88R6699 MM-D
 
  By: Longoria H.B. No. 4222
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to Medicaid reimbursement rates for certain ground
  ambulance services.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 32.028, Human Resources Code, is amended
  by adding Subsection (o) to read as follows:
         (o)  The executive commissioner shall ensure that the rules
  governing the determination of medical assistance reimbursement
  rates paid to a provider for providing ground ambulance services
  are at least equal to the rates paid under Medicare for providing
  ground ambulance services originating in a rural area.
         SECTION 2.  Section 533.005, Government Code, is amended by
  adding Subsection (f) to read as follows:
         (f)  In addition to the requirements specified by Subsection
  (a), a contract described by that subsection must require a managed
  care organization to reimburse a provider who is in the
  organization's provider network and who provides ground ambulance
  services at a rate that is at least equal to the rate paid under
  Medicare for the provision of ground ambulance services originating
  in a rural area.
         SECTION 3.  (a) The Health and Human Services Commission
  shall, in a contract between the commission and a 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 533.005(f),
  Government Code, as added by this Act.
         (b)  The Health and Human Services Commission shall seek to
  amend contracts entered into with managed care organizations under
  Chapter 533, Government Code, before the effective date of this Act
  to require those managed care organizations to comply with Section
  533.005(f), Government Code, as added by this Act. To the extent of
  a conflict between Section 533.005(f), 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.  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.  This Act takes effect September 1, 2023.