Bill Text: TX HB1576 | 2019-2020 | 86th Legislature | Enrolled
Bill Title: Relating to the delivery of certain transportation services under Medicaid and certain other health and human services programs.
Spectrum: Bipartisan Bill
Status: (Passed) 2019-06-14 - Effective immediately [HB1576 Detail]
Download: Texas-2019-HB1576-Enrolled.html
H.B. No. 1576 |
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relating to the delivery of certain transportation services under | ||
Medicaid and certain other health and human services programs. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 531.001, Government Code, is amended by | ||
adding Subdivision (4-c) to read as follows: | ||
(4-c) "Medicaid managed care organization" means a | ||
managed care organization as defined by Section 533.001 that | ||
contracts with the commission under Chapter 533 to provide health | ||
care services to Medicaid recipients. | ||
SECTION 2. The heading to Section 531.02414, Government | ||
Code, is amended to read as follows: | ||
Sec. 531.02414. NONEMERGENCY TRANSPORTATION SERVICES UNDER | ||
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SECTION 3. Section 531.02414(a), Government Code, is | ||
amended by amending Subdivision (1) and adding Subdivisions (1-a) | ||
and (3) to read as follows: | ||
(1) "Medical transportation program" means the | ||
program that provides nonemergency transportation services [ |
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recipients under Medicaid, subject to Subsection (a-1), the | ||
children with special health care needs program, and the | ||
transportation for indigent cancer patients program, who have no | ||
other means of transportation. | ||
(1-a) "Nonemergency transportation service" means | ||
nonemergency medical transportation services authorized under: | ||
(A) for a Medicaid recipient, the state Medicaid | ||
plan; and | ||
(B) for a recipient under another program | ||
described by Subdivision (1), that program. | ||
(3) "Transportation network company" has the meaning | ||
assigned by Section 2402.001, Occupations Code. | ||
SECTION 4. Section 531.02414, Government Code, is amended | ||
by adding Subsections (a-1), (i), (j), (k), (l), and (m) and | ||
amending Subsections (b), (e), and (f) to read as follows: | ||
(a-1) Subject to Section 533.002571(i), this section does | ||
not apply to the provision of nonemergency transportation services | ||
on or after September 1, 2020, to a Medicaid recipient who is | ||
enrolled in a managed care plan offered by a Medicaid managed care | ||
organization. | ||
(b) Notwithstanding any other law, the commission shall | ||
directly supervise the administration and operation of the medical | ||
transportation program under this section. | ||
(e) The executive commissioner shall adopt rules to ensure | ||
the safe and efficient provision of nonemergency transportation | ||
services under this section [ |
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(1) minimum standards regarding the physical | ||
condition and maintenance of motor vehicles used to provide the | ||
services, including standards regarding the accessibility of motor | ||
vehicles by persons with disabilities; | ||
(2) a requirement that a regional contracted broker | ||
verify that each motor vehicle operator providing the services or | ||
seeking to provide the services has a valid driver's license; | ||
(3) a requirement that a regional contracted broker | ||
check the driving record information maintained by the Department | ||
of Public Safety under Subchapter C, Chapter 521, Transportation | ||
Code, of each motor vehicle operator providing the services or | ||
seeking to provide the services; | ||
(4) a requirement that a regional contracted broker | ||
check the public criminal record information maintained by the | ||
Department of Public Safety and made available to the public | ||
through the department's Internet website of each motor vehicle | ||
operator providing the services or seeking to provide the services; | ||
and | ||
(5) training requirements for motor vehicle operators | ||
providing the services through a regional contracted broker, | ||
including training on the following topics: | ||
(A) passenger safety; | ||
(B) passenger assistance; | ||
(C) assistive devices, including wheelchair | ||
lifts, tie-down equipment, and child safety seats; | ||
(D) sensitivity and diversity; | ||
(E) customer service; | ||
(F) defensive driving techniques; and | ||
(G) prohibited behavior by motor vehicle | ||
operators. | ||
(f) Except as provided by Subsection (j), the [ |
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commission shall require compliance with the rules adopted under | ||
