TX
Texas Senate Bill SB2450

Texas 2025 - 89th Regular

Texas Senate Bill SB2450

Voted on by Senate
 
Out of House Committee
 
Voted on by House
 
Governor Action
 
Bill Becomes Law
 

Caption

Relating to the participation and reimbursement of and requirements affecting certain providers, including providers of eye health care and vision care services, under Medicaid.

Impact

One of the key impacts of SB2450 is the mandate for Medicaid managed care organizations to offer reimbursement to eye health care service providers at rates that meet or exceed the established Medicaid fee-for-service rates. This stipulation is significant as it may improve the financial viability of eye care providers and ensure better service delivery to Medicaid recipients. The bill also mandates certain reforms regarding provider disenrollment during the revalidation period, requiring prior notice and allowing providers to rectify any deficiencies, which is aimed at reducing unnecessary disenrollments.

Summary

Senate Bill 2450 pertains to the participation and reimbursement requirements affecting certain providers involved in eye health care and vision care services under Medicaid. The bill aims to streamline the Medicaid provider enrollment process by establishing dedicated support for providers to navigate administrative barriers and ensuring they can effectively participate in the Medicaid system. This includes requiring the Health and Human Services Commission to develop processes to handle complaints and feedback from providers to enhance the enrollment and credentialing experience.

Contention

During discussions, there may be concerns regarding the administrative burden that the implementation of these measures will place on the Health and Human Services Commission as well as on the insurance and managed care entities involved in Medicaid. Critics might argue that while the bill sets positive goals for provider support and service accessibility, it could complicate existing processes if not properly implemented. Furthermore, oversight about the effectiveness of the support team for providers and its timeliness may also be points of tension among stakeholders in the legislative discussions.

Texas Constitutional Statutes Affected

Government Code

  • Chapter 532. Medicaid Administration And Operation In General
    • Section: New Section
  • Chapter 540. Medicaid Managed Care Program
    • Section: New Section

Insurance Code

  • Chapter 1451. Access To Certain Practitioners And Facilities
    • Section: New Section

Companion Bills

TX HB5512

Identical Relating to the participation and reimbursement of and requirements affecting certain providers, including providers of eye health care and vision care services, under Medicaid.

Previously Filed As

TX SB1239

Relating to reimbursement rates for eye health care services providers participating in the Medicaid managed care program.

TX HB3778

Relating to reimbursement rates for eye health care services providers participating in the Medicaid managed care program.

TX HB4611

Relating to the nonsubstantive revision of the health and human services laws governing the Health and Human Services Commission, Medicaid, and other social services.

TX HB1293

Relating to the reimbursement of prescription drugs under Medicaid and the child health plan program.

TX SB1629

Relating to the regulation of certain nursing facilities, including licensing requirements and Medicaid participation requirements.

TX HB3916

Relating to the reimbursement of certain durable medical equipment providers participating in the Medicaid managed care program.

TX SB1915

Relating to the reimbursement of certain durable medical equipment providers participating in the Medicaid managed care program.

TX HB3725

Relating to Medicaid coverage and reimbursement for doula services and reports on the provision of those services.

TX HB3394

Relating to Medicaid coverage and reimbursement for doula services and reports on the provision of those services.

TX HB652

Relating to the development and implementation of the Live Well Texas program and the expansion of Medicaid eligibility to provide health benefit coverage to certain individuals; imposing penalties.

Similar Bills

TX HB5512

Relating to the participation and reimbursement of and requirements affecting certain providers, including providers of eye health care and vision care services, under Medicaid.

TX SB2388

Relating to managed care contracts, including the procurement of managed care contracts, under Medicaid and the child health plan program.

TX HB2453

Relating to the operation and administration of Medicaid, including the Medicaid managed care program.

TX SB1139

Relating to the operation and administration of Medicaid, including the Medicaid managed care program.

TX HB4459

Relating to the provision of certain services under the Medicaid managed care program to recipients who are victims of family violence.

TX SB2548

Relating to awarding contracts to managed care organizations under Medicaid and the child health plan program.

TX HB3982

Relating to the Medicaid program, including the administration and operation of the Medicaid managed care program.

TX SB760

Relating to access and assignment requirements for, support and information regarding, and investigations of certain providers of health care and long-term services.