84R13639 LED-F
By: Klick H.B. No. 3921
A BILL TO BE ENTITLED
AN ACT
relating to reimbursement for certain emergency eye health care
services provided to persons enrolled in the Medicaid managed care
program.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter A, Chapter 533, Government Code, is
amended by adding Section 533.00265 to read as follows:
Sec. 533.00265. EMERGENCY EYE HEALTH CARE SERVICES. A
managed care organization that contracts with the commission under
this chapter shall reimburse an out-of-network eye care specialist
who is an enrolled Medicaid provider for providing to a recipient
enrolled in the organization's managed care plan emergency eye
health care services, including services to treat an emergency
medical condition affecting the visual system, eye, or adnexa, as
determined by executive commissioner rule, at a rate equal to the
rate at which the managed care organization would reimburse an eye
care specialist in the organization's provider network for the same
services.
SECTION 2. As soon as practicable after the effective date
of this Act, the executive commissioner of the Health and Human
Services Commission shall adopt the rules required by Section
533.00265, Government Code, as added 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, 2015.