89R8398 SCF-D
By: Blanco S.B. No. 1753
A BILL TO BE ENTITLED
AN ACT
relating to requiring contracts with Medicaid managed care
organizations to permit the organizations to offer certain mental
health or substance use services or food and nutrition assistance
services in lieu of other state Medicaid plan services.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 540.0272, Government Code, as effective
April 1, 2025, is amended to read as follows:
Sec. 540.0272. CERTAIN SERVICES PERMITTED IN LIEU OF STATE
MEDICAID PLAN SERVICES [OTHER MENTAL HEALTH OR SUBSTANCE USE
DISORDER SERVICES]; ANNUAL REPORT. A contract to which this
subchapter applies must contain language permitting the
contracting Medicaid managed care organization to offer recipients
enrolled in the organization's managed care plan medically
appropriate, cost-effective, evidence-based mental health or
substance use services or food and nutrition assistance services
from a list of services approved by the state Medicaid managed care
advisory committee and included in the contract as services the
organization may provide recipients in lieu of [mental health or
substance use disorder] services specified in the state Medicaid
plan. A recipient is not required to use a service from the list
included in the contract in lieu of a [another mental health or
substance use disorder] service specified in the state Medicaid
plan. The commission shall:
(1) prepare and submit to the legislature an annual
report on the number of times during the preceding year a service
from the list included in the contract is used; and
(2) consider the actual cost and use of any services
from the list included in the contract that are offered by a
Medicaid managed care organization when setting the capitation
rates for that organization under the contract.
SECTION 2. The changes in law made by this Act apply to a
contract entered into or renewed on or after the effective date of
this Act. A contract entered into or renewed before that date is
governed by the law in effect on the date the contract was entered
into or renewed, and that law is continued in effect for that
purpose.
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 September 1, 2025.