Texas 2011 - 82nd Regular

Texas House Bill HB3191 Compare Versions

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1	1	82R13806 EES-F
2	2	By: Alonzo H.B. No. 3191
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the inclusion of optometrists, therapeutic
8	8	optometrists, and ophthalmologists in Medicaid managed care
9	9	provider networks providing services in the Texas-Mexico border
10	10	region and other regions of the state.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. EXPANSION OF PROVIDER NETWORKS OF MANAGED CARE
13	13	ORGANIZATIONS IN TEXAS-MEXICO BORDER REGION AND OTHER AREAS OF
14	14	STATE. Subchapter A, Chapter 533, Government Code, is amended by
15	15	adding Section 533.0065 to read as follows:
16	16	Sec. 533.0065. EYE HEALTH CARE SERVICE PROVIDERS. (a) In
17	17	this section, "Texas-Mexico border region" has the meaning assigned
18	18	by Section 2056.002.
19	19	(b) Subject to Section 32.047, Human Resources Code, but
20	20	notwithstanding any other law, the commission shall require that
21	21	each managed care organization that contracts with the commission
22	22	under any Medicaid managed care model or arrangement to provide
23	23	health care services to recipients in a region, including a region
24	24	consisting of all or part of the Texas-Mexico border region,
25	25	include in the organization's provider network each optometrist,
26	26	therapeutic optometrist, and ophthalmologist who:
27	27	(1) agrees to comply with the terms and conditions of
28	28	the organization;
29	29	(2) agrees to accept the prevailing provider contract
30	30	rate of the organization;
31	31	(3) agrees to abide by the standards of care required
32	32	by the organization; and
33	33	(4) has the credentials required by the organization.
34	34	SECTION 2. STUDY IN TEXAS-MEXICO BORDER REGION. (a) The
35	35	Health and Human Services Commission shall conduct a study of the
36	36	fiscal impact on this state of requiring each Medicaid managed care
37	37	organization that contracts with the commission under any Medicaid
38	38	managed care model or arrangement implemented under Chapter 533,
39	39	Government Code, to include in the organization's health care
40	40	provider network providing services in all or part of the
41	41	Texas-Mexico border region, as defined by Section 2056.002,
42	42	Government Code, each optometrist, therapeutic optometrist, and
43	43	ophthalmologist who meets the requirements under Section 533.0065,
44	44	Government Code, as added by this Act.
45	45	(b) Not later than September 1, 2016, the Health and Human
46	46	Services Commission shall submit to the legislature a written
47	47	report containing the findings of the study conducted under
48	48	Subsection (a) of this section and the commission's recommendations
49	49	regarding the requirement addressed in the study.
50	50	SECTION 3. CONTRACTS. (a) The Health and Human Services
51	51	Commission shall, in a contract between the commission and a
52	52	Medicaid managed care organization under Chapter 533, Government
53	53	Code, that is entered into or renewed on or after the effective date
54	54	of this Act, require that the managed care organization comply with
55	55	Section 533.0065, Government Code, as added by this Act.
56	56	(b) The Health and Human Services Commission shall seek to
57	57	amend each contract entered into with a Medicaid managed care
58	58	organization under Chapter 533, Government Code, before the
59	59	effective date of this Act to require those managed care
60	60	organizations to comply with Section 533.0065, Government Code, as
61	61	added by this Act. To the extent of a conflict between Section
62	62	533.0065, Government Code, as added by this Act, and a provision of
63	63	a contract with a managed care organization entered into before the
64	64	effective date of this Act, the contract provision prevails.
65	65	SECTION 4. WAIVER. If before implementing any provision of
66	66	this Act a state agency determines that a waiver or authorization
67	67	from a federal agency is necessary for implementation of that
68	68	provision, the agency affected by the provision shall request the
69	69	waiver or authorization and may delay implementing that provision
70	70	until the waiver or authorization is granted.
71	71	SECTION 5. EFFECTIVE DATE. This Act takes effect September
72	72	1, 2011.