Texas 2019 - 86th Regular

Texas Senate Bill SB1235 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		By: Buckingham S.B. No. 1235
2		-	(Oliverson)
3	2
4	3
5	4		A BILL TO BE ENTITLED
6	5		AN ACT
7	6		relating to the enrollment of health care providers in Medicaid.
8	7		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	8		SECTION 1. Section 531.02118, Government Code, is amended
10	9		by amending Subsection (c) and adding Subsections (e), (f), (g),
11	10		(h), and (i) to read as follows:
12	11		(c) In streamlining the Medicaid provider credentialing
13	12		process under this section, the commission may designate a
14	13		centralized credentialing entity and shall require [may]:
15	14		(1) that the credentialing entity and the entity
16	15		serving as the state's Medicaid claims administrator share
17	16		information to reduce the submission of duplicative information or
18	17		documents necessary for both Medicaid enrollment and credentialing
19	18		[in the database established under Subchapter C, Chapter 32, Human
20	19		Resources Code, with the centralized credentialing entity]; and
21	20		(2) [require] all managed care organizations
22	21		contracting with the commission to provide health care services to
23	22		Medicaid recipients under a managed care plan issued by the
24	23		organization to use the centralized credentialing entity as a hub
25	24		for the collection and sharing of information.
26	25		(e) Subject to Subsection (f), the commission shall enroll a
27	26		provider as a Medicaid provider, without requiring the provider to
28	27		separately apply for enrollment through the entity serving as the
29	28		state's Medicaid claims administrator, if the provider is:
30	29		(1) credentialed by a managed care organization that
31	30		contracts with the commission under Chapter 533; or
32	31		(2) enrolled as a Medicare provider.
33	32		(f) The executive commissioner by rule may establish
34	33		additional enrollment requirements that are:
35	34		(1) necessary to enroll a provider as a Medicaid
36	35		provider; and
37	36		(2) not otherwise required by managed care
38	37		organization credentialing or Medicare provider enrollment.
39	38		(g) The commission shall track the number of providers that
40	39		enroll as Medicaid providers through each type of enrollment
41	40		process described by Subsection (e), including the enrollment
42	41		process through the entity serving as the state's Medicaid claims
43	42		administrator.
44	43		(h) The commission shall develop a process to streamline the
45	44		Medicaid enrollment of a provider who:
46	45		(1) provides services through a single case agreement
47	46		to a recipient who is also enrolled in a private group health
48	47		benefit plan; and
49	48		(2) is enrolled as a provider in that group health
50	49		benefit plan.
51	50		(i) The commission shall use a provider's national provider
52	51		identifier number to enroll a provider under Subsection (h). In
53	52		this subsection, "national provider identifier number" means the
54	53		national provider identifier number required under Section
55	54		1128J(e), Social Security Act (42 U.S.C. Section 1320a-7k(e)).
56	55		SECTION 2. If before implementing any provision of this Act
57	56		a state agency determines that a waiver or authorization from a
58	57		federal agency is necessary for implementation of that provision,
59	58		the agency affected by the provision shall request the waiver or
60	59		authorization and may delay implementing that provision until the
61	60		waiver or authorization is granted.
62	61		SECTION 3. The Health and Human Services Commission is
63	62		required to implement a provision of this Act only if the
64	63		legislature appropriates money specifically for that purpose. If
65	64		the legislature does not appropriate money specifically for that
66	65		purpose, the commission may, but is not required to, implement a
67	66		provision of this Act using other appropriations available for that
68	67		purpose.
69	68		SECTION 4. This Act takes effect September 1, 2019.