Texas 2019 - 86th Regular

Texas Senate Bill SB2239 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	86R10228 JG-D
2	2	By: Kolkhorst S.B. No. 2239
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the operation and administration of certain health and
8	8	human services programs, including the Medicaid managed care
9	9	program.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. Section 531.001, Government Code, is amended by
12	12	adding Subdivision (4-c) to read as follows:
13	13	(4-c) "Medicaid managed care organization" means a
14	14	managed care organization as defined by Section 533.001 that
15	15	contracts with the commission under Chapter 533 to provide health
16	16	care services to Medicaid recipients.
17	17	SECTION 2. Subchapter B, Chapter 531, Government Code, is
18	18	amended by adding Section 531.02112 to read as follows:
19	19	Sec. 531.02112. PROCEDURE FOR IMPLEMENTING CHANGES TO
20	20	PAYMENT RATES UNDER MEDICAID AND CHILD HEALTH PLAN PROGRAM. (a) In
21	21	adopting rules and standards related to the determination of fees,
22	22	charges, and rates for payments under Medicaid and the child health
23	23	plan program, the executive commissioner, in consultation with the
24	24	advisory committee established under Subsection (b), shall adopt
25	25	rules to ensure that changes to the fees, charges, and rates are
26	26	implemented in accordance with this section and in a way that
27	27	minimizes administrative complexity and financial uncertainty.
28	28	(b) The executive commissioner shall establish an advisory
29	29	committee to provide input for the adoption of rules and standards
30	30	that comply with this section. The advisory committee is composed
31	31	of representatives of managed care organizations and providers
32	32	under Medicaid and the child health plan program. The advisory
33	33	committee is abolished on the date the rules that comply with this
34	34	section are adopted. This subsection expires September 1, 2021.
35	35	(c) Before implementing a change to the fees, charges, and
36	36	rates for payments under Medicaid or the child health plan program,
37	37	the commission shall:
38	38	(1) before or at the time notice of the proposed change
39	39	is published under Subdivision (2), notify managed care
40	40	organizations and the entity serving as the state's Medicaid claims
41	41	administrator under the Medicaid fee-for-service delivery model of
42	42	the proposed change;
43	43	(2) publish notice of the proposed change:
44	44	(A) for public comment in the Texas Register for
45	45	a period of not less than 60 days; and
46	46	(B) on the commission's and state Medicaid claims
47	47	administrator's Internet websites during the period specified
48	48	under Paragraph (A);
49	49	(3) publish notice of a final determination to make
50	50	the proposed change:
51	51	(A) in the Texas Register for a period of not less
52	52	than 30 days before the change becomes effective; and
53	53	(B) on the commission's and state Medicaid claims
54	54	administrator's Internet websites during the period specified
55	55	under Paragraph (A); and
56	56	(4) provide managed care organizations and the entity
57	57	serving as the state's Medicaid claims administrator under the
58	58	Medicaid fee-for-service delivery model with a period of not less
59	59	than 30 days before the effective date of the final change to make
60	60	any necessary administrative or systems adjustments to implement
61	61	the change.
62	62	(d) If changes to the fees, charges, or rates for payments
63	63	under Medicaid or the child health plan program are mandated by the
64	64	legislature or federal government on a date that does not fall
65	65	within the time frame for the implementation of those changes
66	66	described by this section, the commission shall:
67	67	(1) prorate the amount of the change over the fee,
68	68	charge, or rate period; and
69	69	(2) publish the proration schedule described by
70	70	Subdivision (1) in the Texas Register along with the notice
71	71	provided under Subsection (c)(3).
72	72	(e) This section does not apply to changes to the fees,
73	73	charges, or rates for payments made to a nursing facility.
74	74	SECTION 3. Section 531.02118, Government Code, is amended
75	75	by amending Subsection (c) and adding Subsections (e) and (f) to
76	76	read as follows:
77	77	(c) In streamlining the Medicaid provider credentialing
78	78	process under this section, the commission may designate a
79	79	centralized credentialing entity and, if a centralized
80	80	credentialing entity is designated, shall [may]:
81	81	(1) share information in the database established
82	82	under Subchapter C, Chapter 32, Human Resources Code, with the
83	83	centralized credentialing entity to reduce the submission of
84	84	duplicative information or documents necessary for both Medicaid
85	85	enrollment and credentialing; and
86	86	(2) require all Medicaid managed care organizations
87	87	[contracting with the commission to provide health care services to
88	88	Medicaid recipients under a managed care plan issued by the
89	89	organization] to use the centralized credentialing entity as a hub
90	90	for the collection and sharing of information.
