85R5900 KFF-D
By: Martinez H.B. No. 1420
A BILL TO BE ENTITLED
AN ACT
relating to the imposition of a late payment penalty against
Medicaid managed care organizations that fail to timely pay certain
physician and provider claims.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter A, Chapter 533, Government Code, is
amended by adding Section 533.00551 to read as follows:
Sec. 533.00551. LATE PAYMENT PENALTY FOR CERTAIN CLAIMS. A
managed care organization that fails to pay a claim on or before the
15th day after the date the time limit for payment of the claim
prescribed by Section 533.005(a)(7) expires is liable to the
physician or provider who submitted the claim for a late payment
penalty. A late payment penalty under this section:
(1) is equal to 20 percent of the outstanding claim
amount;
(2) must be paid not later than the seventh day after
the date the liability for the penalty accrues under this section;
and
(3) is in addition to any other penalty or recourse to
which the physician or provider may be entitled under a contract
with the managed care organization.
SECTION 2. To the extent of a conflict between Section
533.00551, Government Code, as added by this Act, and a provision of
a contract between a managed care organization and a physician or
provider entered into before the implementation date of that
section, the contract provision prevails.
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 September 1, 2017.