Texas 2019 - 86th Regular

Texas House Bill HB1576 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	H.B. No. 1576
	1	+	By: Phelan, et al. H.B. No. 1576
	2	+	(Senate Sponsor - Buckingham, et al.)
	3	+	(In the Senate - Received from the House April 26, 2019;
	4	+	April 29, 2019, read first time and referred to Committee on Health &
	5	+	Human Services; May 19, 2019, reported adversely, with favorable
	6	+	Committee Substitute by the following vote: Yeas 9, Nays 0;
	7	+	May 19, 2019, sent to printer.)
	8	+	Click here to see the committee vote
	9	+	COMMITTEE SUBSTITUTE FOR H.B. No. 1576 By: Buckingham
2	10
3	11
	12	+	A BILL TO BE ENTITLED
4	13		AN ACT
5	14		relating to the delivery of certain transportation services under
6	15		Medicaid and certain other health and human services programs.
7	16		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
8	17		SECTION 1. Section 531.001, Government Code, is amended by
9	18		adding Subdivision (4-c) to read as follows:
10	19		(4-c) "Medicaid managed care organization" means a
11	20		managed care organization as defined by Section 533.001 that
12	21		contracts with the commission under Chapter 533 to provide health
13	22		care services to Medicaid recipients.
14	23		SECTION 2. The heading to Section 531.02414, Government
15	24		Code, is amended to read as follows:
16	25		Sec. 531.02414. NONEMERGENCY TRANSPORTATION SERVICES UNDER
17	26		[ADMINISTRATION AND OPERATION OF] MEDICAL TRANSPORTATION PROGRAM.
18	27		SECTION 3. Section 531.02414(a), Government Code, is
19	28		amended by amending Subdivision (1) and adding Subdivisions (1-a)
20	29		and (3) to read as follows:
21	30		(1) "Medical transportation program" means the
22	31		program that provides nonemergency transportation services [to and
23	32		from covered health care services, based on medical necessity,] to
24	33		recipients under Medicaid, subject to Subsection (a-1), the
25	34		children with special health care needs program, and the
26	35		transportation for indigent cancer patients program, who have no
27	36		other means of transportation.
28	37		(1-a) "Nonemergency transportation service" means
29	38		nonemergency medical transportation services authorized under:
30	39		(A) for a Medicaid recipient, the state Medicaid
31	40		plan; and
32	41		(B) for a recipient under another program
33	42		described by Subdivision (1), that program.
34	43		(3) "Transportation network company" has the meaning
35	44		assigned by Section 2402.001, Occupations Code.
36	45		SECTION 4. Section 531.02414, Government Code, is amended
37	46		by adding Subsections (a-1), (i), (j), (k), (l), and (m) and
38	47		amending Subsections (b), (e), and (f) to read as follows:
39		-	(a-1) Subject to Section 533.002571(i), this section does
40		-	not apply to the provision of nonemergency transportation services
41		-	on or after September 1, 2020, to a Medicaid recipient who is
42		-	enrolled in a managed care plan offered by a Medicaid managed care
43		-	organization.
	48	+	(a-1) This section does not apply to the provision of
	49	+	nonemergency transportation services on or after September 1, 2020,
	50	+	to a Medicaid recipient who is enrolled in a managed care plan
	51	+	offered by a Medicaid managed care organization.
44	52		(b) Notwithstanding any other law, the commission shall
45	53		directly supervise the administration and operation of the medical
46	54		transportation program under this section.