Subsection (e) in any contract entered into with a regional | ||
contracted broker to provide nonemergency transportation services | ||
under the medical transportation program. | ||
(i) Emergency medical services personnel and emergency | ||
medical services vehicles, as those terms are defined by Section | ||
773.003, Health and Safety Code, may not provide nonemergency | ||
transportation services under the medical transportation program. | ||
(j) A regional contracted broker may subcontract with a | ||
transportation network company to provide services under this | ||
section. A rule or other requirement adopted by the executive | ||
commissioner under Subsection (e) does not apply to the | ||
subcontracted transportation network company or a motor vehicle | ||
operator who is part of the company's network. The commission or | ||
the regional contracted broker may not require a motor vehicle | ||
operator who is part of the subcontracted transportation network | ||
company's network to enroll as a Medicaid provider to provide | ||
services under this section. | ||
(k) The commission or a regional contracted broker that | ||
subcontracts with a transportation network company under | ||
Subsection (j) may require the transportation network company or a | ||
motor vehicle operator who provides services under this section to | ||
be periodically screened against the list of excluded individuals | ||
and entities maintained by the Office of Inspector General of the | ||
United States Department of Health and Human Services. | ||
(l) Notwithstanding any other law, a motor vehicle operator | ||
who is part of the network of a transportation network company that | ||
subcontracts with a regional contracted broker under Subsection (j) | ||
and who satisfies the driver requirements in Section 2402.107, | ||
Occupations Code, is qualified to provide services under this | ||
section. The commission and the regional contracted broker may not | ||
impose any additional requirements on a motor vehicle operator who | ||
satisfies the driver requirements in Section 2402.107, Occupations | ||
Code, to provide services under this section. | ||
(m) For purposes of this section and notwithstanding | ||
Section 2402.111(a)(2)(A), Occupations Code, a motor vehicle | ||
operator who provides services under this section may use a | ||
wheelchair-accessible vehicle equipped with a lift or ramp that is | ||
capable of transporting passengers using a fixed-frame wheelchair | ||
in the cabin of the vehicle if the vehicle otherwise meets the | ||
requirements of Section 2402.111, Occupations Code. | ||
SECTION 5. The heading to Section 533.00257, Government | ||
Code, is amended to read as follows: | ||
Sec. 533.00257. DELIVERY OF MEDICAL TRANSPORTATION PROGRAM | ||
SERVICES THROUGH MANAGED TRANSPORTATION ORGANIZATION. | ||
SECTION 6. Section 533.00257(a), Government Code, is | ||
amended by adding Subdivision (2-a) to read as follows: | ||
(2-a) "Transportation network company" has the | ||
meaning assigned by Section 2402.001, Occupations Code. | ||
SECTION 7. Section 533.00257, Government Code, is amended | ||
by amending Subsections (b), (d), and (g) and adding Subsections | ||
(k), (l), (m), and (n) to read as follows: | ||
(b) The [ |
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regional basis through a managed transportation delivery model | ||
using managed transportation organizations and providers, as | ||
appropriate, that: | ||
(1) operate under a capitated rate system; | ||
(2) assume financial responsibility under a full-risk | ||
model; | ||
(3) operate a call center; | ||
(4) use fixed routes when available and appropriate; | ||
and | ||
(5) agree to provide data to the commission if the | ||
commission determines that the data is required to receive federal | ||
matching funds. | ||
(d) Except as provided by Subsections (k) and (m), a [ |
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managed transportation organization that participates in the | ||
medical transportation program must attempt to contract with | ||
medical transportation providers that: | ||
(1) are considered significant traditional providers, | ||
as defined by rule by the executive commissioner; | ||
(2) meet the minimum quality and efficiency measures | ||
required under Subsection (g) and other requirements that may be | ||
imposed by the managed transportation organization; and | ||
(3) agree to accept the prevailing contract rate of | ||
the managed transportation organization. | ||
(g) Except as provided by Subsections (k) and (m), the [ |
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commission shall require that managed transportation organizations | ||
