By: Perry S.R. No. 846
SENATE RESOLUTION
BE IT RESOLVED by the Senate of the State of Texas, 86th
Legislature, 2019, That Senate Rule 12.03 be suspended in part as
provided by Senate Rule 12.08 to enable the conference committee
appointed to resolve the differences on Senate Bill 1207 (the
operation and administration of Medicaid, including the Medicaid
managed care program and the medically dependent children (MDCP)
waiver program) to consider and take action on the following
matters:
(1) Senate Rule 12.03(4) is suspended to permit the
committee to add text on a matter not included in either the house
or senate version of the bill by adding the following SECTION to
the bill:
SECTION 2. Section 531.024, Government Code, is amended
by amending Subsection (b) and adding Subsection (c) to read as
follows:
(b) The rules promulgated under Subsection (a)(7) must
provide due process to an applicant for Medicaid services and to
a Medicaid recipient who seeks a Medicaid service, including a
service that requires prior authorization. The rules must
provide the protections for applicants and recipients required
by 42 C.F.R. Part 431, Subpart E, including requiring that:
(1) the written notice to an individual of the
individual's right to a hearing must:
(A) contain an explanation of the
circumstances under which Medicaid is continued if a hearing is
requested; and
(B) be delivered by mail, and postmarked
[mailed] at least 10 business days, before the date the
individual's Medicaid eligibility or service is scheduled to be
terminated, suspended, or reduced, except as provided by 42
C.F.R. Section 431.213 or 431.214; and
(2) if a hearing is requested before the date a
Medicaid recipient's service, including a service that requires
prior authorization, is scheduled to be terminated, suspended,
or reduced, the agency may not take that proposed action before a
decision is rendered after the hearing unless:
(A) it is determined at the hearing that the
sole issue is one of federal or state law or policy; and
(B) the agency promptly informs the recipient
in writing that services are to be terminated, suspended, or
reduced pending the hearing decision.
(c) The commission shall develop a process to address a
situation in which:
(1) an individual does not receive adequate notice
as required by Subsection (b)(1); or
(2) the notice required by Subsection (b)(1) is
delivered without a postmark.
Explanation: This addition is necessary to change the
requirements for notice of a right to a hearing for an applicant
for Medicaid services and a Medicaid recipient.
(2) Senate Rule 12.03(4) is suspended to permit the
committee to add text on a matter not included in either the house
or senate version of the bill by adding the following text to
SECTION 3 of the bill:
(a) To the extent of any conflict, Section 531.024162,
Government Code, as added by this section, prevails over any
provision of another Act of the 86th Legislature, Regular
Session, 2019, relating to notice requirements regarding
Medicaid coverage or prior authorization denials or incomplete
requests, that becomes law.
Explanation: This addition is necessary to provide that
the amendment adding Section 531.024162, Government Code,
prevails over other similar amendments made by the 86th
Legislature.