85R26978 EES-F
By: Price H.B. No. 3541
Substitute the following for H.B. No. 3541:
By: Price C.S.H.B. No. 3541
A BILL TO BE ENTITLED
AN ACT
relating to requirements for Medicaid managed care organizations
that provide behavioral health services through a third party or
subsidiary.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter A, Chapter 533, Government Code, is
amended by adding Section 533.002553 to read as follows:
Sec. 533.002553. BEHAVIORAL HEALTH SERVICES PROVIDED
THROUGH THIRD PARTY OR SUBSIDIARY. (a) In this section,
"behavioral health services" has the meaning assigned by Section
533.00255.
(b) For a managed care organization that contracts with the
commission under this chapter and that provides behavioral health
services through a contract with a third party or an arrangement
with a subsidiary of the managed care organization, the commission
shall:
(1) require the effective sharing and integration of
care coordination, service authorization, and utilization
management data between the managed care organization and the third
party or subsidiary;
(2) encourage, to the extent feasible, the colocation
of physical health and behavioral health care coordination staff;
(3) require warm call transfers between physical
health and behavioral health care coordination staff;
(4) require the managed care organization and the
third party or subsidiary to implement joint rounds for physical
health and behavioral health services network providers or some
other effective means for sharing clinical information; and
(5) ensure that the managed care organization makes
available a seamless provider portal for both physical health and
behavioral health services network providers, to the extent allowed
by federal law.
SECTION 2. 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 3. This Act takes effect September 1, 2017.