and providers participating in the medical transportation program | ||
meet minimum quality and efficiency measures as determined by the | ||
commission. | ||
(k) A managed transportation organization may subcontract | ||
with a transportation network company to provide services under | ||
this section. A rule or other requirement adopted by the executive | ||
commissioner under this section or Section 531.02414 does not apply | ||
to the subcontracted transportation network company or a motor | ||
vehicle operator who is part of the company's network. The | ||
commission or the managed transportation organization may not | ||
require a motor vehicle operator who is part of the subcontracted | ||
transportation network company's network to enroll as a Medicaid | ||
provider to provide services under this section. | ||
(l) The commission or a managed transportation organization | ||
that subcontracts with a transportation network company under | ||
Subsection (k) may require the transportation network company or a | ||
motor vehicle operator who provides services under this section to | ||
be periodically screened against the list of excluded individuals | ||
and entities maintained by the Office of Inspector General of the | ||
United States Department of Health and Human Services. | ||
(m) Notwithstanding any other law, a motor vehicle operator | ||
who is part of the network of a transportation network company that | ||
subcontracts with a managed transportation organization under | ||
Subsection (k) and who satisfies the driver requirements in Section | ||
2402.107, Occupations Code, is qualified to provide services under | ||
this section. The commission and the managed transportation | ||
organization may not impose any additional requirements on a motor | ||
vehicle operator who satisfies the driver requirements in Section | ||
2402.107, Occupations Code, to provide services under this section. | ||
(n) For purposes of this section and notwithstanding | ||
Section 2402.111(a)(2)(A), Occupations Code, a motor vehicle | ||
operator who provides services under this section may use a | ||
wheelchair-accessible vehicle equipped with a lift or ramp that is | ||
capable of transporting passengers using a fixed-frame wheelchair | ||
in the cabin of the vehicle if the vehicle otherwise meets the | ||
requirements of Section 2402.111, Occupations Code. | ||
SECTION 8. Subchapter A, Chapter 533, Government Code, is | ||
amended by adding Sections 533.002571, 533.00258, and 533.002581 to | ||
read as follows: | ||
Sec. 533.002571. DELIVERY OF NONEMERGENCY TRANSPORTATION | ||
SERVICES TO CERTAIN MEDICAID RECIPIENTS THROUGH MEDICAID MANAGED | ||
CARE ORGANIZATION. (a) In this section: | ||
(1) "Nonemergency transportation service" has the | ||
meaning assigned by Section 531.02414. | ||
(2) "Nonmedical transportation service" and | ||
"transportation network company" have the meanings assigned by | ||
Section 533.00258. | ||
(b) The commission shall require each Medicaid managed care | ||
organization to arrange and provide nonemergency transportation | ||
services to a recipient enrolled in a managed care plan offered by | ||
the organization using the most cost-effective and cost-efficient | ||
method of delivery, including by delivering nonmedical | ||
transportation services through a transportation network company | ||
or other transportation vendor as provided by Section 533.002581, | ||
if available and medically appropriate. The commission shall | ||
supervise the provision of the services. | ||
(c) Subject to Subsection (d), the executive commissioner | ||
shall adopt rules as necessary to ensure the safe and efficient | ||
provision of nonemergency transportation services by a Medicaid | ||
managed care organization under this section. | ||
(d) A Medicaid managed care organization may subcontract | ||
with a transportation network company to provide nonemergency | ||
transportation services under this section. A rule or other | ||
requirement adopted by the executive commissioner under Subsection | ||
(c) or Section 531.02414 does not apply to the subcontracted | ||
transportation network company or a motor vehicle operator who is | ||
part of the company's network. The commission or the Medicaid | ||
managed care organization may not require a motor vehicle operator | ||
who is part of the subcontracted transportation network company's | ||
network to enroll as a Medicaid provider to provide services under | ||
this section. | ||
(e) The commission or a Medicaid managed care organization | ||
that subcontracts with a transportation network company under | ||
Subsection (d) may require the transportation network company or a | ||