47	55		(e) The executive commissioner shall adopt rules to ensure
48	56		the safe and efficient provision of nonemergency transportation
49	57		services under this section [the medical transportation program by
50	58		regional contracted brokers and subcontractors of regional
51	59		contracted brokers]. The rules must include:
52	60		(1) minimum standards regarding the physical
53	61		condition and maintenance of motor vehicles used to provide the
54	62		services, including standards regarding the accessibility of motor
55	63		vehicles by persons with disabilities;
56	64		(2) a requirement that a regional contracted broker
57	65		verify that each motor vehicle operator providing the services or
58	66		seeking to provide the services has a valid driver's license;
59	67		(3) a requirement that a regional contracted broker
60	68		check the driving record information maintained by the Department
61	69		of Public Safety under Subchapter C, Chapter 521, Transportation
62	70		Code, of each motor vehicle operator providing the services or
63	71		seeking to provide the services;
64	72		(4) a requirement that a regional contracted broker
65	73		check the public criminal record information maintained by the
66	74		Department of Public Safety and made available to the public
67	75		through the department's Internet website of each motor vehicle
68	76		operator providing the services or seeking to provide the services;
69	77		and
70	78		(5) training requirements for motor vehicle operators
71	79		providing the services through a regional contracted broker,
72	80		including training on the following topics:
73	81		(A) passenger safety;
74	82		(B) passenger assistance;
75	83		(C) assistive devices, including wheelchair
76	84		lifts, tie-down equipment, and child safety seats;
77	85		(D) sensitivity and diversity;
78	86		(E) customer service;
79	87		(F) defensive driving techniques; and
80	88		(G) prohibited behavior by motor vehicle
81	89		operators.
82	90		(f) Except as provided by Subsection (j), the [The]
83	91		commission shall require compliance with the rules adopted under
84	92		Subsection (e) in any contract entered into with a regional
85	93		contracted broker to provide nonemergency transportation services
86	94		under the medical transportation program.
87	95		(i) Emergency medical services personnel and emergency
88	96		medical services vehicles, as those terms are defined by Section
89	97		773.003, Health and Safety Code, may not provide nonemergency
90	98		transportation services under the medical transportation program.
91	99		(j) A regional contracted broker may subcontract with a
92	100		transportation network company to provide services under this
93	101		section. A rule or other requirement adopted by the executive
94	102		commissioner under Subsection (e) does not apply to the
95	103		subcontracted transportation network company or a motor vehicle
96	104		operator who is part of the company's network. The commission or
97	105		the regional contracted broker may not require a motor vehicle
98	106		operator who is part of the subcontracted transportation network
99	107		company's network to enroll as a Medicaid provider to provide
100	108		services under this section.
101	109		(k) The commission or a regional contracted broker that
102	110		subcontracts with a transportation network company under
103	111		Subsection (j) may require the transportation network company or a
104	112		motor vehicle operator who provides services under this section to
105	113		be periodically screened against the list of excluded individuals
106	114		and entities maintained by the Office of Inspector General of the
107	115		United States Department of Health and Human Services.
108	116		(l) Notwithstanding any other law, a motor vehicle operator
109	117		who is part of the network of a transportation network company that
110	118		subcontracts with a regional contracted broker under Subsection (j)
111	119		and who satisfies the driver requirements in Section 2402.107,
112	120		Occupations Code, is qualified to provide services under this
113	121		section. The commission and the regional contracted broker may not
114	122		impose any additional requirements on a motor vehicle operator who
115	123		satisfies the driver requirements in Section 2402.107, Occupations
116	124		Code, to provide services under this section.
117	125		(m) For purposes of this section and notwithstanding
118	126		Section 2402.111(a)(2)(A), Occupations Code, a motor vehicle
119	127		operator who provides services under this section may use a
120	128		wheelchair-accessible vehicle equipped with a lift or ramp that is
121	129		capable of transporting passengers using a fixed-frame wheelchair
122	130		in the cabin of the vehicle if the vehicle otherwise meets the
123	131		requirements of Section 2402.111, Occupations Code.
124	132		SECTION 5. The heading to Section 533.00257, Government
125	133		Code, is amended to read as follows:
126	134		Sec. 533.00257. DELIVERY OF MEDICAL TRANSPORTATION PROGRAM
127	135		SERVICES THROUGH MANAGED TRANSPORTATION ORGANIZATION.
128	136		SECTION 6. Section 533.00257(a), Government Code, is
129	137		amended by adding Subdivision (2-a) to read as follows:
130	138		(2-a) "Transportation network company" has the
131	139		meaning assigned by Section 2402.001, Occupations Code.
