Bill Text: TX HB1080 | 2019-2020 | 86th Legislature | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Relating to the regulation of the practice of physical therapy.

Spectrum: Bipartisan Bill

Status: (Introduced - Dead) 2019-04-22 - Committee report sent to Calendars [HB1080 Detail]

Download: Texas-2019-HB1080-Introduced.html

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86R6449 LED-D
By: White H.B. No. 1080

A BILL TO BE ENTITLED
AN ACT
relating to prior authorization procedures for physical therapy
services in Medicaid and the child health plan program.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter B, Chapter 531, Government Code, is
amended by adding Section 531.0755 to read as follows:
Sec. 531.0755. PRIOR AUTHORIZATION PROCEDURES FOR PHYSICAL
THERAPY SERVICES. (a) The commission shall standardize prior
authorization request procedures for physical therapy services in
Medicaid and the child health plan program by:
(1) developing a standard prior authorization request
form for use in both fee-for-service and managed care delivery
models;
(2) requiring a provider to submit a prior
authorization request to the entity serving as the state's Medicaid
claims administrator using the standard prior authorization
request form;
(3) requiring the entity serving as the state's
Medicaid claims administrator to make a determination regarding the
prior authorization; and
(4) if applicable, requiring the entity serving as the
state's Medicaid claims administrator to forward for processing the
prior authorization request and the determination to the managed
care organization with which the Medicaid recipient or child health
plan program enrollee is enrolled.
(b) A managed care organization with which a Medicaid
recipient or child health plan program enrollee is enrolled may not
require a provider or the recipient or enrollee to use any prior
authorization request procedure for physical therapy services
other than the procedure under Subsection (a).
SECTION 2. Not later than December 1, 2019, the Health and
Human Services Commission shall develop the standard prior
authorization request form required by Section 531.0755,
Government Code, as added by this Act.
SECTION 3. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2019.