91	91	(e) To the extent permitted by federal law, the commission
92	92	shall use available Medicare data to streamline the enrollment and
93	93	credentialing of Medicaid providers by reducing the submission of
94	94	duplicative information or documents.
95	95	(f) The commission shall develop and implement a process to
96	96	expedite the Medicaid provider enrollment process for a health care
97	97	provider who is providing health care services through a single
98	98	case agreement to a Medicaid recipient with primary insurance
99	99	coverage. The commission shall use a provider's national provider
100	100	identifier number to enroll a provider under this subsection. In
101	101	this subsection, "national provider identifier number" has the
102	102	meaning assigned by Section 531.021182.
103	103	SECTION 4. Subchapter B, Chapter 531, Government Code, is
104	104	amended by adding Section 531.021182 to read as follows:
105	105	Sec. 531.021182. USE OF NATIONAL PROVIDER IDENTIFIER
106	106	NUMBER. (a) In this section, "national provider identifier
107	107	number" means the national provider identifier number required
108	108	under Section 1128J(e), Social Security Act (42 U.S.C. Section
109	109	1320a-7k(e)).
110	110	(b) Beginning September 1, 2020, the commission:
111	111	(1) may not use a state-issued provider identifier
112	112	number to identify a Medicaid provider;
113	113	(2) shall use only a national provider identifier
114	114	number to identify a Medicaid provider; and
115	115	(3) must allow a Medicaid provider to bill for
116	116	Medicaid services using the provider's national provider
117	117	identifier number.
118	118	SECTION 5. Section 531.024(b), Government Code, is amended
119	119	to read as follows:
120	120	(b) The rules promulgated under Subsection (a)(7) must
121	121	provide due process to an applicant for Medicaid services or
122	122	programs and to a Medicaid recipient who seeks a Medicaid service,
123	123	including a service that requires prior authorization. The rules
124	124	must provide the protections for applicants and recipients required
125	125	by 42 C.F.R. Part 431, Subpart E, including requiring that:
126	126	(1) the written notice to an individual of the
127	127	individual's right to a hearing must:
128	128	(A) contain a clear [an] explanation of:
129	129	(i) the adverse determination and the
130	130	circumstances under which Medicaid is continued if a hearing is
131	131	requested; and
132	132	(ii) the fair hearing process, including
133	133	the individual's ability to use an independent review process; and
134	134	(B) be mailed at least 10 days before the date the
135	135	individual's Medicaid eligibility or service is scheduled to be
136	136	terminated, suspended, or reduced, except as provided by 42 C.F.R.
137	137	Section 431.213 or 431.214; and
138	138	(2) if a hearing is requested before the date a
139	139	Medicaid recipient's service, including a service that requires
140	140	prior authorization, is scheduled to be terminated, suspended, or
141	141	reduced, the agency may not take that proposed action before a
142	142	decision is rendered after the hearing unless:
143	143	(A) it is determined at the hearing that the sole
144	144	issue is one of federal or state law or policy; and
145	145	(B) the agency promptly informs the recipient in
146	146	writing that services are to be terminated, suspended, or reduced
147	147	pending the hearing decision.
148	148	SECTION 6. Subchapter B, Chapter 531, Government Code, is
149	149	amended by adding Sections 531.024162, 531.0319, and 531.0602 to
150	150	read as follows:
151	151	Sec. 531.024162. NOTICE REQUIREMENTS REGARDING DENIAL OF
152	152	COVERAGE OR PRIOR AUTHORIZATION. The commission shall ensure that
153	153	notice sent by the commission or a Medicaid managed care
154	154	organization to a Medicaid recipient or provider regarding the
155	155	denial of coverage or prior authorization for a service includes:
156	156	(1) information required by federal law;
157	157	(2) a clear and easy-to-understand explanation of the
158	158	reason for the denial for the recipient; and
159	159	(3) a clinical explanation of the reason for the
160	160	denial for the provider.
161	161	Sec. 531.0319. MEDICAID MEDICAL POLICY MANUAL. (a) The
162	162	commission shall develop and publish on the commission's Internet
163	163	website a Medicaid medical policy manual. The manual must:
164	164	(1) be updated monthly, as necessary;
165	165	(2) primarily address the managed care delivery model
166	166	for Medicaid benefits;
167	167	(3) include a description of each service covered
168	168	under Medicaid, including the scope, duration, and amount of
169	169	coverage; and
170	170	(4) direct Medicaid providers to the Medicaid managed
171	171	care manual that applies to the provider for specific prior
172	172	authorization and billing policies.
