Texas 2021 - 87th Regular

Texas House Bill HB3441

Caption

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

Impact

The bill proposes to amend Section 533.005 of the Government Code to require MCOs to demonstrate that they can meet specific claims payment timelines—such as processing certain claims within 10 days for nursing facilities and 30 days for long-term services. Furthermore, by establishing a mandatory payment standard, the bill seeks to enhance the financial stability of healthcare providers. Notably, it envisions a more transparent process by which providers can appeal and resolve payment disputes, further addressing significant concerns within the current payment system.

Summary

House Bill 3441 focuses on improving the timeliness of claims payments in the Medicaid managed care program. It aims to amend existing legislation to set stricter timelines and accountability measures for managed care organizations (MCOs) regarding how quickly they must process and pay claims submitted by healthcare providers. The intent is to ensure that healthcare professionals are paid fairly and promptly for the services they provide to Medicaid recipients, thereby improving the healthcare ecosystem in Texas.

Contention

Debate surrounding HB 3441 may center on the balance between ensuring timely payments to providers and the potential administrative burdens these regulations impose on MCOs. While supporters argue that timely payments will foster a healthier relationship between providers and MCOs and ultimately benefit patients, opponents might argue that the regulatory requirements could lead to increased operational costs for managed care organizations, which could then impact the overall budget of the Medicaid program. There may also be concerns about how these standards could affect newly established MCOs entering the market.

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 HB1696

Relating to the relationship between managed care plans and optometrists and therapeutic optometrists.

TX HB5018

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

TX SB860

Relating to the relationship between managed care plans and optometrists, therapeutic optometrists, and ophthalmologists.

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 HB3685

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

TX SB1096

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

TX SB760

Relating to access and assignment requirements for, support and information regarding, and investigations of certain providers of health care and long-term services.

TX SB1567

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