| 1 | 1 | | 84R13639 LED-F |
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| 2 | 2 | | By: Klick H.B. No. 3921 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to reimbursement for certain emergency eye health care |
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| 8 | 8 | | services provided to persons enrolled in the Medicaid managed care |
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| 9 | 9 | | program. |
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| 10 | 10 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 11 | 11 | | SECTION 1. Subchapter A, Chapter 533, Government Code, is |
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| 12 | 12 | | amended by adding Section 533.00265 to read as follows: |
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| 13 | 13 | | Sec. 533.00265. EMERGENCY EYE HEALTH CARE SERVICES. A |
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| 14 | 14 | | managed care organization that contracts with the commission under |
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| 15 | 15 | | this chapter shall reimburse an out-of-network eye care specialist |
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| 16 | 16 | | who is an enrolled Medicaid provider for providing to a recipient |
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| 17 | 17 | | enrolled in the organization's managed care plan emergency eye |
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| 18 | 18 | | health care services, including services to treat an emergency |
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| 19 | 19 | | medical condition affecting the visual system, eye, or adnexa, as |
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| 20 | 20 | | determined by executive commissioner rule, at a rate equal to the |
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| 21 | 21 | | rate at which the managed care organization would reimburse an eye |
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| 22 | 22 | | care specialist in the organization's provider network for the same |
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| 23 | 23 | | services. |
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| 24 | 24 | | SECTION 2. As soon as practicable after the effective date |
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| 25 | 25 | | of this Act, the executive commissioner of the Health and Human |
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| 26 | 26 | | Services Commission shall adopt the rules required by Section |
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| 27 | 27 | | 533.00265, Government Code, as added by this Act. |
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| 28 | 28 | | SECTION 3. If before implementing any provision of this Act |
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| 29 | 29 | | a state agency determines that a waiver or authorization from a |
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| 30 | 30 | | federal agency is necessary for implementation of that provision, |
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| 31 | 31 | | the agency affected by the provision shall request the waiver or |
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| 32 | 32 | | authorization and may delay implementing that provision until the |
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| 33 | 33 | | waiver or authorization is granted. |
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| 34 | 34 | | SECTION 4. This Act takes effect immediately if it receives |
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| 35 | 35 | | a vote of two-thirds of all the members elected to each house, as |
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| 36 | 36 | | provided by Section 39, Article III, Texas Constitution. If this |
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| 37 | 37 | | Act does not receive the vote necessary for immediate effect, this |
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| 38 | 38 | | Act takes effect September 1, 2015. |
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