89R1441 KKR-F
By: Hughes S.B. No. 1334
A BILL TO BE ENTITLED
AN ACT
relating to the approval, selection, and use of an alternative
electronic visit verification system under Medicaid.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 532.0257, Government Code, as effective
April 1, 2025, is amended to read as follows:
Sec. 532.0257. HEALTH CARE PROVIDER COMPLIANCE. A health
care provider that provides to recipients personal care services,
attendant care services, or other services the commission
identifies shall:
(1) use the electronic visit verification system or an
alternative [a proprietary] system the commission approves
[allows] as provided by Section 532.0258 to document the provision
of those services;
(2) comply with all documentation requirements the
commission establishes;
(3) comply with federal and state laws regarding
confidentiality of recipients' information;
(4) ensure that the commission or the Medicaid managed
care organization with which a claim for reimbursement for a
service is filed may review electronic visit verification system
documentation related to the claim or obtain a copy of that
documentation at no charge to the commission or the organization;
and
(5) at any time, allow the commission or a Medicaid
managed care organization with which a health care provider
contracts to provide health care services to recipients enrolled in
the organization's managed care plan to have direct, on-site access
to the electronic visit verification system in use by the health
care provider.
SECTION 2. Section 532.0258, Government Code, as effective
April 1, 2025, is amended to read as follows:
Sec. 532.0258. HEALTH CARE PROVIDER: USE OF ALTERNATIVE
[PROPRIETARY] SYSTEM. (a) The commission may approve an
alternative [recognize a health care provider's proprietary]
electronic visit verification system, including a system [whether]
purchased or developed by a health care [the] provider, as
complying with this subchapter and allow a [the] health care
provider to use the [that] system [for a period the commission
determines] if the commission determines that the system[:
[(1) complies with all necessary data submission,
exchange, and reporting requirements established under this
subchapter; and
[(2)] meets all [other] standards and requirements,
including electronic visit verification business rules,
established under this subchapter.
(b) To the extent allowed by federal law [If feasible], the
executive commissioner shall ensure the vendor of an approved
alternative electronic visit verification system selected by a
health care provider under this section is reimbursed for any
electronic visit verification visit transaction costs if the [use
of the provider's proprietary electronic visit verification]
system maintains the minimum standards and requirements the
commission establishes [recognizes].
(b-1) The commission shall:
(1) allow a health care provider to select, on a form
the provider signs and in the manner the commission prescribes, any
alternative electronic visit verification system the commission
approves under this section;
(2) timely approve a provider's signed selection of
the alternative system under Subdivision (1); and
(3) allow the provider a period of 90 days to implement
the selected alternative system.
(b-2) The commission shall maintain a current list of
alternative electronic visit verification systems the commission
has approved. The list must:
(1) include:
(A) each alternative system the commission has
approved under this section;
(B) contact information for the person from whom
the alternative system may be obtained; and
(C) an electronic link to an alternative
electronic visit verification system selection form for use by a
health care provider in making a selection; and
(2) be prominently posted on the Internet website of
the commission or the commission's designee in the same location
that other information on alternative electronic visit
verification systems under this subchapter is posted.
(b-3) The commission may not limit the number of alternative
electronic visit verification systems approved under this section.
(c) For purposes of facilitating the use of alternative
[proprietary] electronic visit verification systems by health care
providers and in consultation with industry stakeholders and the
work group established under Section 532.0259, the commission or
the executive commissioner, as appropriate, shall:
(1) develop an open model system that mitigates the
administrative burdens providers required to use electronic visit
verification identify;
(2) allow providers to use emerging technologies,
including Internet-based, mobile telephone-based, and global
positioning-based technologies, in the alternative [providers'
proprietary] electronic visit verification systems approved under
this section;
(2-a) allow providers to choose a system that best meets
the providers' needs, including, if the commission changes the
vendor for the electronic visit verification system under Section
532.0253, continuing to use the previous vendor's system if the
system meets commission standards and requirements; and
(3) adopt rules governing:
(A) data submission;
(B) [and provider] reimbursement of electronic
visit verification visit transaction costs; and
(C) an efficient alternative electronic visit
verification system approval process.
SECTION 3. As soon as possible after the effective date of
this Act, the executive commissioner of the Health and Human
Services Commission shall adopt rules necessary to implement
Section 532.0258, Government Code, as amended by this Act.
SECTION 4. 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 5. This Act takes effect September 1, 2025.