Texas Senate Bill SB2450

Texas 2025 - 89th Regular

• Filed: 3/13/25

Caption

Relating to the participation and reimbursement of and requirements affecting certain providers, including providers of eye health care and vision care services, under Medicaid.

Impact

One of the key impacts of SB2450 is the mandate for Medicaid managed care organizations to offer reimbursement to eye health care service providers at rates that meet or exceed the established Medicaid fee-for-service rates. This stipulation is significant as it may improve the financial viability of eye care providers and ensure better service delivery to Medicaid recipients. The bill also mandates certain reforms regarding provider disenrollment during the revalidation period, requiring prior notice and allowing providers to rectify any deficiencies, which is aimed at reducing unnecessary disenrollments.

Summary

Senate Bill 2450 pertains to the participation and reimbursement requirements affecting certain providers involved in eye health care and vision care services under Medicaid. The bill aims to streamline the Medicaid provider enrollment process by establishing dedicated support for providers to navigate administrative barriers and ensuring they can effectively participate in the Medicaid system. This includes requiring the Health and Human Services Commission to develop processes to handle complaints and feedback from providers to enhance the enrollment and credentialing experience.

Contention

During discussions, there may be concerns regarding the administrative burden that the implementation of these measures will place on the Health and Human Services Commission as well as on the insurance and managed care entities involved in Medicaid. Critics might argue that while the bill sets positive goals for provider support and service accessibility, it could complicate existing processes if not properly implemented. Furthermore, oversight about the effectiveness of the support team for providers and its timeliness may also be points of tension among stakeholders in the legislative discussions.

Texas Constitutional Statutes Affected

Government Code

• Chapter 532. Medicaid Administration And Operation In General
  • Section: New Section

• Chapter 540. Medicaid Managed Care Program
  • Section: New Section

Insurance Code

• Chapter 1451. Access To Certain Practitioners And Facilities
  • Section: New Section