| 1 | 1 | | 89R385 JG-D |
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| 2 | 2 | | By: Miles S.B. No. 374 |
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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 Medicaid coverage and reimbursement for emergency |
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| 10 | 10 | | outpatient dialysis treatment provided to certain individuals with |
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| 11 | 11 | | end stage renal disease. |
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| 12 | 12 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 13 | 13 | | SECTION 1. Subchapter B, Chapter 32, Human Resources Code, |
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| 14 | 14 | | is amended by adding Section 32.02465 to read as follows: |
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| 15 | 15 | | Sec. 32.02465. MEDICAL ASSISTANCE COVERAGE AND |
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| 16 | 16 | | REIMBURSEMENT FOR CERTAIN PERSONS REQUIRING EMERGENCY OUTPATIENT |
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| 17 | 17 | | DIALYSIS TREATMENT. (a) This section applies only to an individual |
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| 18 | 18 | | who: |
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| 19 | 19 | | (1) has end stage renal disease; and |
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| 20 | 20 | | (2) in accordance with Section 1903(v), Social |
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| 21 | 21 | | Security Act (42 U.S.C. Section 1396b(v)), is eligible for medical |
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| 22 | 22 | | assistance benefits if the benefits are necessary to treat an |
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| 23 | 23 | | emergency medical condition. |
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| 24 | 24 | | (b) For purposes of 42 C.F.R. Section 440.255, emergency |
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| 25 | 25 | | services required to treat an emergency medical condition include |
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| 26 | 26 | | outpatient dialysis treatment provided to an individual to whom |
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| 27 | 27 | | this section applies at a hospital or an end stage renal disease |
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| 28 | 28 | | facility, as defined by Section 251.001, Health and Safety Code. |
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| 29 | 29 | | (c) The commission shall ensure that medical assistance |
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| 30 | 30 | | reimbursement authorized under Section 1903(v), Social Security |
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| 31 | 31 | | Act (42 U.S.C. Section 1396b(v)), is provided for outpatient |
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| 32 | 32 | | dialysis treatment provided to an individual to whom this section |
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| 33 | 33 | | applies. |
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| 34 | 34 | | SECTION 2. If before implementing any provision of this Act |
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| 35 | 35 | | a state agency determines that a waiver or authorization from a |
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| 36 | 36 | | federal agency is necessary for implementation of that provision, |
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| 37 | 37 | | the agency affected by the provision shall request the waiver or |
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| 38 | 38 | | authorization and may delay implementing that provision until the |
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| 39 | 39 | | waiver or authorization is granted. |
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| 40 | 40 | | SECTION 3. This Act takes effect September 1, 2025. |
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