Bill Text: TX HB3191 | 2011-2012 | 82nd Legislature | Introduced
Bill Title: Relating to the inclusion of optometrists, therapeutic optometrists, and ophthalmologists in Medicaid managed care provider networks providing services in the Texas-Mexico border region and other regions of the state.
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2011-04-19 - Committee report sent to Calendars [HB3191 Detail]
Download: Texas-2011-HB3191-Introduced.html
82R13806 EES-F | ||
By: Alonzo | H.B. No. 3191 |
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relating to the inclusion of optometrists, therapeutic | ||
optometrists, and ophthalmologists in Medicaid managed care | ||
provider networks providing services in the Texas-Mexico border | ||
region and other regions of the state. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. EXPANSION OF PROVIDER NETWORKS OF MANAGED CARE | ||
ORGANIZATIONS IN TEXAS-MEXICO BORDER REGION AND OTHER AREAS OF | ||
STATE. Subchapter A, Chapter 533, Government Code, is amended by | ||
adding Section 533.0065 to read as follows: | ||
Sec. 533.0065. EYE HEALTH CARE SERVICE PROVIDERS. (a) In | ||
this section, "Texas-Mexico border region" has the meaning assigned | ||
by Section 2056.002. | ||
(b) Subject to Section 32.047, Human Resources Code, but | ||
notwithstanding any other law, the commission shall require that | ||
each managed care organization that contracts with the commission | ||
under any Medicaid managed care model or arrangement to provide | ||
health care services to recipients in a region, including a region | ||
consisting of all or part of the Texas-Mexico border region, | ||
include in the organization's provider network each optometrist, | ||
therapeutic optometrist, and ophthalmologist who: | ||
(1) agrees to comply with the terms and conditions of | ||
the organization; | ||
(2) agrees to accept the prevailing provider contract | ||
rate of the organization; | ||
(3) agrees to abide by the standards of care required | ||
by the organization; and | ||
(4) has the credentials required by the organization. | ||
SECTION 2. STUDY IN TEXAS-MEXICO BORDER REGION. (a) The | ||
Health and Human Services Commission shall conduct a study of the | ||
fiscal impact on this state of requiring each Medicaid managed care | ||
organization that contracts with the commission under any Medicaid | ||
managed care model or arrangement implemented under Chapter 533, | ||
Government Code, to include in the organization's health care | ||
provider network providing services in all or part of the | ||
Texas-Mexico border region, as defined by Section 2056.002, | ||
Government Code, each optometrist, therapeutic optometrist, and | ||
ophthalmologist who meets the requirements under Section 533.0065, | ||
Government Code, as added by this Act. | ||
(b) Not later than September 1, 2016, the Health and Human | ||
Services Commission shall submit to the legislature a written | ||
report containing the findings of the study conducted under | ||
Subsection (a) of this section and the commission's recommendations | ||
regarding the requirement addressed in the study. | ||
SECTION 3. CONTRACTS. (a) The Health and Human Services | ||
Commission shall, in a contract between the commission and a | ||
Medicaid managed care organization under Chapter 533, Government | ||
Code, that is entered into or renewed on or after the effective date | ||
of this Act, require that the managed care organization comply with | ||
Section 533.0065, Government Code, as added by this Act. | ||
(b) The Health and Human Services Commission shall seek to | ||
amend each contract entered into with a Medicaid managed care | ||
organization under Chapter 533, Government Code, before the | ||
effective date of this Act to require those managed care | ||
organizations to comply with Section 533.0065, Government Code, as | ||
added by this Act. To the extent of a conflict between Section | ||
533.0065, Government Code, as added by this Act, and a provision of | ||
a contract with a managed care organization entered into before the | ||
effective date of this Act, the contract provision prevails. | ||
SECTION 4. WAIVER. 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 5. EFFECTIVE DATE. This Act takes effect September | ||
1, 2011. |