TX
Texas Senate Bill SB2082

Texas 2019 - 86th Regular

Texas Senate Bill SB2082

Caption

Relating to the Medicaid program, including the administration and operation of the Medicaid managed care program.

Impact

The legislation is set to amend several sections of the Government Code to reinforce accountability in managed care contracts. These amendments include guidelines for provider payment timelines, prohibiting organizations from penalizing providers for overpayments made in good faith, and requiring public reporting of services rendered and their outcomes. This is expected to considerably improve healthcare delivery by ensuring providers are compensated appropriately and timely, while also safeguarding their interests against unwarranted recoupments by managed care organizations.

Summary

SB2082 aims to enhance the administration and operation of the Medicaid program within Texas, specifically focusing on the managed care delivery model. The bill introduces various provisions that regulate the relationship between managed care organizations and healthcare providers, ensuring that patients receive timely access to necessary services. Notably, it emphasizes the need for continuity of care and a structured approach to dispute resolution regarding claims for services provided. By mandating specific timelines for authorizing post-acute care services, the bill strives to reduce delays in treatment and enhance patient outcomes as they transition from hospital settings.

Contention

Despite the bill's intent to streamline processes and increase healthcare accessibility for Medicaid recipients, there are notable points of contention. Concerns have been raised about potential administrative burdens that could arise from stricter compliance requirements for managed care organizations. Additionally, the stipulations regarding medical necessity determinations and prior authorization processes may create complexities in service delivery, possibly delaying care for some patients. Stakeholders in the healthcare sector are keenly evaluating these impacts, advocating for measures that balance regulatory oversight with the operational realities faced by providers.

Companion Bills

No companion bills found.

Previously Filed As

TX HB1283

Relating to prescription drug formularies applicable to the Medicaid managed care program.

TX SB1113

Relating to prescription drug formularies applicable to the Medicaid managed care program.

TX HB1293

Relating to the reimbursement of prescription drugs under Medicaid and the child health plan program.

TX HB5018

Relating to certain payment recovery efforts by managed care organizations under Medicaid or the child health plan program.

TX HB4111

Relating to access to and the provision of behavioral and mental health care services and trauma-informed care in the Medicaid managed care program.

TX SB2201

Relating to certain prescription drug benefits under the Medicaid managed care program.

TX HB4611

Relating to the nonsubstantive revision of the health and human services laws governing the Health and Human Services Commission, Medicaid, and other social services.

TX SB1629

Relating to the regulation of certain nursing facilities, including licensing requirements and Medicaid participation requirements.

TX HB3916

Relating to the reimbursement of certain durable medical equipment providers participating in the Medicaid managed care program.

TX SB1915

Relating to the reimbursement of certain durable medical equipment providers participating in the Medicaid managed care program.

Similar Bills

TX SB760

Relating to access and assignment requirements for, support and information regarding, and investigations of certain providers of health care and long-term services.

TX SB1567

Relating to the reimbursement of prescription drugs under Medicaid and the child health plan program.

TX HB3288

Relating to the reimbursement of prescription drugs under Medicaid and the child health plan program.

TX HB3670

Relating to the administration and operation of the Medicaid program.

TX HB437

Relating to allowing Medicaid managed care organizations to adopt their own drug formularies.

TX HB3366

Relating to the reimbursement of prescription drugs under Medicaid and the child health plan program.

TX SB1612

Relating to the reimbursement of prescription drugs under the Medicaid managed care and child health plan programs.

TX SB1283

Relating to the availability under Medicaid of certain drugs used to treat human immunodeficiency virus or prevent acquired immune deficiency syndrome.