88R11715 BDP-F
 
  By: Raney H.B. No. 3916
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the reimbursement of certain durable medical equipment
  providers participating in the Medicaid managed care program.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 533.005, Government Code, is amended by
  adding Subsection (i) to read as follows:
         (i)  In addition to the requirements specified by Subsection
  (a) and notwithstanding any other law, a contract described by that
  subsection must require the managed care organization to reimburse
  a specialty provider of durable medical equipment and related
  supplies and services who provides the equipment, supplies, or
  services to a recipient at a rate that is at least equal to 95
  percent of the rate paid under the Medicaid fee-for-service fee
  schedule.
         SECTION 2.  (a) The Health and Human Services Commission
  shall, in a contract between the commission and a managed care
  organization under Chapter 533, Government Code, that is entered
  into or renewed on or after the effective date of this Act, require
  that the managed care organization comply with Section 533.005(i),
  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 under
  Chapter 533, Government Code, before the effective date of this Act
  to require those managed care organizations to comply with Section
  533.005(i), Government Code, as added by this Act. To the extent of
  a conflict between Section 533.005(i), 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 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, 2023.