, that is entered into or renewed on or after the effective date of this Act, require that the managed care organization comply with Section 540.0281, Government Code, as added by this Act.

(b) The Health and Human Services Commission shall seek to amend contracts entered into with managed care organizations before the effective date of this Act to require those managed care organizations to comply with Section 540.0281, Government Code, as added by this Act. To the extent of a conflict between Section 540.0281, Government Code, as added by this Act, and a provision of a contract with a managed care organization entered into before the effective date of this Act, the contract provision prevails.

SECTION 4. 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 5. This Act takes effect September 1, 2025.