173	173	(b) The commission shall publish the Medicaid medical
174	174	policy manual not later than January 1, 2020. Beginning on that
175	175	date, the commission may not use any prior Medicaid procedures
176	176	manual for providers. This subsection expires September 1, 2021.
177	177	Sec. 531.0602. MEDICALLY DEPENDENT CHILDREN (MDCP) WAIVER
178	178	PROGRAM REASSESSMENTS. To the extent allowed by federal law, the
179	179	commission shall require that a child participating in the
180	180	medically dependent children (MDCP) waiver program be reassessed to
181	181	determine whether the child meets the level of care criteria for
182	182	medical necessity for nursing facility care only if the child has a
183	183	significant change in function that may affect the medical
184	184	necessity for that level of care instead of requiring that the
185	185	reassessment be made annually.
186	186	SECTION 7. Section 531.072(c), Government Code, is amended
187	187	to read as follows:
188	188	(c) In making a decision regarding the placement of a drug
189	189	on each of the preferred drug lists, the commission shall consider:
190	190	(1) the recommendations of the Drug Utilization Review
191	191	Board under Section 531.0736;
192	192	(2) the clinical efficacy of the drug;
193	193	(3) the price of competing drugs after deducting any
194	194	federal and state rebate amounts; [and]
195	195	(4) the impact on recipient health outcomes and
196	196	continuity of care; and
197	197	(5) program benefit offerings solely or in conjunction
198	198	with rebates and other pricing information.
199	199	SECTION 8. Section 531.0736(c), Government Code, is amended
200	200	to read as follows:
201	201	(c) The executive commissioner shall determine the
202	202	composition of the board, which must:
203	203	(1) comply with applicable federal law, including 42
204	204	C.F.R. Section 456.716;
205	205	(2) include five [two] representatives of managed care
206	206	organizations to represent each managed care product [as nonvoting
207	207	members], at least one of whom must be a physician and one of whom
208	208	must be a pharmacist;
209	209	(3) include at least 17 physicians and pharmacists
210	210	who:
211	211	(A) provide services across the entire
212	212	population of Medicaid recipients and represent different
213	213	specialties, including at least one of each of the following types
214	214	of physicians:
215	215	(i) a pediatrician;
216	216	(ii) a primary care physician;
217	217	(iii) an obstetrician and gynecologist;
218	218	(iv) a child and adolescent psychiatrist;
219	219	and
220	220	(v) an adult psychiatrist; and
221	221	(B) have experience in either developing or
222	222	practicing under a preferred drug list; and
223	223	(4) include a consumer advocate who represents
224	224	Medicaid recipients.
225	225	SECTION 9. Subchapter A, Chapter 533, Government Code, is
226	226	amended by adding Sections 533.00284 and 533.00285 to read as
227	227	follows:
228	228	Sec. 533.00284. ADOPTION OF PRIOR AUTHORIZATION PRACTICE
229	229	GUIDELINES; ACCESSIBILITY. (a) In developing medical policies and
230	230	standards for making medical necessity determinations for prior
231	231	authorizations, each Medicaid managed care organization shall:
232	232	(1) in consultation with health care providers in the
233	233	organization's provider network, adopt practice guidelines that:
234	234	(A) are based on valid and reliable clinical
235	235	evidence or the medical consensus among health care professionals
236	236	who practice in the applicable field; and
237	237	(B) take into consideration the health care needs
238	238	of the recipients enrolled in a managed care plan offered by the
239	239	organization; and
240	240	(2) develop a written process describing the method
241	241	for periodically reviewing and amending utilization management
242	242	clinical review criteria.
243	243	(b) A Medicaid managed care organization shall annually
244	244	review and, as necessary, update the practice guidelines adopted
245	245	under Subsection (a)(1).