132	140		SECTION 7. Section 533.00257, Government Code, is amended
133	141		by amending Subsections (b), (d), and (g) and adding Subsections
134	142		(k), (l), (m), and (n) to read as follows:
135	143		(b) The [Subject to Subsection (i), the] commission may
136	144		[shall] provide medical transportation program services on a
137	145		regional basis through a managed transportation delivery model
138	146		using managed transportation organizations and providers, as
139	147		appropriate, that:
140	148		(1) operate under a capitated rate system;
141	149		(2) assume financial responsibility under a full-risk
142	150		model;
143	151		(3) operate a call center;
144	152		(4) use fixed routes when available and appropriate;
145	153		and
146	154		(5) agree to provide data to the commission if the
147	155		commission determines that the data is required to receive federal
148	156		matching funds.
149	157		(d) Except as provided by Subsections (k) and (m), a [A]
150	158		managed transportation organization that participates in the
151	159		medical transportation program must attempt to contract with
152	160		medical transportation providers that:
153	161		(1) are considered significant traditional providers,
154	162		as defined by rule by the executive commissioner;
155	163		(2) meet the minimum quality and efficiency measures
156	164		required under Subsection (g) and other requirements that may be
157	165		imposed by the managed transportation organization; and
158	166		(3) agree to accept the prevailing contract rate of
159	167		the managed transportation organization.
160	168		(g) Except as provided by Subsections (k) and (m), the [The]
161	169		commission shall require that managed transportation organizations
162	170		and providers participating in the medical transportation program
163	171		meet minimum quality and efficiency measures as determined by the
164	172		commission.
165	173		(k) A managed transportation organization may subcontract
166	174		with a transportation network company to provide services under
167	175		this section. A rule or other requirement adopted by the executive
168	176		commissioner under this section or Section 531.02414 does not apply
169	177		to the subcontracted transportation network company or a motor
170	178		vehicle operator who is part of the company's network. The
171	179		commission or the managed transportation organization may not
172	180		require a motor vehicle operator who is part of the subcontracted
173	181		transportation network company's network to enroll as a Medicaid
174	182		provider to provide services under this section.
175	183		(l) The commission or a managed transportation organization
176	184		that subcontracts with a transportation network company under
177	185		Subsection (k) may require the transportation network company or a
178	186		motor vehicle operator who provides services under this section to
179	187		be periodically screened against the list of excluded individuals
180	188		and entities maintained by the Office of Inspector General of the
181	189		United States Department of Health and Human Services.
182	190		(m) Notwithstanding any other law, a motor vehicle operator
183	191		who is part of the network of a transportation network company that
184	192		subcontracts with a managed transportation organization under
185	193		Subsection (k) and who satisfies the driver requirements in Section
186	194		2402.107, Occupations Code, is qualified to provide services under
187	195		this section. The commission and the managed transportation
188	196		organization may not impose any additional requirements on a motor
189	197		vehicle operator who satisfies the driver requirements in Section
190	198		2402.107, Occupations Code, to provide services under this section.
191	199		(n) For purposes of this section and notwithstanding
192	200		Section 2402.111(a)(2)(A), Occupations Code, a motor vehicle
193	201		operator who provides services under this section may use a
194	202		wheelchair-accessible vehicle equipped with a lift or ramp that is
195	203		capable of transporting passengers using a fixed-frame wheelchair
196	204		in the cabin of the vehicle if the vehicle otherwise meets the
197	205		requirements of Section 2402.111, Occupations Code.
198	206		SECTION 8. Subchapter A, Chapter 533, Government Code, is
199	207		amended by adding Sections 533.002571, 533.00258, and 533.002581 to
200	208		read as follows:
201	209		Sec. 533.002571. DELIVERY OF NONEMERGENCY TRANSPORTATION
202	210		SERVICES TO CERTAIN MEDICAID RECIPIENTS THROUGH MEDICAID MANAGED
203	211		CARE ORGANIZATION. (a) In this section:
204	212		(1) "Nonemergency transportation service" has the
205	213		meaning assigned by Section 531.02414.
