83R6472 KKR-D
By: Kolkhorst H.B. No. 2919
A BILL TO BE ENTITLED
AN ACT
relating to the provision of orthodontic services under the
Medicaid program.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter B, Chapter 32, Human Resources Code,
is amended by adding Section 32.0271 to read as follows:
Sec. 32.0271. PROVIDERS OF ORTHODONTIC SERVICES. (a)
Orthodontic services designated as Level I or Level II by the
department under the medical assistance program, regardless of
whether under a fee-for-service or managed care model, must be
provided by a dentist licensed in this state who:
(1) has completed a residency in pediatric dentistry;
(2) has completed at least 200 hours of clinical
continuing dental education in orthodontics; or
(3) is board certified or eligible to become board
certified by a specialty orthodontic board recognized by the
American Dental Association.
(b) Orthodontic services designated as Level III or Level IV
by the department under the medical assistance program, regardless
of whether under a fee-for-service or managed care model, must be
provided by a dentist licensed in this state who is board certified
or eligible to become board certified by a specialty orthodontic
board recognized by the American Dental Association.
(c) The department may waive a requirement under this
section in rural areas with limited access to orthodontic care.
SECTION 2. (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 Section 32.0271,
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 Section
32.0271, 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 3. 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 4. This Act takes effect September 1, 2013.