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A BILL TO BE ENTITLED
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AN ACT
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relating to considerations in awarding contracts under the Medicaid |
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managed care program to managed care organizations that are public |
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benefit corporations. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 540.0204, Government Code, as effective |
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April 1, 2025, is amended to read as follows: |
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Sec. 540.0204. CONTRACT CONSIDERATIONS RELATING TO MANAGED |
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CARE ORGANIZATIONS. (a) In awarding contracts to managed care |
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organizations, the commission shall: |
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(1) give preference to an organization that has |
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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 an organization that |
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agrees to assure continuity of care for at least three months beyond |
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a recipient's Medicaid eligibility period; |
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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; and |
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(4) consider the ability of an organization to process |
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Medicaid claims electronically. |
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(b) In awarding contracts to managed care organizations, |
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the commission shall: |
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(1) if an organization is a public benefit |
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corporation, as defined by Section 21.952, Business Organizations |
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Code, apply a five percent increase to the bid score assigned to the |
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organization for purposes of awarding a contract under this |
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chapter; and |
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(2) if two or more bids receive the same score, give |
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preference to the organization that is a public benefit |
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corporation. |
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SECTION 2. Section 540.0204, Government Code, as amended by |
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this Act, applies only to a contract awarded by the Health and Human |
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Services Commission to a managed care organization on or after the |
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effective date of this Act. |
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SECTION 3. 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 4. This Act takes effect September 1, 2025. |