206	214		(2) "Nonmedical transportation service" and
207	215		"transportation network company" have the meanings assigned by
208	216		Section 533.00258.
209	217		(b) The commission shall require each Medicaid managed care
210	218		organization to arrange and provide nonemergency transportation
211	219		services to a recipient enrolled in a managed care plan offered by
212	220		the organization using the most cost-effective and cost-efficient
213	221		method of delivery, including by delivering nonmedical
214	222		transportation services through a transportation network company
215	223		or other transportation vendor as provided by Section 533.002581,
216	224		if available and medically appropriate. The commission shall
217	225		supervise the provision of the services.
218	226		(c) Subject to Subsection (d), the executive commissioner
219		-	shall adopt rules as necessary to ensure the safe and efficient
220		-	provision of nonemergency transportation services by a Medicaid
221		-	managed care organization under this section.
	227	+	shall adopt:
	228	+	(1) rules applicable to the provision of nonemergency
	229	+	medical transportation services by a Medicaid managed care
	230	+	organization that impose the same standards and requirements as
	231	+	those adopted under Section 531.02414(e); and
	232	+	(2) other rules as necessary to ensure the safe and
	233	+	efficient provision of nonemergency transportation services by a
	234	+	Medicaid managed care organization under this section.
222	235		(d) A Medicaid managed care organization may subcontract
223	236		with a transportation network company to provide nonemergency
224	237		transportation services under this section. A rule or other
225	238		requirement adopted by the executive commissioner under Subsection
226	239		(c) or Section 531.02414 does not apply to the subcontracted
227	240		transportation network company or a motor vehicle operator who is
228	241		part of the company's network. The commission or the Medicaid
229	242		managed care organization may not require a motor vehicle operator
230	243		who is part of the subcontracted transportation network company's
231	244		network to enroll as a Medicaid provider to provide services under
232	245		this section.
233	246		(e) The commission or a Medicaid managed care organization
234	247		that subcontracts with a transportation network company under
235	248		Subsection (d) may require the transportation network company or a
236	249		motor vehicle operator who provides services under this section to
237	250		be periodically screened against the list of excluded individuals
238	251		and entities maintained by the Office of Inspector General of the
239	252		United States Department of Health and Human Services.
240	253		(f) Notwithstanding any other law, a motor vehicle operator
241	254		who is part of the network of a transportation network company that
242	255		subcontracts with a Medicaid managed care organization under
243	256		Subsection (d) and who satisfies the driver requirements in Section
244	257		2402.107, Occupations Code, is qualified to provide services under
245	258		this section. The commission and the Medicaid managed care
246	259		organization may not impose any additional requirements on a motor
247	260		vehicle operator who satisfies the driver requirements in Section
248	261		2402.107, Occupations Code, to provide services under this section.
249	262		(g) For purposes of this section and notwithstanding
250	263		Section 2402.111(a)(2)(A), Occupations Code, a motor vehicle
251	264		operator who provides services under this section may use a
252	265		wheelchair-accessible vehicle equipped with a lift or ramp that is
253	266		capable of transporting passengers using a fixed-frame wheelchair
254	267		in the cabin of the vehicle if the vehicle otherwise meets the
255	268		requirements of Section 2402.111, Occupations Code.
256	269		(h) The commission may temporarily waive the applicability
257	270		of Subsection (b) to a Medicaid managed care organization as
258	271		necessary based on the results of a review conducted under Section
259	272		533.007 and until enrollment of recipients in a managed care plan
260	273		offered by the organization is permitted under that section.
261	274		(i) The commission shall extend a contract for the provision
262	275		of nonemergency transportation services under Section 533.00257 or
263	276		other law as necessary until the requirements of this section are
264	277		implemented with respect to each Medicaid managed care
265	278		organization. This subsection expires September 1, 2023.
