TX
Texas House Bill HB3748

Texas 2019 - 86th Regular

Texas House Bill HB3748

Caption

Relating to the coordination of private health benefits with Medicaid benefits.

Impact

The implementation of HB 3748 is expected to have significant implications for Texans who qualify for both private health insurance and Medicaid. By ensuring that Medicaid managed care organizations are responsible for coordinating these benefits, recipients can expect their healthcare needs to be met with fewer barriers when seeking services. The bill would also streamline the process for healthcare providers, allowing them to receive reimbursement directly for services rendered, thus potentially improving provider participation in Medicaid programs.

Summary

House Bill 3748 focuses on enhancing the coordination between private health insurance and Medicaid benefits in Texas. The bill outlines new policies that will ensure that individuals with both types of insurance can access services seamlessly. It establishes clear protocols for Medicaid managed care organizations to deliver 'wrap-around' benefits, which cover services that exceed primary health insurance limits or are not included in those plans. This legislation aims to support recipients by offering them more comprehensive healthcare coverage and improving service delivery efficiency.

Contention

While the enactment of this bill is aimed at benefiting a vulnerable population, there are points of contention surrounding its specifics, particularly regarding the balance of responsibilities between private insurers and Medicaid. Some healthcare advocates argue that reliance on managed care organizations needs to be balanced with sufficient oversight to prevent discrepancies in coverage and care quality. Additionally, discussions around federal waivers needed for implementation may raise concerns about the flexibility and integrity of services provided under this new framework.

Companion Bills

TX SB1207

Same As Relating to the operation and administration of Medicaid, including the Medicaid managed care program and the medically dependent children (MDCP) waiver program.

Previously Filed As

TX HB4823

Relating to the provision and delivery of benefits to certain recipients under Medicaid.

TX SB2145

Relating to the provision and delivery of benefits to certain recipients under Medicaid.

TX SB861

Relating to coordination of vision and eye care benefits under certain health benefit plans and vision benefit plans.

TX HB1322

Relating to coordination of vision and eye care benefits under certain health benefit plans and vision benefit plans.

TX SB1051

Relating to a uniform coordination of benefits questionnaire for health benefit plans.

TX HB4501

Relating to a uniform coordination of benefits questionnaire for health benefit plans.

TX SB46

Relating to a uniform coordination of benefits questionnaire for health benefit plans.

TX SB34

Relating to a uniform coordination of benefits questionnaire for health benefit plans.

TX HB3286

Relating to prescription drug benefits under Medicaid and the child health plan program.

TX HB4951

Relating to the Medicare Primacy Coordination Audit and Assistance Program to assist eligible individuals in obtaining certain Medicare benefits.

Similar Bills

UT SB0257

Medicaid Accounts Amendments

UT HB0247

Child Health Care Coverage Amendments

AR SB518

To Amend The Medicaid Fraud Act And The Medicaid Fraud False Claims Act; And To Update Language And Definitions To Reflect Changes Within The Healthcare System;.

AR SB515

To Amend The Medicaid Fraud Act And The Medicaid Fraud False Claims Act.

UT HB0463

Medicaid Funding Amendments

NJ A3334

Requires Medicaid reimbursement for covered behavioral health services provided by local education agency to student who is eligible Medicaid beneficiary.

NJ S2416

Requires Medicaid reimbursement for covered behavioral health services provided by local education agency to student who is eligible Medicaid beneficiary.

NJ S3495

Provides for presumptive eligibility for home and community-based services and services provided through program of all-inclusive care for the elderly under Medicaid.