246	246	(c) The executive commissioner by rule shall require each
247	247	Medicaid managed care organization or other entity responsible for
248	248	authorizing coverage for health care services under Medicaid to
249	249	ensure that:
250	250	(1) coverage criteria and prior authorization
251	251	requirements are:
252	252	(A) made available to recipients and providers on
253	253	the organization's or entity's Internet website; and
254	254	(B) communicated in a clear, concise, and easily
255	255	understandable manner;
256	256	(2) any necessary or supporting documents needed to
257	257	obtain prior authorization are made available on a web page of the
258	258	organization's or entity's Internet website accessible through a
259	259	clearly marked link to the web page; and
260	260	(3) the process for contacting the organization or
261	261	entity for clarification or assistance in obtaining prior
262	262	authorization is not arduous or overly burdensome to a recipient or
263	263	provider.
264	264	Sec. 533.00285. PRIOR AUTHORIZATION PROCEDURES. In
265	265	addition to the requirements of Section 533.005, a contract between
266	266	a Medicaid managed care organization and the commission described
267	267	by that section must include:
268	268	(1) time frames for the prior authorization of health
269	269	care services that enable Medicaid providers to:
270	270	(A) deliver those services in a timely manner;
271	271	and
272	272	(B) request a peer review regarding the prior
273	273	authorization before the organization makes a final decision on the
274	274	prior authorization; and
275	275	(2) a requirement that the organization:
276	276	(A) has appropriate personnel reasonably
277	277	available at a toll-free telephone number to receive prior
278	278	authorization requests between 6 a.m. and 6 p.m. central time
279	279	Monday through Friday on each day that is not a legal holiday and
280	280	between 9 a.m. and noon central time on Saturday and Sunday; and
281	281	(B) has a telephone system capable of receiving
282	282	and recording incoming telephone calls for prior authorization
283	283	requests after 6 p.m. central time Monday through Friday and after
284	284	noon central time on Saturday and Sunday.
285	285	SECTION 10. Section 533.0071, Government Code, is amended
286	286	to read as follows:
287	287	Sec. 533.0071. ADMINISTRATION OF CONTRACTS. The commission
288	288	shall make every effort to improve the administration of contracts
289	289	with Medicaid managed care organizations. To improve the
290	290	administration of these contracts, the commission shall:
291	291	(1) ensure that the commission has appropriate
292	292	expertise and qualified staff to effectively manage contracts with
293	293	managed care organizations under the Medicaid managed care program;
294	294	(2) evaluate options for Medicaid payment recovery
295	295	from managed care organizations if the enrollee dies or is
296	296	incarcerated or if an enrollee is enrolled in more than one state
297	297	program or is covered by another liable third party insurer;
298	298	(3) maximize Medicaid payment recovery options by
299	299	contracting with private vendors to assist in the recovery of
300	300	capitation payments, payments from other liable third parties, and
301	301	other payments made to managed care organizations with respect to
302	302	enrollees who leave the managed care program;
303	303	(4) decrease the administrative burdens of managed
304	304	care for the state, the managed care organizations, and the
305	305	providers under managed care networks to the extent that those
306	306	changes are compatible with state law and existing Medicaid managed
307	307	care contracts, including decreasing those burdens by:
308	308	(A) where possible, decreasing the duplication
309	309	of administrative reporting and process requirements for the
310	310	managed care organizations and providers, such as requirements for
311	311	the submission of encounter data, quality reports, historically
312	312	underutilized business reports, and claims payment summary
313	313	reports;
314	314	(B) allowing managed care organizations to
315	315	provide updated address information directly to the commission for
316	316	correction in the state system;
317	317	(C) promoting consistency and uniformity among
318	318	managed care organization policies, including policies relating to
319	319	the preauthorization process, lengths of hospital stays, filing
320	320	deadlines, levels of care, and case management services;
321	321	(D) reviewing the appropriateness of primary
322	322	care case management requirements in the admission and clinical
323	323	criteria process, such as requirements relating to including a
324	324	separate cover sheet for all communications, submitting
325	325	handwritten communications instead of electronic or typed review
326	326	processes, and admitting patients listed on separate
327	327	notifications; and
328	328	(E) providing a portal through which providers in
329	329	any managed care organization's provider network may submit acute
330	330	care services and long-term services and supports claims; and
331	331	(5) ensure that the commission's fair hearing process
332	332	and [reserve the right to amend] the managed care organization's
333	333	process for resolving recipient and provider appeals of denials
334	334	based on medical necessity [to] include an independent review
335	335	process established by the commission for final determination of
336	336	these disputes.