motor vehicle operator who provides services under this section to | ||
be periodically screened against the list of excluded individuals | ||
and entities maintained by the Office of Inspector General of the | ||
United States Department of Health and Human Services. | ||
(f) Notwithstanding any other law, a motor vehicle operator | ||
who is part of the network of a transportation network company that | ||
subcontracts with a Medicaid managed care organization under | ||
Subsection (d) and who satisfies the driver requirements in Section | ||
2402.107, Occupations Code, is qualified to provide services under | ||
this section. The commission and the Medicaid managed care | ||
organization may not impose any additional requirements on a motor | ||
vehicle operator who satisfies the driver requirements in Section | ||
2402.107, Occupations Code, to provide services under this section. | ||
(g) For purposes of this section and notwithstanding | ||
Section 2402.111(a)(2)(A), Occupations Code, a motor vehicle | ||
operator who provides services under this section may use a | ||
wheelchair-accessible vehicle equipped with a lift or ramp that is | ||
capable of transporting passengers using a fixed-frame wheelchair | ||
in the cabin of the vehicle if the vehicle otherwise meets the | ||
requirements of Section 2402.111, Occupations Code. | ||
(h) The commission may temporarily waive the applicability | ||
of Subsection (b) to a Medicaid managed care organization as | ||
necessary based on the results of a review conducted under Section | ||
533.007 and until enrollment of recipients in a managed care plan | ||
offered by the organization is permitted under that section. | ||
(i) The commission shall extend a contract for the provision | ||
of nonemergency transportation services under Section 533.00257 or | ||
other law as necessary until the requirements of this section are | ||
implemented with respect to each Medicaid managed care | ||
organization. This subsection expires September 1, 2023. | ||
Sec. 533.00258. NONMEDICAL TRANSPORTATION SERVICES UNDER | ||
MEDICAID MANAGED CARE PROGRAM. (a) In this section: | ||
(1) "Nonmedical transportation service" means: | ||
(A) curb-to-curb transportation to or from a | ||
medically necessary, nonemergency covered health care service in a | ||
standard passenger vehicle that is scheduled not more than 48 hours | ||
before the transportation occurs, that is provided to a recipient | ||
enrolled in a managed care plan offered by a Medicaid managed care | ||
organization, and that the organization determines meets the level | ||
of care that is medically appropriate for the recipient, including | ||
transportation related to: | ||
(i) discharge of a recipient from a health | ||
care facility; | ||
(ii) receipt of urgent care; and | ||
(iii) obtaining pharmacy services and | ||
prescription drugs; and | ||
(B) any other transportation to or from a | ||
medically necessary, nonemergency covered health care service the | ||
commission considers appropriate to be provided by a transportation | ||
vendor, as determined by commission rule or policy. | ||
(2) "Transportation network company" has the meaning | ||
assigned by Section 2402.001, Occupations Code. | ||
(3) "Transportation vendor" means an entity, | ||
including a transportation network company, that contracts with a | ||
Medicaid managed care organization to provide nonmedical | ||
transportation services. | ||
(b) The executive commissioner shall adopt rules regarding | ||
the manner in which nonmedical transportation services may be | ||
arranged and provided. | ||
(c) The rules must require a Medicaid managed care | ||
organization to create a process to: | ||
(1) verify that a passenger is eligible to receive | ||
nonmedical transportation services; | ||
(2) ensure that nonmedical transportation services | ||
are provided only to and from covered health care services in areas | ||
in which a transportation network company operates; and | ||
(3) ensure the timely delivery of nonmedical | ||
transportation services to a recipient, including by setting | ||
reasonable service response goals. | ||
(d) Before September 1, 2020, and subject to Section | ||
533.002581(h), a rule adopted in accordance with Subsection (c)(3) | ||
may not impose a penalty on a Medicaid managed care organization | ||
that contracts with a transportation vendor under this section if | ||
the vendor is unable to provide nonmedical transportation services | ||
to a recipient after the Medicaid managed care organization has | ||
made a specific request for those services. | ||
(e) The rules must require a transportation vendor to, | ||
