85R14946 JG-D
By: Muñoz, Jr. H.B. No. 3884
A BILL TO BE ENTITLED
AN ACT
relating to the establishment of a schedule for the payment of
reimbursable claims under the Medicaid managed care program.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter A, Chapter 533, Government Code, is
amended by adding Section 533.0067 to read as follows:
Sec. 533.0067. REQUIRED CONTRACT PROVISIONS; SCHEDULE FOR
PAYMENT OF REIMBURSABLE CLAIMS. (a) A managed care organization
that contracts with the commission to provide health care services
to recipients shall establish a schedule for the payment of
reimbursable claims that complies with Sections 533.005(a)(7) and
(7-a) and include the schedule in a contract between the managed
care organization and a health care provider in the managed care
organization's provider network.
(b) If a managed care organization to which this section
applies delegates the payment of reimbursable claims to a third
party through a subcontract or otherwise, the third party shall
also pay those claims according to the schedule described by
Subsection (a).
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. The change in law made by this Act applies only
to a contract between a managed care organization and a health care
provider entered into or renewed on or after the effective date of
this Act. A contract between a managed care organization and a
health care provider entered into or renewed before the effective
date of this Act is governed by the law applicable to the contract
immediately before the effective date of this Act, and that law is
continued in effect for that purpose.
SECTION 4. This Act takes effect September 1, 2017.