| 1 | 1 | | 85R5900 KFF-D |
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| 2 | 2 | | By: Martinez H.B. No. 1420 |
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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 the imposition of a late payment penalty against |
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| 8 | 8 | | Medicaid managed care organizations that fail to timely pay certain |
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| 9 | 9 | | physician and provider claims. |
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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 533.00551 to read as follows: |
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| 13 | 13 | | Sec. 533.00551. LATE PAYMENT PENALTY FOR CERTAIN CLAIMS. A |
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| 14 | 14 | | managed care organization that fails to pay a claim on or before the |
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| 15 | 15 | | 15th day after the date the time limit for payment of the claim |
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| 16 | 16 | | prescribed by Section 533.005(a)(7) expires is liable to the |
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| 17 | 17 | | physician or provider who submitted the claim for a late payment |
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| 18 | 18 | | penalty. A late payment penalty under this section: |
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| 19 | 19 | | (1) is equal to 20 percent of the outstanding claim |
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| 20 | 20 | | amount; |
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| 21 | 21 | | (2) must be paid not later than the seventh day after |
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| 22 | 22 | | the date the liability for the penalty accrues under this section; |
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| 23 | 23 | | and |
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| 24 | 24 | | (3) is in addition to any other penalty or recourse to |
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| 25 | 25 | | which the physician or provider may be entitled under a contract |
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| 26 | 26 | | with the managed care organization. |
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| 27 | 27 | | SECTION 2. To the extent of a conflict between Section |
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| 28 | 28 | | 533.00551, Government Code, as added by this Act, and a provision of |
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| 29 | 29 | | a contract between a managed care organization and a physician or |
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| 30 | 30 | | provider entered into before the implementation date of that |
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| 31 | 31 | | section, the contract provision prevails. |
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| 32 | 32 | | SECTION 3. If before implementing any provision of this Act |
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| 33 | 33 | | a state agency determines that a waiver or authorization from a |
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| 34 | 34 | | federal agency is necessary for implementation of that provision, |
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| 35 | 35 | | the agency affected by the provision shall request the waiver or |
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| 36 | 36 | | authorization and may delay implementing that provision until the |
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| 37 | 37 | | waiver or authorization is granted. |
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| 38 | 38 | | SECTION 4. This Act takes effect September 1, 2017. |
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