| 1 | 1 | | 84R7917 LED-F |
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| 2 | 2 | | By: Hinojosa S.B. No. 702 |
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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 ambulance services provided to |
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| 8 | 8 | | persons enrolled in the Medicaid managed care program. |
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| 9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 10 | 10 | | SECTION 1. Subchapter A, Chapter 533, Government Code, is |
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| 11 | 11 | | amended by adding Section 533.01316 to read as follows: |
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| 12 | 12 | | Sec. 533.01316. REIMBURSEMENT FOR AMBULANCE SERVICES. (a) |
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| 13 | 13 | | This section applies with respect to a recipient of medical |
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| 14 | 14 | | assistance who is an enrollee in a managed care plan under any |
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| 15 | 15 | | Medicaid managed care model or arrangement. |
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| 16 | 16 | | (b) The commission shall ensure that a person providing |
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| 17 | 17 | | ambulance services to a Medicaid managed care enrollee is |
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| 18 | 18 | | reimbursed for emergency and nonemergency services provided to the |
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| 19 | 19 | | enrollee at a rate that is equal to 100 percent of the allowable |
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| 20 | 20 | | rate for those services as determined under Section 32.028, Human |
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| 21 | 21 | | Resources Code, regardless of whether the services are provided by |
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| 22 | 22 | | a provider in the applicable Medicaid managed care plan's network |
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| 23 | 23 | | of providers. |
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| 24 | 24 | | SECTION 2. If before implementing any provision of this Act |
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| 25 | 25 | | a state agency determines that a waiver or authorization from a |
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| 26 | 26 | | federal agency is necessary for implementation of that provision, |
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| 27 | 27 | | the agency affected by the provision shall request the waiver or |
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| 28 | 28 | | authorization and may delay implementing that provision until the |
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| 29 | 29 | | waiver or authorization is granted. |
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| 30 | 30 | | SECTION 3. This Act takes effect September 1, 2015. |
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