266	279		Sec. 533.00258. NONMEDICAL TRANSPORTATION SERVICES UNDER
267	280		MEDICAID MANAGED CARE PROGRAM. (a) In this section:
268	281		(1) "Nonmedical transportation service" means:
269	282		(A) curb-to-curb transportation to or from a
270	283		medically necessary, nonemergency covered health care service in a
271	284		standard passenger vehicle that is scheduled not more than 48 hours
272	285		before the transportation occurs, that is provided to a recipient
273	286		enrolled in a managed care plan offered by a Medicaid managed care
274	287		organization, and that the organization determines meets the level
275	288		of care that is medically appropriate for the recipient, including
276	289		transportation related to:
277	290		(i) discharge of a recipient from a health
278	291		care facility;
279	292		(ii) receipt of urgent care; and
280	293		(iii) obtaining pharmacy services and
281	294		prescription drugs; and
282	295		(B) any other transportation to or from a
283	296		medically necessary, nonemergency covered health care service the
284	297		commission considers appropriate to be provided by a transportation
285	298		vendor, as determined by commission rule or policy.
286	299		(2) "Transportation network company" has the meaning
287	300		assigned by Section 2402.001, Occupations Code.
288	301		(3) "Transportation vendor" means an entity,
289	302		including a transportation network company, that contracts with a
290	303		Medicaid managed care organization to provide nonmedical
291	304		transportation services.
292	305		(b) The executive commissioner shall adopt rules regarding
293	306		the manner in which nonmedical transportation services may be
294	307		arranged and provided.
295	308		(c) The rules must require a Medicaid managed care
296	309		organization to create a process to:
297	310		(1) verify that a passenger is eligible to receive
298	311		nonmedical transportation services;
299	312		(2) ensure that nonmedical transportation services
300	313		are provided only to and from covered health care services in areas
301	314		in which a transportation network company operates; and
302	315		(3) ensure the timely delivery of nonmedical
303	316		transportation services to a recipient, including by setting
304	317		reasonable service response goals.
305	318		(d) Before September 1, 2020, and subject to Section
306	319		533.002581(h), a rule adopted in accordance with Subsection (c)(3)
307	320		may not impose a penalty on a Medicaid managed care organization
308	321		that contracts with a transportation vendor under this section if
309	322		the vendor is unable to provide nonmedical transportation services
310	323		to a recipient after the Medicaid managed care organization has
311	324		made a specific request for those services.
312	325		(e) The rules must require a transportation vendor to,
313	326		before permitting a motor vehicle operator to provide nonmedical
314	327		transportation services:
315	328		(1) confirm that the operator:
316	329		(A) is at least 18 years of age;
317	330		(B) maintains a valid driver's license issued by
318	331		this state, another state, or the District of Columbia; and
319	332		(C) possesses proof of registration and
320	333		automobile financial responsibility for each motor vehicle to be
321	334		used to provide nonmedical transportation services;
322	335		(2) conduct, or cause to be conducted, a local, state,
323	336		and national criminal background check for the operator that
324	337		includes the use of:
325	338		(A) a commercial multistate and
326	339		multijurisdiction criminal records locator or other similar
327	340		commercial nationwide database; and
328	341		(B) the national sex offender public website
329	342		maintained by the United States Department of Justice or a
330	343		successor agency;
331	344		(3) confirm that any vehicle to be used to provide
332	345		nonmedical transportation services:
333	346		(A) meets the applicable requirements of Chapter
334	347		548, Transportation Code; and
335	348		(B) except as provided by Subsection (j), has at
336	349		least four doors; and
337	350		(4) obtain and review the operator's driving record.
