Bill Text: TX HB5023 | 2023-2024 | 88th Legislature | Introduced
Bill Title: Relating to requiring Medicaid managed care organizations to provide an annual bonus payment to certain Medicaid providers.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2023-04-18 - Left pending in committee [HB5023 Detail]
Download: Texas-2023-HB5023-Introduced.html
88R13511 JG-D | ||
By: Guerra | H.B. No. 5023 |
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relating to requiring Medicaid managed care organizations to | ||
provide an annual bonus payment to certain Medicaid providers. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subchapter A, Chapter 533, Government Code, is | ||
amended by adding Section 533.01317 to read as follows: | ||
Sec. 533.01317. ANNUAL BONUS PAYMENT FOR CERTAIN PROVIDERS. | ||
(a) Notwithstanding any other law, the executive commissioner by | ||
rule shall, in accordance with this section, require each Medicaid | ||
managed care organization to provide an annual bonus payment to | ||
certain providers in the organization's provider network. The rule | ||
must require that a Medicaid managed care organization provide a | ||
bonus payment to a provider in the organization's provider network | ||
if: | ||
(1) during the immediately preceding fiscal year, the | ||
provider: | ||
(A) was an enrolled Medicaid provider who | ||
provided health care services to recipients throughout the entire | ||
fiscal year; and | ||
(B) provided health care services to recipients | ||
not later than an average of: | ||
(i) 48 hours from the time a request for | ||
services was made for recipients with an acute health care | ||
condition; and | ||
(ii) three weeks from the date a request for | ||
services was made for recipients with a chronic health care | ||
condition; and | ||
(2) the provider is in good standing with the | ||
provider's applicable licensing or regulatory authority. | ||
(b) The bonus payment provided to a health care provider by | ||
a Medicaid managed care organization under this section must be in | ||
an amount equal to 25 percent of the profits the organization made | ||
during the immediately preceding fiscal year on health care | ||
services provided by the provider to recipients enrolled in the | ||
organization's managed care plan. | ||
(c) The executive commissioner shall ensure rules adopted | ||
under this section prescribe a deadline by which a Medicaid managed | ||
care organization must provide a bonus payment under this section. | ||
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, 2023. |