before permitting a motor vehicle operator to provide nonmedical | ||
transportation services: | ||
(1) confirm that the operator: | ||
(A) is at least 18 years of age; | ||
(B) maintains a valid driver's license issued by | ||
this state, another state, or the District of Columbia; and | ||
(C) possesses proof of registration and | ||
automobile financial responsibility for each motor vehicle to be | ||
used to provide nonmedical transportation services; | ||
(2) conduct, or cause to be conducted, a local, state, | ||
and national criminal background check for the operator that | ||
includes the use of: | ||
(A) a commercial multistate and | ||
multijurisdiction criminal records locator or other similar | ||
commercial nationwide database; and | ||
(B) the national sex offender public website | ||
maintained by the United States Department of Justice or a | ||
successor agency; | ||
(3) confirm that any vehicle to be used to provide | ||
nonmedical transportation services: | ||
(A) meets the applicable requirements of Chapter | ||
548, Transportation Code; and | ||
(B) except as provided by Subsection (j), has at | ||
least four doors; and | ||
(4) obtain and review the operator's driving record. | ||
(f) The rules may not permit a motor vehicle operator to | ||
provide nonmedical transportation services if the operator: | ||
(1) has been convicted in the three-year period | ||
preceding the issue date of the driving record obtained under | ||
Subsection (e)(4) of: | ||
(A) more than three offenses classified by the | ||
Department of Public Safety as moving violations; or | ||
(B) one or more of the following offenses: | ||
(i) fleeing or attempting to elude a police | ||
officer under Section 545.421, Transportation Code; | ||
(ii) reckless driving under Section | ||
545.401, Transportation Code; | ||
(iii) driving without a valid driver's | ||
license under Section 521.025, Transportation Code; or | ||
(iv) driving with an invalid driver's | ||
license under Section 521.457, Transportation Code; | ||
(2) has been convicted in the preceding seven-year | ||
period of any of the following: | ||
(A) driving while intoxicated under Section | ||
49.04 or 49.045, Penal Code; | ||
(B) use of a motor vehicle to commit a felony; | ||
(C) a felony crime involving property damage; | ||
(D) fraud; | ||
(E) theft; | ||
(F) an act of violence; or | ||
(G) an act of terrorism; or | ||
(3) is found to be registered in the national sex | ||
offender public website maintained by the United States Department | ||
of Justice or a successor agency. | ||
(g) The commission may not require: | ||
(1) a motor vehicle operator to enroll as a Medicaid | ||
provider to provide nonmedical transportation services; or | ||
(2) a Medicaid managed care organization to credential | ||
a motor vehicle operator to provide nonmedical transportation | ||
services. | ||
(h) The commission or a Medicaid managed care organization | ||
that contracts with a transportation vendor may require the | ||
transportation vendor or a motor vehicle operator who provides | ||
services under this section to be periodically screened against the | ||
list of excluded individuals and entities maintained by the Office | ||
of Inspector General of the United States Department of Health and | ||
Human Services. | ||
(i) Notwithstanding any other law, a motor vehicle operator | ||
who is part of a transportation network company's network and who | ||
satisfies the driver requirements in Section 2402.107, Occupations | ||
Code, is qualified to provide nonmedical transportation services. | ||
The commission and a Medicaid managed care organization may not | ||
impose any additional requirements on a motor vehicle operator who | ||
satisfies the driver requirements in Section 2402.107, Occupations | ||
Code, to provide nonmedical transportation services. | ||
(j) For purposes of this section and notwithstanding | ||
Section 2402.111(a)(2)(A), Occupations Code, a motor vehicle | ||
operator who provides services under this section may use a | ||
wheelchair-accessible vehicle equipped with a lift or ramp that is | ||
capable of transporting passengers using a fixed-frame wheelchair | ||
in the cabin of the vehicle if the vehicle otherwise meets the | ||
requirements of Section 2402.111, Occupations Code. | ||
Sec. 533.002581. DELIVERY OF NONMEDICAL TRANSPORTATION | ||
SERVICES UNDER MEDICAID MANAGED CARE PROGRAM. (a) In this section, | ||
"nonmedical transportation service" and "transportation vendor" | ||
have the meanings assigned by Section 533.00258. | ||
(b) The commission shall designate managed care service | ||
areas in which to require, beginning not later than January 1, 2020, | ||
