Bill Text: TX HB4035 | 2021-2022 | 87th Legislature | Introduced
Bill Title: Relating to Medicaid reimbursement rates.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2021-03-29 - Referred to Human Services [HB4035 Detail]
Download: Texas-2021-HB4035-Introduced.html
| 87R8329 MM-F | ||
| By: Walle | H.B. No. 4035 | |
|
|
||
|
|
||
| relating to Medicaid reimbursement rates. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Section 32.028, Human Resources Code, is amended | ||
| by adding Subsection (o) to read as follows: | ||
| (o) Notwithstanding any other provision of this section or | ||
| other law, the executive commissioner shall ensure that the rules | ||
| governing the determination of rates paid to a medical assistance | ||
| provider are at least equal to the rates paid under Medicare for the | ||
| provision of the same or substantially similar services. | ||
| SECTION 2. Section 533.005, Government Code, is amended by | ||
| adding Subsection (f) to read as follows: | ||
| (f) 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 provider who is in the organization's provider network and who | ||
| provides health care services to a recipient at a rate that is at | ||
| least equal to the rate paid under Medicare for the provision of the | ||
| same or substantially similar service. | ||
| SECTION 3. (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(f), | ||
| 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(f), Government Code, as added by this Act. To the extent of | ||
| a conflict between Section 533.005(f), 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 4. 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 5. This Act takes effect September 1, 2021. | ||
