Texas 2025 - 89th Regular

Texas Senate Bill SB855 Compare Versions

Version 1 (Old)

Version 2 (New)

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1	1	By: Sparks, Perry S.B. No. 855
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6	6	A BILL TO BE ENTITLED
7	7	AN ACT
8	8	relating to the authority of certain medical consenters to assume
9	9	financial responsibility for certain out-of-network medical care
10	10	provided to children in foster care.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Chapter 266, Family Code, is amended by adding
13	13	Section 266.0043 to read as follows:
14	14	Sec. 266.0043. ASSUMPTION OF FINANCIAL RESPONSIBILITY BY
15	15	MEDICAL CONSENTERS. (a) In this section:
16	16	(1) "Health care provider" means an individual who is
17	17	licensed, certified, or otherwise authorized to provide health care
18	18	services in this state. The term does not include a pharmacy.
19	19	(2) "Managed care plan" has the meaning assigned by
20	20	Section 540.0001, Government Code.
21	21	(3) "Medicaid" and "Medicaid managed care
22	22	organization" have the meanings assigned by Section 521.0001,
23	23	Government Code.
24	24	(4) "Medicaid managed care plan" means a managed care
25	25	plan offered by a Medicaid managed care organization.
26	26	(5) "Medical consenter" means a person authorized to
27	27	consent to medical care for a foster child under Section
28	28	266.004(b).
29	29	(6) "Out-of-network provider" means a health care
30	30	provider who is not included in the provider network of the Medicaid
31	31	managed care plan in which a foster child is enrolled.
32	32	(7) "Pharmacy" has the meaning assigned by Section
33	33	551.003, Occupations Code.
34	34	(b) Notwithstanding any other law, a medical consenter
35	35	other than the department may assume financial responsibility for
36	36	medical care, including behavioral health services, provided to a
37	37	foster child by an out-of-network provider engaged by the medical
38	38	consenter on behalf of the child. For purposes of this section,
39	39	assuming financial responsibility may include the medical
40	40	consenter enrolling the child in a health insurance plan.
41	41	(c) The department is not liable for the cost of medical
42	42	care described by Subsection (b), unless a court orders the
43	43	department to cover the cost of the medical care.
44	44	(d) This section may not be construed to:
45	45	(1) limit or restrict a foster child's access to
46	46	Medicaid benefits, including in-network benefits provided under
47	47	the Medicaid managed care program;
48	48	(2) change or limit the rights of parents of children
49	49	in the temporary managing conservatorship of the department; or
50	50	(3) limit a court's authority to order the department
51	51	to assume financial responsibility for the cost of services
52	52	provided to a foster child by an out-of-network provider.
53	53	(e) Not later than the 10th business day after the date
54	54	medical care for which a medical consenter assumes financial
55	55	responsibility under this section is provided, the medical
56	56	consenter shall notify, in the form and manner prescribed by the
57	57	department, the child's caseworker of the provision of that care.
58	58	The department shall ensure the child's health passport includes
59	59	records of the medical care provided under this section.
60	60	SECTION 2. Subchapter Q, Chapter 540, Government Code, is
61	61	amended by adding Section 540.0807 to read as follows:
62	62	Sec. 540.0807. ACCESS TO CARE PAID FOR BY CERTAIN MEDICAL
63	63	CONSENTERS. (a) A Medicaid managed care organization may not take
64	64	adverse action to prevent or discourage a recipient from accessing
65	65	health care and related services and benefits in accordance with
66	66	Section 266.0043, Family Code.
67	67	(b) A STAR Health program managed care contract between a
68	68	Medicaid managed care organization and the commission must require
69	69	that the organization comply with Subsection (a).
70	70	(c) This section may not be construed to confer liability on
71	71	a Medicaid managed care organization for the cost of health care and
72	72	related services and benefits described by Section 266.0043(b),
73	73	Family Code.
74	74	SECTION 3. If before implementing any provision of this Act
75	75	a state agency determines that a waiver or authorization from a
76	76	federal agency is necessary for implementation of that provision,
77	77	the agency affected by the provision shall request the waiver or
78	78	authorization and may delay implementing that provision until the
79	79	waiver or authorization is granted.
80	80	SECTION 4. This Act takes effect September 1, 2025.