| 1 | 1 | | 89R8398 SCF-D |
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| 2 | 2 | | By: Blanco S.B. No. 1753 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | |
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| 6 | 6 | | |
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| 7 | 7 | | A BILL TO BE ENTITLED |
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| 8 | 8 | | AN ACT |
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| 9 | 9 | | relating to requiring contracts with Medicaid managed care |
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| 10 | 10 | | organizations to permit the organizations to offer certain mental |
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| 11 | 11 | | health or substance use services or food and nutrition assistance |
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| 12 | 12 | | services in lieu of other state Medicaid plan services. |
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| 13 | 13 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 14 | 14 | | SECTION 1. Section 540.0272, Government Code, as effective |
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| 15 | 15 | | April 1, 2025, is amended to read as follows: |
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| 16 | 16 | | Sec. 540.0272. CERTAIN SERVICES PERMITTED IN LIEU OF STATE |
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| 17 | 17 | | MEDICAID PLAN SERVICES [OTHER MENTAL HEALTH OR SUBSTANCE USE |
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| 18 | 18 | | DISORDER SERVICES]; ANNUAL REPORT. A contract to which this |
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| 19 | 19 | | subchapter applies must contain language permitting the |
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| 20 | 20 | | contracting Medicaid managed care organization to offer recipients |
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| 21 | 21 | | enrolled in the organization's managed care plan medically |
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| 22 | 22 | | appropriate, cost-effective, evidence-based mental health or |
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| 23 | 23 | | substance use services or food and nutrition assistance services |
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| 24 | 24 | | from a list of services approved by the state Medicaid managed care |
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| 25 | 25 | | advisory committee and included in the contract as services the |
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| 26 | 26 | | organization may provide recipients in lieu of [mental health or |
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| 27 | 27 | | substance use disorder] services specified in the state Medicaid |
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| 28 | 28 | | plan. A recipient is not required to use a service from the list |
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| 29 | 29 | | included in the contract in lieu of a [another mental health or |
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| 30 | 30 | | substance use disorder] service specified in the state Medicaid |
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| 31 | 31 | | plan. The commission shall: |
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| 32 | 32 | | (1) prepare and submit to the legislature an annual |
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| 33 | 33 | | report on the number of times during the preceding year a service |
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| 34 | 34 | | from the list included in the contract is used; and |
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| 35 | 35 | | (2) consider the actual cost and use of any services |
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| 36 | 36 | | from the list included in the contract that are offered by a |
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| 37 | 37 | | Medicaid managed care organization when setting the capitation |
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| 38 | 38 | | rates for that organization under the contract. |
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| 39 | 39 | | SECTION 2. The changes in law made by this Act apply to a |
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| 40 | 40 | | contract entered into or renewed on or after the effective date of |
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| 41 | 41 | | this Act. A contract entered into or renewed before that date is |
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| 42 | 42 | | governed by the law in effect on the date the contract was entered |
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| 43 | 43 | | into or renewed, and that law is continued in effect for that |
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| 44 | 44 | | purpose. |
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| 45 | 45 | | SECTION 3. If before implementing any provision of this Act |
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| 46 | 46 | | a state agency determines that a waiver or authorization from a |
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| 47 | 47 | | federal agency is necessary for implementation of that provision, |
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| 48 | 48 | | the agency affected by the provision shall request the waiver or |
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| 49 | 49 | | authorization and may delay implementing that provision until the |
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| 50 | 50 | | waiver or authorization is granted. |
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| 51 | 51 | | SECTION 4. This Act takes effect September 1, 2025. |
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