TX
Texas House Bill HB2933

Texas 2019 - 86th Regular

Texas House Bill HB2933

Caption

Relating to timely claims payments in the Medicaid managed care program.

Impact

The implications of HB 2933 are significant as it seeks to strengthen the financial accountability of MCOs to healthcare providers within Texas's Medicaid program. By stipulating specific payment timelines and performance standards, it aims to mitigate delays in reimbursements which have historically posed challenges for providers, particularly in underserved areas. The bill reflects a broader effort to maintain quality care for recipients by ensuring that providers are not financially hindered by slow claims processes.

Summary

House Bill 2933 focuses on amending the procedures and requirements for claims payments in the Medicaid managed care program in Texas. It aims to ensure that managed care organizations (MCOs) adhere to strict timelines for processing claims submitted by healthcare providers. Among the highlighted provisions are requirements that MCOs must make payments for certain claims within designated timeframes, such as 10 days for nursing facilities, and establish guidelines for managing claims with missing documentation. This bill seeks to improve the efficiency of the claims process and enhance accountability for timely payments to providers.

Contention

While the bill has garnered support for its focus on timely claims payments, opposition may arise surrounding the potential burden it places on MCOs to comply with the new metrics and timelines. Stakeholders may express concerns over possible administrative challenges and the impact of these changes on the operational flexibility of MCOs. Critics could argue that overly stringent requirements might lead to increased operational costs that could be passed on to consumers or result in stricter limitations on provider networks.

Companion Bills

No companion bills found.

Previously Filed As

TX HB1283

Relating to prescription drug formularies applicable to the Medicaid managed care program.

TX SB1113

Relating to prescription drug formularies applicable to the Medicaid managed care program.

TX HB1293

Relating to the reimbursement of prescription drugs under Medicaid and the child health plan program.

TX HB4611

Relating to the nonsubstantive revision of the health and human services laws governing the Health and Human Services Commission, Medicaid, and other social services.

TX HB4111

Relating to access to and the provision of behavioral and mental health care services and trauma-informed care in the Medicaid managed care program.

TX SB2201

Relating to certain prescription drug benefits under the Medicaid managed care program.

TX SB745

Relating to fraud prevention under certain health care programs.

TX HB5018

Relating to certain payment recovery efforts by managed care organizations under Medicaid or the child health plan program.

TX HB3779

Relating to fraud prevention under certain health care programs.

TX HB3286

Relating to prescription drug benefits under Medicaid and the child health plan program.

Similar Bills

TX HB3366

Relating to the reimbursement of prescription drugs under Medicaid and the child health plan program.

TX SB1612

Relating to the reimbursement of prescription drugs under the Medicaid managed care and child health plan programs.

TX HB939

Relating to required access to care and provider network provisions in a contract between the Health and Human Services Commission and a Medicaid managed care organization.

TX HB4315

Relating to required access to care and provider network provisions in a contract between the Health and Human Services Commission and a Medicaid managed care organization.

TX SB1096

Relating to the Medicaid managed care program, including the provision of pharmacy benefits.

TX HB3685

Relating to pharmacy benefits provided through the Medicaid managed care program.

TX SB1567

Relating to the reimbursement of prescription drugs under Medicaid and the child health plan program.

TX HB1293

Relating to the reimbursement of prescription drugs under Medicaid and the child health plan program.