87R12392 BDP-F
By: Buckingham S.B. No. 1403
A BILL TO BE ENTITLED
AN ACT
relating to the award of health plan provider contracts under the
Medicaid managed care program.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 533.004(a), Government Code, is amended
to read as follows:
(a) In providing health care services through Medicaid
managed care to recipients in a health care service region, the
commission shall contract with a managed care organization in that
region that is licensed under Chapter 843, Insurance Code, if
subject to that chapter, to provide health care in that region and
that is:
(1) wholly owned and operated by a hospital district
in that region;
(2) created by a nonprofit corporation that:
(A) has a contract, agreement, or other
arrangement with a hospital district in that region or with a
municipality in that region that owns a hospital licensed under
Chapter 241, Health and Safety Code, and has an obligation to
provide health care to indigent patients; and
(B) under the contract, agreement, or other
arrangement, assumes the obligation to provide health care to
indigent patients and leases, manages, or operates a hospital
facility owned by the hospital district or municipality; [or]
(3) created by a nonprofit corporation that has a
contract, agreement, or other arrangement with a hospital district
in that region under which the nonprofit corporation acts as an
agent of the district and assumes the district's obligation to
arrange for services under the Medicaid expansion for children as
authorized by Chapter 444, Acts of the 74th Legislature, Regular
Session, 1995; or
(4) a provider-sponsored health organization
affiliated with two trauma facilities designated as level I trauma
facilities by the Department of State Health Services under Section
773.115, Health and Safety Code, provided the commission does not
have an existing contract with a managed care organization under
Subdivision (1).
SECTION 2. The changes in law made by this Act apply only to
the award of a contract by the Health and Human Services Commission
on or after the effective date of this Act.
SECTION 3. 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 4. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2021.