81R1467 KLA-D
By: Anchia, Naishtat, Gonzales H.B. No. 279
A BILL TO BE ENTITLED
AN ACT
relating to reimbursement for medical assistance provided by a
school-based health center to certain recipients.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 32.028, Human Resources Code, is amended
by adding Subsections (o) and (p) to read as follows:
(o) Notwithstanding any other law, the executive
commissioner of the Health and Human Services Commission by rule
shall ensure that a school-based health center established under
Subchapter B, Chapter 38, Education Code, is reimbursed under the
medical assistance program for the provision to a recipient of
medical assistance of a medical assistance service or procedure,
regardless of whether the recipient:
(1) is required to have a primary care physician or
other gatekeeper or health care coordinator; or
(2) has obtained a referral for the service or
procedure from that physician, gatekeeper, or coordinator that is
otherwise required.
(p) Subsection (o) may not be construed to expand the scope
of services and procedures provided under the medical assistance
program.
SECTION 2. Except as provided by Section 3(b) of this Act,
Section 32.028(o), Human Resources Code, as added by this Act,
applies to a reimbursement for a medical assistance health care
service or procedure that is provided on or after the effective date
of this Act by a school-based health center.
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 rules adopted in
accordance with Section 32.028(o), Human Resources 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 rules
adopted in accordance with Section 32.028(o), Human Resources Code,
as added by this Act. To the extent of a conflict between that
section 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, 2009.