Texas 2019 - 86th Regular

Texas Senate Bill SB2138 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	S.B. No. 2138
	1	+	86R33841 KFF-F
	2	+	By: Hinojosa, et al. S.B. No. 2138
	3	+	(Davis of Harris)
	4	+	Substitute the following for S.B. No. 2138: No.
2	5
3	6
	7	+	A BILL TO BE ENTITLED
4	8		AN ACT
5		-	relating to the administration and operation of Medicaid.
	9	+	relating to the authority of the Health and Human Services
	10	+	Commission to retain certain money received by the commission to
	11	+	administer certain Medicaid programs.
6	12		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
7	13		SECTION 1. Subchapter B, Chapter 531, Government Code, is
8	14		amended by adding Section 531.021135 to read as follows:
9	15		Sec. 531.021135. COMMISSION'S AUTHORITY TO RETAIN CERTAIN
10	16		MONEY TO ADMINISTER CERTAIN MEDICAID PROGRAMS; REPORT REQUIRED.
11	17		(a) In this section, "directed payment program" means a delivery
12	18		system and provider patient initiative implemented by this state
13	19		under 42 C.F.R. Section 438.6(c).
14	20		(b) This section applies only to money the commission
15	21		receives from a source other than the general revenue fund to
16	22		operate a waiver program established under Section 1115 of the
17	23		federal Social Security Act (42 U.S.C. Section 1315) or a directed
18	24		payment program or successor program as determined by the
19	25		commission.
20	26		(c) Subject to Subsection (e), the commission may retain
21	27		from money to which this section applies an amount equal to the
22	28		estimated costs necessary to administer the program for which the
23	29		money is received, but not to exceed $8 million for a state fiscal
24		-	~~year~~.
	30	+	biennium.
25	31		(d) The commission shall spend money retained under this
26	32		section to assist in paying the costs necessary to administer the
27	33		program for which the money is received, except that the commission
28	34		may not use the money to pay any type of administrative cost that,
29	35		before June 1, 2019, was funded with general revenue.
30	36		(e) If the commission determines that the commission needs
31	37		additional money to administer a program described by Subsection
32		-	(b), the commission may ~~retain an additional amount~~ with the
33		-	~~approval of the governor and the~~ Legislative Budget Board, ~~but~~ not
34		-	~~to exceed a total retained amount equal to 0.25~~ percent of the total
35		-	~~amount estimated to be received for the~~ program.
	38	+	(b), the commission may, with the approval of the governor and the
	39	+	Legislative Budget Board, retain not more than an additional 0.25
	40	+	percent of the total amount estimated to be received for the
	41	+	program.
36	42		(f) The commission shall submit an annual report to the
37	43		governor and the Legislative Budget Board that:
38	44		(1) details the amount of money retained and spent by
39	45		the commission under this section during the preceding state fiscal
40	46		year, including a separate detail of any increase in the amount of
41	47		money retained for a program under Subsection (e);
42	48		(2) contains a transparent description of how the
43	49		commission used the money described by Subdivision (1); and
44	50		(3) assesses the extent to which the money retained by
45	51		the commission under this section covered the estimated costs to
46	52		administer the applicable program and states whether, based on that
47	53		assessment, the commission adjusted or considered adjustments to
48	54		the amount retained.
49	55		(g) The executive commissioner shall adopt rules necessary
50	56		to implement this section.
51		-	SECTION 2. Section 531.1023, Government Code, is amended to
52		-	read as follows:
53		-	Sec. 531.1023. COMPLIANCE WITH FEDERAL CODING GUIDELINES.
54		-	(a) The commission's office of inspector general, including
55		-	office staff and any third party with which the office contracts to
56		-	perform coding services, and the commission's medical and
57		-	utilization review appeals unit shall comply with federal coding
58		-	guidelines, including guidelines for diagnosis-related group (DRG)
59		-	validation and related audits.
60		-	(b) In this section, "federal coding guidelines" means the
61		-	code sets and guidelines adopted by the United States Department of
62		-	Health and Human Services in accordance with the Health Insurance
63		-	Portability and Accountability Act of 1996 (42 U.S.C. Section 1320d
64		-	et seq.).
65		-	SECTION 3. Subchapter A, Chapter 533, Government Code, is
66		-	amended by adding Section 533.0031 to read as follows:
67		-	Sec. 533.0031. MEDICAID MANAGED CARE PLAN ACCREDITATION.
68		-	(a) A managed care plan offered by a Medicaid managed care
69		-	organization must be accredited by a nationally recognized
70		-	accreditation organization. The commission may choose whether to
71		-	require all managed care plans offered by Medicaid managed care
72		-	organizations to be accredited by the same organization or to allow
73		-	for accreditation by different organizations.
74		-	(b) The commission may use the data, scoring, and other
75		-	information provided to or received from an accreditation
76		-	organization in the commission's contract oversight processes.
77		-	SECTION 4. The Health and Human Services Commission shall
78		-	require that a managed care plan offered by a Medicaid managed care
79		-	organization with which the commission enters into or renews a
80		-	contract under Chapter 533, Government Code, on or after the
81		-	effective date of this Act complies with Section 533.0031,
82		-	Government Code, as added by this Act, not later than September 1,
83		-	2022.
84		-	SECTION 5. If before implementing any provision of this Act
	57	+	SECTION 2. If before implementing any provision of this Act
85	58		a state agency determines that a waiver or authorization from a
86	59		federal agency is necessary for implementation of that provision,
87	60		the agency affected by the provision shall request the waiver or
88	61		authorization and may delay implementing that provision until the
89	62		waiver or authorization is granted.
90		-	SECTION 6. This Act takes effect immediately if it receives
	63	+	SECTION 3. This Act takes effect immediately if it receives
91	64		a vote of two-thirds of all the members elected to each house, as
92	65		provided by Section 39, Article III, Texas Constitution. If this
93	66		Act does not receive the vote necessary for immediate effect, this
94	67		Act takes effect September 1, 2019.
95		-	______________________________ ______________________________
96		-	President of the Senate Speaker of the House
97		-	I hereby certify that S.B. No. 2138 passed the Senate on
98		-	April 29, 2019, by the following vote: Yeas 30, Nays 1;
99		-	May 23, 2019, Senate refused to concur in House amendments and
100		-	requested appointment of Conference Committee; May 23, 2019, House
101		-	granted request of the Senate; May 26, 2019, Senate adopted
102		-	Conference Committee Report by the following vote: Yeas 31,
103		-	Nays 0.
104		-	______________________________
105		-	Secretary of the Senate
106		-	I hereby certify that S.B. No. 2138 passed the House, with
107		-	amendments, on May 22, 2019, by the following vote: Yeas 131,
108		-	Nays 13, two present not voting; May 23, 2019, House granted
109		-	request of the Senate for appointment of Conference Committee;
110		-	May 26, 2019, House adopted Conference Committee Report by the
111		-	following vote: Yeas 125, Nays 21, one present not voting.
112		-	______________________________
113		-	Chief Clerk of the House
114		-	Approved:
115		-	______________________________
116		-	Date
117		-	______________________________
118		-	Governor