each Medicaid managed care organization with which the commission | ||
has a contract that is anticipated to be in effect on September 1, | ||
2020, and that operates in a designated service area to arrange for | ||
the provision of nonmedical transportation services to recipients | ||
enrolled in a managed care plan offered by the organization. The | ||
commission shall designate at least three, but not more than four, | ||
managed care service areas for purposes of this subsection. At | ||
least one of the designated service areas must be located in an | ||
urban service area, and at least one must be located in a rural | ||
service area. This subsection expires September 1, 2021. | ||
(c) Beginning not later than September 1, 2020, the | ||
commission shall require each Medicaid managed care organization to | ||
arrange for the provision of nonmedical transportation services to | ||
recipients enrolled in a managed care plan offered by the | ||
organization. | ||
(d) A Medicaid managed care organization may contract with a | ||
transportation vendor or other third party to arrange for the | ||
provision of nonmedical transportation services. If a Medicaid | ||
managed care organization contracts with a third party that is not a | ||
transportation vendor to arrange for the provision of nonmedical | ||
transportation services, the third party shall contract with a | ||
transportation vendor to deliver the nonmedical transportation | ||
services. | ||
(e) A Medicaid managed care organization that contracts | ||
with a transportation vendor or other third party to arrange for the | ||
provision of nonmedical transportation services shall ensure the | ||
effective sharing and integration of service coordination, service | ||
authorization, and utilization management data between the managed | ||
care organization and the transportation vendor or third party. | ||
(f) A Medicaid managed care organization may not require: | ||
(1) a motor vehicle operator to enroll as a Medicaid | ||
provider to provide nonmedical transportation services; or | ||
(2) the credentialing of a motor vehicle operator to | ||
provide nonmedical transportation services. | ||
(g) For purposes of this section and notwithstanding | ||
Section 2402.111(a)(2)(A), Occupations Code, a motor vehicle | ||
operator who provides services under this section may use a | ||
wheelchair-accessible vehicle equipped with a lift or ramp that is | ||
capable of transporting passengers using a fixed-frame wheelchair | ||
in the cabin of the vehicle if the vehicle otherwise meets the | ||
requirements of Section 2402.111, Occupations Code. | ||
(h) The commission may waive the applicability of | ||
Subsection (c) to a Medicaid managed care organization for not more | ||
than three months as necessary based on the results of a review | ||
conducted under Section 533.007 and until enrollment of recipients | ||
in a managed care plan offered by the organization is permitted | ||
under that section. | ||
SECTION 9. Section 533.00257(i), Government Code, is | ||
repealed. | ||
SECTION 10. Notwithstanding Sections 533.002571(b) and | ||
533.002581(c), Government Code, as added by this Act, the Health | ||
and Human Services Commission is not required to implement those | ||
subsections until September 1, 2020. | ||
SECTION 11. 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 12. As soon as practicable after the effective date | ||
of this Act, the executive commissioner of the Health and Human | ||
Services Commission shall adopt rules as necessary to implement the | ||
changes in law made by this Act. | ||
SECTION 13. This Act takes effect immediately if it | ||
receives a vote of two-thirds of all the members elected to each | ||
house, as provided by Section 39, Article III, Texas Constitution. | ||
If this Act does not receive the vote necessary for immediate | ||
effect, this Act takes effect September 1, 2019. | ||
______________________________ | ______________________________ | |
President of the Senate | Speaker of the House | |
I certify that H.B. No. 1576 was passed by the House on April | ||
25, 2019, by the following vote: Yeas 133, Nays 2, 1 present, not | ||
voting; and that the House concurred in Senate amendments to H.B. | ||
No. 1576 on May 24, 2019, by the following vote: Yeas 141, Nays 0, | ||
2 present, not voting. | ||
______________________________ | ||
Chief Clerk of the House | ||
I certify that H.B. No. 1576 was passed by the Senate, with | ||
amendments, on May 22, 2019, by the following vote: Yeas 31, Nays | ||
0. | ||
______________________________ | ||
Secretary of the Senate | ||
APPROVED: __________________ | ||
Date | ||
__________________ | ||
Governor |