| |
| |
| |
|
|
AN ACT
|
|
|
relating to the award of health plan provider contracts under |
|
|
Medicaid managed care. |
|
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
|
SECTION 1. Subchapter A, Chapter 533, Government Code, is |
|
|
amended by adding Section 533.0035 to read as follows: |
|
|
Sec. 533.0035. CERTIFICATION BY COMMISSION. (a) Before |
|
|
the commission may award a contract under this chapter to a managed |
|
|
care organization, the commission shall evaluate and certify that |
|
|
the organization is reasonably able to fulfill the terms of the |
|
|
contract, including all requirements of applicable federal and |
|
|
state law. |
|
|
(b) Notwithstanding any other law, the commission may not |
|
|
award a contract under this chapter to a managed care organization |
|
|
that does not receive the certification required under this |
|
|
section. |
|
|
(c) A managed care organization may appeal a denial of |
|
|
certification by the commission under this section. |
|
|
SECTION 2. Section 533.004(a), Government Code, is amended |
|
|
to read as follows: |
|
|
(a) Subject to the considerations required under Section |
|
|
533.003 and the certification required under Section 533.0035, in |
|
|
[In] providing health care services through Medicaid managed care |
|
|
to recipients in a health care service region, the commission shall |
|
|
contract with a managed care organization in that region that is |
|
|
licensed under Chapter 843, Insurance Code, to provide health care |
|
|
in that region and that is: |
|
|
(1) wholly owned and operated by a hospital district |
|
|
in that region; |
|
|
(2) created by a nonprofit corporation that: |
|
|
(A) has a contract, agreement, or other |
|
|
arrangement with a hospital district in that region or with a |
|
|
municipality in that region that owns a hospital licensed under |
|
|
Chapter 241, Health and Safety Code, and has an obligation to |
|
|
provide health care to indigent patients; and |
|
|
(B) under the contract, agreement, or other |
|
|
arrangement, assumes the obligation to provide health care to |
|
|
indigent patients and leases, manages, or operates a hospital |
|
|
facility owned by the hospital district or municipality; or |
|
|
(3) created by a nonprofit corporation that has a |
|
|
contract, agreement, or other arrangement with a hospital district |
|
|
in that region under which the nonprofit corporation acts as an |
|
|
agent of the district and assumes the district's obligation to |
|
|
arrange for services under the Medicaid expansion for children as |
|
|
authorized by Chapter 444, Acts of the 74th Legislature, Regular |
|
|
Session, 1995. |
|
|
SECTION 3. 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 4. This Act takes effect September 1, 2021. |
|
|
|
|
|
|
| |
| |
| |
| |
______________________________ |
______________________________ |
| |
President of the Senate |
Speaker of the House |
| |
|
|
I hereby certify that S.B. No. 1244 passed the Senate on |
|
|
April 29, 2021, by the following vote: Yeas 31, Nays 0. |
|
|
|
| |
| |
______________________________ |
| |
Secretary of the Senate |
| |
|
|
I hereby certify that S.B. No. 1244 passed the House on |
|
|
May 26, 2021, by the following vote: Yeas 132, Nays 15, two |
|
|
present not voting. |
|
|
|
| |
| |
______________________________ |
| |
Chief Clerk of the House |
| |
|
|
|
| |
|
|
Approved: |
|
|
|
|
|
______________________________ |
|
|
Date |
|
|
|
|
|
|
|
|
______________________________ |
|
|
Governor |