338	351		(f) The rules may not permit a motor vehicle operator to
339	352		provide nonmedical transportation services if the operator:
340	353		(1) has been convicted in the three-year period
341	354		preceding the issue date of the driving record obtained under
342	355		Subsection (e)(4) of:
343	356		(A) more than three offenses classified by the
344	357		Department of Public Safety as moving violations; or
345	358		(B) one or more of the following offenses:
346	359		(i) fleeing or attempting to elude a police
347	360		officer under Section 545.421, Transportation Code;
348	361		(ii) reckless driving under Section
349	362		545.401, Transportation Code;
350	363		(iii) driving without a valid driver's
351	364		license under Section 521.025, Transportation Code; or
352	365		(iv) driving with an invalid driver's
353	366		license under Section 521.457, Transportation Code;
354	367		(2) has been convicted in the preceding seven-year
355	368		period of any of the following:
356	369		(A) driving while intoxicated under Section
357	370		49.04 or 49.045, Penal Code;
358	371		(B) use of a motor vehicle to commit a felony;
359	372		(C) a felony crime involving property damage;
360	373		(D) fraud;
361	374		(E) theft;
362	375		(F) an act of violence; or
363	376		(G) an act of terrorism; or
364	377		(3) is found to be registered in the national sex
365	378		offender public website maintained by the United States Department
366	379		of Justice or a successor agency.
367	380		(g) The commission may not require:
368	381		(1) a motor vehicle operator to enroll as a Medicaid
369	382		provider to provide nonmedical transportation services; or
370	383		(2) a Medicaid managed care organization to credential
371	384		a motor vehicle operator to provide nonmedical transportation
372	385		services.
373	386		(h) The commission or a Medicaid managed care organization
374	387		that contracts with a transportation vendor may require the
375	388		transportation vendor or a motor vehicle operator who provides
376	389		services under this section to be periodically screened against the
377	390		list of excluded individuals and entities maintained by the Office
378	391		of Inspector General of the United States Department of Health and
379	392		Human Services.
380	393		(i) Notwithstanding any other law, a motor vehicle operator
381	394		who is part of a transportation network company's network and who
382	395		satisfies the driver requirements in Section 2402.107, Occupations
383	396		Code, is qualified to provide nonmedical transportation services.
384	397		The commission and a Medicaid managed care organization may not
385	398		impose any additional requirements on a motor vehicle operator who
386	399		satisfies the driver requirements in Section 2402.107, Occupations
387	400		Code, to provide nonmedical transportation services.
388	401		(j) For purposes of this section and notwithstanding
389	402		Section 2402.111(a)(2)(A), Occupations Code, a motor vehicle
390	403		operator who provides services under this section may use a
391	404		wheelchair-accessible vehicle equipped with a lift or ramp that is
392	405		capable of transporting passengers using a fixed-frame wheelchair
393	406		in the cabin of the vehicle if the vehicle otherwise meets the
394	407		requirements of Section 2402.111, Occupations Code.
395	408		Sec. 533.002581. DELIVERY OF NONMEDICAL TRANSPORTATION
396	409		SERVICES UNDER MEDICAID MANAGED CARE PROGRAM. (a) In this section,
397	410		"nonmedical transportation service" and "transportation vendor"
398	411		have the meanings assigned by Section 533.00258.
399	412		(b) The commission shall designate managed care service
400	413		areas in which to require, beginning not later than January 1, 2020,
401	414		each Medicaid managed care organization with which the commission
402	415		has a contract that is anticipated to be in effect on September 1,
403	416		2020, and that operates in a designated service area to arrange for
404	417		the provision of nonmedical transportation services to recipients
405	418		enrolled in a managed care plan offered by the organization. The
406	419		commission shall designate at least three, but not more than four,
407	420		managed care service areas for purposes of this subsection. At
408	421		least one of the designated service areas must be located in an
409	422		urban service area, and at least one must be located in a rural
410	423		service area. This subsection expires September 1, 2021.
411		-	(c) Beginning not later than September 1, 2020, the
412		-	commission shall require each Medicaid managed care organization to
413		-	arrange for the provision of nonmedical transportation services to
414		-	recipients enrolled in a managed care plan offered by the
415		-	organization.
	424	+	(c) The commission shall require each Medicaid managed care
	425	+	organization to arrange for the provision of nonmedical
	426	+	transportation services to recipients enrolled in a managed care
	427	+	plan offered by the organization.
