83R12986 JSL-F
By: Raymond H.B. No. 3398
A BILL TO BE ENTITLED
AN ACT
relating to the inclusion of enteral nutrition therapy providers in
Medicaid managed care organizations' provider networks.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 533.006, Government Code, is amended by
adding Subsection (c) to read as follows:
(c) The commission shall require that each managed care
organization that contracts with the commission to provide health
care services to recipients in a region allow a supplier of durable
medical equipment and other supplies used specifically for enteral
nutrition therapy to participate as a provider in the managed care
organization's provider network if the supplier:
(1) agrees to comply with the financial terms and
conditions of the managed care organization's provider contract as
well as other reasonable administrative and professional terms of
that contract; and
(2) is not prohibited from participating as a Medicaid
provider by Section 32.047, Human Resources Code, or any other
provision excluding the provider based on conduct that constitutes
fraud, waste, or abuse.
SECTION 2. 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 533.006(c),
Government Code, as amended by this Act.
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 immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2013.