337	337	SECTION 11. Section 533.0076(c), Government Code, is
338	338	amended to read as follows:
339	339	(c) The commission shall allow a recipient who is enrolled
340	340	in a managed care plan under this chapter to disenroll from that
341	341	plan and enroll in another managed care plan[:
342	342	[(1)] at any time for cause in accordance with federal
343	343	law[; and
344	344	[(2) once for any reason after the periods described
345	345	by Subsections (a) and (b)].
346	346	SECTION 12. Subchapter A, Chapter 533, Government Code, is
347	347	amended by adding Sections 533.038 and 533.039 to read as follows:
348	348	Sec. 533.038. COORDINATION OF BENEFITS. (a) In this
349	349	section, "Medicaid wrap-around benefit" means a Medicaid-covered
350	350	service, including a pharmacy or medical benefit, that is provided
351	351	to a recipient with both Medicaid and primary health benefit plan
352	352	coverage when the recipient has exceeded the primary health benefit
353	353	plan coverage limit or when the service is not covered by the
354	354	primary health benefit plan issuer.
355	355	(b) The commission, in coordination with Medicaid managed
356	356	care organizations, shall develop and adopt a clear policy for a
357	357	Medicaid managed care organization to ensure the coordination and
358	358	timely delivery of Medicaid wrap-around benefits for recipients
359	359	with both primary health benefit plan coverage and Medicaid
360	360	coverage.
361	361	(c) To further assist with the coordination of benefits, the
362	362	commission, in coordination with Medicaid managed care
363	363	organizations, shall develop and maintain a list of services that
364	364	are not traditionally covered by primary health benefit plan
365	365	coverage that a Medicaid managed care organization may approve
366	366	without having to coordinate with the primary health benefit plan
367	367	issuer and that can be resolved through third-party liability
368	368	resolution processes. The commission shall review and update the
369	369	list quarterly.
370	370	(d) A Medicaid managed care organization that in good faith
371	371	and following commission policies provides coverage for a Medicaid
372	372	wrap-around benefit shall include the cost of providing the benefit
373	373	in the organization's financial reports. The commission shall
374	374	include the reported costs in computing capitation rates for the
375	375	managed care organization.
376	376	(e) If the commission determines that a recipient's primary
377	377	health benefit plan issuer should have been the primary payor of a
378	378	claim, the Medicaid managed care organization that paid the claim
379	379	shall work with the commission on the recovery process and make
380	380	every attempt to reduce health care provider and recipient
381	381	abrasion.
382	382	(f) The executive commissioner may seek a waiver from the
383	383	federal government as needed to:
384	384	(1) address federal policies related to coordination
385	385	of benefits and third-party liability; and
386	386	(2) maximize federal financial participation for
387	387	recipients with both primary health benefit plan coverage and
388	388	Medicaid coverage.
389	389	(g) Notwithstanding Sections 531.073 and 533.005(a)(23) or
390	390	any other law, the commission shall ensure that a prescription drug
391	391	that is covered under the Medicaid vendor drug program or other
392	392	applicable formulary and is prescribed to a recipient with primary
393	393	health benefit plan coverage is not subject to any prior
394	394	authorization requirement if the primary health benefit plan issuer
395	395	will pay at least $0.01 on the prescription drug claim. If the
396	396	primary insurer will pay nothing on a prescription drug claim, the
397	397	prescription drug is subject to any applicable Medicaid clinical or
398	398	nonpreferred prior authorization requirement.
399	399	(h) The commission shall ensure that the daily Medicaid
400	400	managed care eligibility files indicate whether a recipient has
401	401	primary health benefit plan coverage or health insurance premium
402	402	payment coverage. For a recipient who has that coverage, the files
403	403	must include the following up-to-date, accurate information
404	404	related to primary health benefit plan coverage:
405	405	(1) the health benefit plan issuer's name and address
406	406	and the recipient's policy number;
407	407	(2) the primary health benefit plan coverage start and
408	408	end dates;
409	409	(3) the primary health benefit plan coverage benefits,
410	410	limits, copayment, and coinsurance information; and
411	411	(4) any additional information that would be useful to
412	412	ensure the coordination of benefits.
413	413	(i) The commission shall develop and implement processes
414	414	and policies to allow a health care provider who is primarily
415	415	providing services to a recipient through primary health benefit
416	416	plan coverage to receive Medicaid reimbursement for services
417	417	ordered, referred, prescribed, or delivered, regardless of whether
418	418	the provider is enrolled as a Medicaid provider. The commission
419	419	shall allow a provider who is not enrolled as a Medicaid provider to
420	420	order, refer, prescribe, or deliver services to a recipient based
421	421	on the provider's national provider identifier number and may not
422	422	require an additional state provider identifier number to receive
423	423	reimbursement for the services. The commission may seek a waiver of
424	424	Medicaid provider enrollment requirements for providers of
425	425	recipients with primary health benefit plan coverage to implement
426	426	this subsection.