416	428		(d) A Medicaid managed care organization may contract with a
417	429		transportation vendor or other third party to arrange for the
418	430		provision of nonmedical transportation services. If a Medicaid
419	431		managed care organization contracts with a third party that is not a
420	432		transportation vendor to arrange for the provision of nonmedical
421	433		transportation services, the third party shall contract with a
422	434		transportation vendor to deliver the nonmedical transportation
423	435		services.
424	436		(e) A Medicaid managed care organization that contracts
425	437		with a transportation vendor or other third party to arrange for the
426	438		provision of nonmedical transportation services shall ensure the
427	439		effective sharing and integration of service coordination, service
428	440		authorization, and utilization management data between the managed
429	441		care organization and the transportation vendor or third party.
430	442		(f) A Medicaid managed care organization may not require:
431	443		(1) a motor vehicle operator to enroll as a Medicaid
432	444		provider to provide nonmedical transportation services; or
433	445		(2) the credentialing of a motor vehicle operator to
434	446		provide nonmedical transportation services.
435	447		(g) For purposes of this section and notwithstanding
436	448		Section 2402.111(a)(2)(A), Occupations Code, a motor vehicle
437	449		operator who provides services under this section may use a
438	450		wheelchair-accessible vehicle equipped with a lift or ramp that is
439	451		capable of transporting passengers using a fixed-frame wheelchair
440	452		in the cabin of the vehicle if the vehicle otherwise meets the
441	453		requirements of Section 2402.111, Occupations Code.
442	454		(h) The commission may waive the applicability of
443	455		Subsection (c) to a Medicaid managed care organization for not more
444	456		than three months as necessary based on the results of a review
445	457		conducted under Section 533.007 and until enrollment of recipients
446	458		in a managed care plan offered by the organization is permitted
447	459		under that section.
448	460		SECTION 9. Section 533.00257(i), Government Code, is
449	461		repealed.
450	462		SECTION 10. Notwithstanding Sections 533.002571(b) and
451		-	533.002581(c), Government Code, as added by this Act, the Health
	463	+	533.002581(b), Government Code, as added by this Act, the Health
452	464		and Human Services Commission is not required to implement those
453	465		subsections until September 1, 2020.
454	466		SECTION 11. If before implementing any provision of this
455	467		Act a state agency determines that a waiver or authorization from a
456	468		federal agency is necessary for implementation of that provision,
457	469		the agency affected by the provision shall request the waiver or
458	470		authorization and may delay implementing that provision until the
459	471		waiver or authorization is granted.
460	472		SECTION 12. As soon as practicable after the effective date
461	473		of this Act, the executive commissioner of the Health and Human
462	474		Services Commission shall adopt rules as necessary to implement the
463	475		changes in law made by this Act.
464	476		SECTION 13. This Act takes effect immediately if it
465	477		receives a vote of two-thirds of all the members elected to each
466	478		house, as provided by Section 39, Article III, Texas Constitution.
467	479		If this Act does not receive the vote necessary for immediate
468	480		effect, this Act takes effect September 1, 2019.
469		-	______________________________ ______________________________
470		-	President of the Senate Speaker of the House
471		-	I certify that H.B. No. 1576 was passed by the House on April
472		-	25, 2019, by the following vote: Yeas 133, Nays 2, 1 present, not
473		-	voting; and that the House concurred in Senate amendments to H.B.
474		-	No. 1576 on May 24, 2019, by the following vote: Yeas 141, Nays 0,
475		-	2 present, not voting.
476		-	______________________________
477		-	Chief Clerk of the House
478		-	I certify that H.B. No. 1576 was passed by the Senate, with
479		-	amendments, on May 22, 2019, by the following vote: Yeas 31, Nays
480		-	0.
481		-	______________________________
482		-	Secretary of the Senate
483		-	APPROVED: __________________
484		-	Date
485		-	__________________
486		-	Governor
	481	+	* * * * *