| 1 | 1 | | 87R12392 BDP-F |
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| 2 | 2 | | By: Buckingham S.B. No. 1403 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to the award of health plan provider contracts under the |
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| 8 | 8 | | Medicaid managed care program. |
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| 9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 10 | 10 | | SECTION 1. Section 533.004(a), Government Code, is amended |
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| 11 | 11 | | to read as follows: |
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| 12 | 12 | | (a) In providing health care services through Medicaid |
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| 13 | 13 | | managed care to recipients in a health care service region, the |
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| 14 | 14 | | commission shall contract with a managed care organization in that |
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| 15 | 15 | | region that is licensed under Chapter 843, Insurance Code, if |
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| 16 | 16 | | subject to that chapter, to provide health care in that region and |
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| 17 | 17 | | that is: |
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| 18 | 18 | | (1) wholly owned and operated by a hospital district |
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| 19 | 19 | | in that region; |
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| 20 | 20 | | (2) created by a nonprofit corporation that: |
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| 21 | 21 | | (A) has a contract, agreement, or other |
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| 22 | 22 | | arrangement with a hospital district in that region or with a |
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| 23 | 23 | | municipality in that region that owns a hospital licensed under |
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| 24 | 24 | | Chapter 241, Health and Safety Code, and has an obligation to |
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| 25 | 25 | | provide health care to indigent patients; and |
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| 26 | 26 | | (B) under the contract, agreement, or other |
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| 27 | 27 | | arrangement, assumes the obligation to provide health care to |
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| 28 | 28 | | indigent patients and leases, manages, or operates a hospital |
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| 29 | 29 | | facility owned by the hospital district or municipality; [or] |
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| 30 | 30 | | (3) created by a nonprofit corporation that has a |
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| 31 | 31 | | contract, agreement, or other arrangement with a hospital district |
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| 32 | 32 | | in that region under which the nonprofit corporation acts as an |
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| 33 | 33 | | agent of the district and assumes the district's obligation to |
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| 34 | 34 | | arrange for services under the Medicaid expansion for children as |
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| 35 | 35 | | authorized by Chapter 444, Acts of the 74th Legislature, Regular |
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| 36 | 36 | | Session, 1995; or |
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| 37 | 37 | | (4) a provider-sponsored health organization |
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| 38 | 38 | | affiliated with two trauma facilities designated as level I trauma |
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| 39 | 39 | | facilities by the Department of State Health Services under Section |
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| 40 | 40 | | 773.115, Health and Safety Code, provided the commission does not |
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| 41 | 41 | | have an existing contract with a managed care organization under |
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| 42 | 42 | | Subdivision (1). |
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| 43 | 43 | | SECTION 2. The changes in law made by this Act apply only to |
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| 44 | 44 | | the award of a contract by the Health and Human Services Commission |
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| 45 | 45 | | on or after the effective date of this Act. |
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| 46 | 46 | | SECTION 3. If before implementing any provision of this Act |
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| 47 | 47 | | a state agency determines that a waiver or authorization from a |
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| 48 | 48 | | federal agency is necessary for implementation of that provision, |
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| 49 | 49 | | the agency affected by the provision shall request the waiver or |
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| 50 | 50 | | authorization and may delay implementing that provision until the |
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| 51 | 51 | | waiver or authorization is granted. |
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| 52 | 52 | | SECTION 4. This Act takes effect immediately if it receives |
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| 53 | 53 | | a vote of two-thirds of all the members elected to each house, as |
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| 54 | 54 | | provided by Section 39, Article III, Texas Constitution. If this |
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| 55 | 55 | | Act does not receive the vote necessary for immediate effect, this |
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| 56 | 56 | | Act takes effect September 1, 2021. |
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