| 1 | 1 | | 81R1467 KLA-D |
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| 2 | 2 | | By: Anchia, Naishtat, Gonzales H.B. No. 279 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to reimbursement for medical assistance provided by a |
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| 8 | 8 | | school-based health center to certain recipients. |
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| 9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 10 | 10 | | SECTION 1. Section 32.028, Human Resources Code, is amended |
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| 11 | 11 | | by adding Subsections (o) and (p) to read as follows: |
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| 12 | 12 | | (o) Notwithstanding any other law, the executive |
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| 13 | 13 | | commissioner of the Health and Human Services Commission by rule |
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| 14 | 14 | | shall ensure that a school-based health center established under |
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| 15 | 15 | | Subchapter B, Chapter 38, Education Code, is reimbursed under the |
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| 16 | 16 | | medical assistance program for the provision to a recipient of |
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| 17 | 17 | | medical assistance of a medical assistance service or procedure, |
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| 18 | 18 | | regardless of whether the recipient: |
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| 19 | 19 | | (1) is required to have a primary care physician or |
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| 20 | 20 | | other gatekeeper or health care coordinator; or |
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| 21 | 21 | | (2) has obtained a referral for the service or |
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| 22 | 22 | | procedure from that physician, gatekeeper, or coordinator that is |
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| 23 | 23 | | otherwise required. |
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| 24 | 24 | | (p) Subsection (o) may not be construed to expand the scope |
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| 25 | 25 | | of services and procedures provided under the medical assistance |
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| 26 | 26 | | program. |
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| 27 | 27 | | SECTION 2. Except as provided by Section 3(b) of this Act, |
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| 28 | 28 | | Section 32.028(o), Human Resources Code, as added by this Act, |
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| 29 | 29 | | applies to a reimbursement for a medical assistance health care |
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| 30 | 30 | | service or procedure that is provided on or after the effective date |
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| 31 | 31 | | of this Act by a school-based health center. |
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| 32 | 32 | | SECTION 3. (a) The Health and Human Services Commission |
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| 33 | 33 | | shall, in a contract between the commission and a managed care |
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| 34 | 34 | | organization under Chapter 533, Government Code, that is entered |
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| 35 | 35 | | into or renewed on or after the effective date of this Act, require |
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| 36 | 36 | | that the managed care organization comply with rules adopted in |
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| 37 | 37 | | accordance with Section 32.028(o), Human Resources Code, as added |
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| 38 | 38 | | by this Act. |
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| 39 | 39 | | (b) The Health and Human Services Commission shall seek to |
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| 40 | 40 | | amend contracts entered into with managed care organizations under |
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| 41 | 41 | | Chapter 533, Government Code, before the effective date of this Act |
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| 42 | 42 | | to require those managed care organizations to comply with rules |
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| 43 | 43 | | adopted in accordance with Section 32.028(o), Human Resources Code, |
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| 44 | 44 | | as added by this Act. To the extent of a conflict between that |
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| 45 | 45 | | section and a provision of a contract with a managed care |
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| 46 | 46 | | organization entered into before the effective date of this Act, |
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| 47 | 47 | | the contract provision prevails. |
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| 48 | 48 | | SECTION 4. If before implementing any provision of this Act |
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| 49 | 49 | | a state agency determines that a waiver or authorization from a |
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| 50 | 50 | | federal agency is necessary for implementation of that provision, |
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| 51 | 51 | | the agency affected by the provision shall request the waiver or |
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| 52 | 52 | | authorization and may delay implementing that provision until the |
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| 53 | 53 | | waiver or authorization is granted. |
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| 54 | 54 | | SECTION 5. This Act takes effect September 1, 2009. |
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