427	427	(j) The commission shall develop and implement a clear and
428	428	easy process to allow a recipient with complex medical needs who has
429	429	established a relationship with a specialty provider in an area
430	430	outside of the recipient's Medicaid managed care organization's
431	431	service delivery area to continue receiving care from that provider
432	432	if the provider will enter into a single-case agreement with the
433	433	Medicaid managed care organization. A single-case agreement with a
434	434	provider outside of the organization's service delivery area in
435	435	accordance with this subsection is not considered an
436	436	out-of-network agreement and must be included in the organization's
437	437	network adequacy determination.
438	438	(k) The commission shall develop and implement processes
439	439	to:
440	440	(1) reimburse a recipient with primary health benefit
441	441	plan coverage who pays a copayment, coinsurance, or other
442	442	cost-sharing amount out of pocket because the primary health
443	443	benefit plan issuer refuses to enroll in Medicaid, enter into a
444	444	single-case agreement, or bill the recipient's Medicaid managed
445	445	care organization; and
446	446	(2) capture encounter data for the Medicaid
447	447	wrap-around benefits provided by the Medicaid managed care
448	448	organization under this subsection.
449	449	Sec. 533.039. COORDINATION OF BENEFITS FOR PERSONS DUALLY
450	450	ELIGIBLE UNDER MEDICAID AND MEDICARE. (a) In this section,
451	451	"Medicaid wrap-around benefit" means a Medicaid-covered service,
452	452	including a pharmacy or medical benefit, that is provided to a
453	453	recipient with both Medicaid and Medicare coverage when the
454	454	recipient has exceeded the Medicare coverage limit or when the
455	455	service is not covered by Medicare.
456	456	(b) The executive commissioner, in consultation with
457	457	Medicaid managed care organizations, by rule shall develop and
458	458	implement a policy that ensures the coordinated and timely delivery
459	459	of Medicaid wrap-around benefits. The policy must:
460	460	(1) include a benefits equivalency crosswalk or other
461	461	method for mapping equivalent benefits under Medicaid and Medicare;
462	462	and
463	463	(2) in a manner that is consistent with federal and
464	464	state law, require sharing of information concerning third-party
465	465	sources of coverage and reimbursement.
466	466	SECTION 13. (a) Not later than December 31, 2019, the
467	467	executive commissioner of the Health and Human Services Commission
468	468	shall establish the advisory committee as required by Section
469	469	531.02112(b), Government Code, as added by this Act.
470	470	(b) The procedure for implementing changes to payment rates
471	471	required by Section 531.02112, Government Code, as added by this
472	472	Act, applies only to a change to a fee, charge, or rate that takes
473	473	effect on or after January 1, 2021.
474	474	SECTION 14. Section 531.0602, Government Code, as added by
475	475	this Act, applies only to a reassessment of a child's eligibility
476	476	for the medically dependent children (MDCP) waiver program made on
477	477	or after December 1, 2019.
478	478	SECTION 15. As soon as practicable after the effective date
479	479	of this Act, the executive commissioner of the Health and Human
480	480	Services Commission shall adopt rules necessary to implement the
481	481	changes in law made by this Act.
482	482	SECTION 16. (a) Section 533.00285, Government Code, as
483	483	added by this Act, applies only to a contract between the Health and
484	484	Human Services Commission and a Medicaid managed care organization
485	485	under Chapter 533, Government Code, that is entered into or renewed
486	486	on or after the effective date of this Act.
487	487	(b) The Health and Human Services Commission shall seek to
488	488	amend contracts entered into with Medicaid managed care
489	489	organizations under Chapter 533, Government Code, before the
490	490	effective date of this Act to include the provisions required by
491	491	Section 533.00285, Government Code, as added by this Act.
492	492	SECTION 17. If before implementing any provision of this
493	493	Act a state agency determines that a waiver or authorization from a
494	494	federal agency is necessary for implementation of that provision,
495	495	the agency affected by the provision shall request the waiver or
496	496	authorization and may delay implementing that provision until the
497	497	waiver or authorization is granted.
498	498	SECTION 18. This Act takes effect September 1, 2019.