By: Menéndez S.B. No. 1177
(Rose)
A BILL TO BE ENTITLED
AN ACT
relating to offering certain evidence-based services in lieu of
other mental health or substance use disorder services by a
Medicaid managed care organization.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 533.005, Government Code, is amended by
adding Subsection (g) to read as follows:
(g) In addition to the requirements specified by Subsection
(a), a contract described by that subsection must contain language
permitting a managed care organization to offer medically
appropriate, cost-effective, evidence-based services from a list
approved by the state Medicaid managed care advisory committee and
included in the contract in lieu of mental health or substance use
disorder services specified in the state Medicaid plan. A
recipient is not required to use a service from the list included in
the contract in lieu of another mental health or substance use
disorder service specified in the state Medicaid plan. The
commission shall:
(1) prepare and submit an annual report to the
legislature on the number of times during the preceding year a
service from the list included in the contract is used; and
(2) take into consideration the actual cost and use of
any services from the list included in the contract that are offered
by a managed care organization when setting the capitation rates
for that organization under the contract.
SECTION 2. Section 533.005, Government Code, as amended by
this Act, applies to a contract entered into or renewed on or after
the effective date of this Act. A contract entered into or renewed
before that date is governed by the law in effect on the date the
contract was entered into or renewed, and that law is continued in
effect for that purpose.
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, 2019.