H.B. No. 2256

	AN ACT
	relating to the requirements for uniform fair hearing rules for
	Medicaid services, including services that require prior
	authorization.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  Section 531.024, Government Code, is amended to
	read as follows:
	Sec. 531.024.  PLANNING AND DELIVERY OF HEALTH AND HUMAN
	SERVICES.  (a)  The executive commissioner shall:
	(1)  facilitate and enforce coordinated planning and
	delivery of health and human services, including:
	(A)  compliance with the coordinated strategic
	plan;
	(B)  co-location of services;
	(C)  integrated intake; and
	(D)  coordinated referral and case management;
	(2)  develop with the Department of Information
	Resources automation standards for computer systems to enable
	health and human services agencies, including agencies operating at
	a local level, to share pertinent data;
	(3)  establish and enforce uniform regional boundaries
	for all health and human services agencies;
	(4)  carry out statewide health and human services
	needs surveys and forecasting;
	(5)  perform independent special-outcome evaluations
	of health and human services programs and activities;
	(6)  at the request of a governmental entity identified
	under Section 531.022(e), assist that entity in implementing a
	coordinated plan that may include co-location of services,
	integrated intake, and coordinated referral and case management and
	is tailored to the needs and priorities of that entity; and
	(7)  promulgate uniform fair hearing rules for all
	Medicaid-funded services.
	(b)  The rules promulgated under Subsection (a)(7) must
	provide due process to an applicant for Medicaid services and to a
	Medicaid recipient who seeks a Medicaid service, including a
	service that requires prior authorization. The rules must provide
	the protections for applicants and recipients required by 42 C.F.R.
	Part 431, Subpart E, including requiring that:
	(1)  the written notice to an individual of the
	individual's right to a hearing must:
	(A)  contain an explanation of the circumstances
	under which Medicaid is continued if a hearing is requested; and
	(B)  be mailed at least 10 days before the date the
	individual's Medicaid eligibility or service is scheduled to be
	terminated, suspended, or reduced, except as provided by 42 C.F.R.
	Section 431.213 or 431.214; and
	(2)  if a hearing is requested before the date a
	Medicaid recipient's service, including a service that requires
	prior authorization, is scheduled to be terminated, suspended, or
	reduced, the agency may not take that proposed action before a
	decision is rendered after the hearing unless:
	(A)  it is determined at the hearing that the sole
	issue is one of federal or state law or policy; and
	(B)  the agency promptly informs the recipient in
	writing that services are to be terminated, suspended, or reduced
	pending the hearing decision.
	SECTION 2.  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 3.  This Act takes effect September 1, 2007.
	______________________________	______________________________
	President of the Senate	Speaker of the House
	I certify that H.B. No. 2256 was passed by the House on May
	11, 2007, by the following vote:  Yeas 136, Nays 1, 2 present, not
	voting.
	______________________________
	Chief Clerk of the House
	I certify that H.B. No. 2256 was passed by the Senate on May
	23, 2007, by the following vote:  Yeas 31, Nays 0.
	______________________________
	Secretary of the Senate
	APPROVED:  _____________________
	Date
	_____________________
	Governor