87R9793 JG-D
By: Raymond H.B. No. 4194
A BILL TO BE ENTITLED
AN ACT
relating to the provision of home health care services under the
Medicaid managed care program.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Chapter 533, Government Code, is amended by
adding Subchapter C to read as follows:
SUBCHAPTER C. HOME HEALTH CARE SERVICES
Sec. 533.071. HOME HEALTH CARE PROVIDER RATINGS AND
STANDARDS. (a) The commission in collaboration with each managed
care organization contracted under this chapter shall develop and
implement a home health care provider rating system to rate
providers and measure quality standards for the delivery of
long-term services and supports.
(b) The commission shall require not less than 85 percent of
home health care services to be processed using the electronic
visit verification system.
(c) The commission shall audit home health care providers
periodically using the rating system under Subsection (a) and to
ensure compliance with Subsection (b).
Sec. 533.072. HOME HEALTH PATIENT TRANSFER AND
SOLICITATION. (a) The commission shall require each managed care
organization to implement a 15-day waiting period before a home
health care attendant or employee or any recipient receiving
services from the attendant or employee may transfer between home
health care providers.
(b) A recipient may not transfer between home health care
providers unless the recipient provides a legitimate reason for the
transfer and the provider from which the recipient is requesting a
transfer holds a poor rating as determined by the rating system
under Section 533.071(a).
(c) The commission shall evaluate policies and rules in
place to prevent the solicitation of home health care attendants or
employees or recipients receiving services from those attendants or
employees and shall seek to strengthen those policies and rules.
Sec. 533.073. PAYMENTS FOR HOME HEALTH CARE CLAIMS. The
commission shall require each managed care organization contracted
under this chapter to pay claims for home health care services not
later than the 10th day after the date on which the organization
receives the claim.
Sec. 533.074. HOME HEALTH CARE ATTENDANT REQUIREMENTS. (a)
The commission shall develop minimum training requirements for home
health care attendants providing services under Medicaid.
(b) The commission shall develop a statewide no-hire list
for home health care attendants and include on the list the unique
identifier of an attendant who fails to meet the minimum training
requirements under Subsection (a). The no-hire list must be
accessible to managed care organizations contracted under this
chapter and home health care providers.
SECTION 2. If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
SECTION 3. This Act takes effect September 1, 2021.