83R12259 KKR-D
By: Paddie H.B. No. 3473
A BILL TO BE ENTITLED
AN ACT
relating to contracts with managed care organizations under the
Medicaid managed care delivery model.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 533.004(a), Government Code, is amended
to read as follows:
(a) In providing health care services through Medicaid
managed care to recipients in a health care service region, the
commission shall contract with a managed care organization in that
region that is licensed under Chapter 843, Insurance Code, to
provide health care in that region and that is:
(1) wholly owned and operated by a hospital district
in that region;
(2) created or owned by a nonprofit corporation that:
(A) has a contract, agreement, or other
arrangement with:
(i) a hospital district;
(ii) a municipal hospital authority in that
region created under Chapter 262, Health and Safety Code, that is
located in a county with a population of at least 25,000 and not
more than 40,000 that is adjacent to a county with a population of
at least 85,000 and not more than 110,000; or
(iii) [with] a municipality in that region
that owns a hospital licensed under Chapter 241, Health and Safety
Code, and has an obligation to provide health care to indigent
patients; and
(B) under the contract, agreement, or other
arrangement:
(i) [,] assumes the obligation, if
applicable, to provide health care to indigent patients; and
(ii) leases, manages, or operates a hospital
facility owned by the hospital district, hospital authority, or
municipality; or
(3) created by a nonprofit corporation that has a
contract, agreement, or other arrangement with a hospital district
in that region under which the nonprofit corporation acts as an
agent of the district and assumes the district's obligation to
arrange for services under the Medicaid expansion for children as
authorized by Chapter 444, Acts of the 74th Legislature, Regular
Session, 1995.
SECTION 2. The change in law made by this Act applies only
to a contract entered into or renewed on or after the effective date
of this Act. A contract entered into or renewed before the
effective date of this Act is governed by the law in effect
immediately before the effective date of this Act, and that law is
continued in effect for that purpose.
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.