86R3443 KKR-D
 
  By: Guillen H.B. No. 4556
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the delivery of certain transportation services under
  Medicaid and certain other health and human services programs.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 531.02414(a), Government Code, is
  amended by amending Subdivision (1) and adding Subdivisions (1-a)
  and (3) to read as follows:
               (1)  "Full-risk regional transportation broker" means
  a regional contracted broker that is paid a capitated rate for
  providing medical transportation program services to program
  participants.
               (1-a)  "Medical transportation program" means the
  program that provides nonemergency transportation services to and
  from covered health care services, based on medical necessity, to
  recipients under Medicaid, the children with special health care
  needs program, and the transportation for indigent cancer patients
  program, who have no other means of transportation.
               (3)  "Rural or urban transit district" means a transit
  district created under Chapter 458, Transportation Code.
         SECTION 2.  Section 531.02414, Government Code, is amended
  by amending Subsection (f) and adding Subsection (k) to read as
  follows:
         (f)  Except as provided by Subsection (k), the [The]
  commission shall require compliance with the rules adopted under
  Subsection (e) in any contract entered into with a regional
  contracted broker to provide nonemergency transportation services
  under the medical transportation program.
         (k)  A full-risk regional transportation broker may
  establish a preferred transportation provider network under which
  medical transportation program services are provided exclusively
  through a rural or urban transit district, subject to rules adopted
  under Subdivision (1).  Rules adopted under Subsection (e) do not
  apply to providers under a preferred transportation provider
  network, and the commission may not regulate those providers.  The
  executive commissioner shall adopt rules relating to the
  establishment of a preferred transportation provider network. The
  rules adopted under this subsection must provide that a full-risk
  regional transportation broker:
               (1)  may provide medical transportation program
  services through another provider with whom the broker contracts if
  a network provider is not able to provide the services to a person
  at a particular time; and
               (2)  may not regulate a transit district's motor
  vehicles or motor vehicle operators.
         SECTION 3.  Section 533.00257, Government Code, is amended
  by amending Subsections (d) and (g) and adding Subsections (m) and
  (n) to read as follows:
         (d)  A managed transportation organization that participates
  in the medical transportation program must attempt to contract with
  medical transportation providers that:
               (1)  are considered significant traditional providers,
  as defined by rule by the executive commissioner;
               (2)  except as provided by Subsections (m) and (n), 
  meet the minimum quality and efficiency measures required under
  Subsection (g) and other requirements that may be imposed by the
  managed transportation organization; and
               (3)  agree to accept the prevailing contract rate of
  the managed transportation organization.
         (g)  Except as provided by Subsections (m) and (n), the [The]
  commission shall require that managed transportation organizations
  and providers participating in the medical transportation program
  meet minimum quality and efficiency measures as determined by the
  commission.
         (m)  A managed transportation organization other than an
  organization described by Subsection (a)(1)(A) may establish a
  preferred transportation provider network under which medical
  transportation program services are provided exclusively through a
  rural or urban transit district, subject to rules adopted under
  Subdivision (1).  Minimum quality and efficiency measures under
  Subsection (g) do not apply to providers under a preferred
  transportation provider network, and the commission may not
  regulate those providers.  The executive commissioner shall adopt
  rules relating to the establishment of a preferred transportation
  provider network. The rules adopted under this subsection must
  provide that a managed transportation organization:
               (1)  may provide medical transportation program
  services through another provider with whom the organization
  contracts if a network provider is not able to provide the services
  to a person at a particular time; and
               (2)  may not regulate a transit district's motor
  vehicles or motor vehicle operators. 
         (n)  The commission may not impose minimum quality or
  efficiency measures on, or otherwise regulate, a managed
  transportation organization described by Subsection (a)(1)(A),
  provided that medical transportation program services are provided
  exclusively through the organization, subject to rules adopted
  under this section.  The executive commissioner shall adopt rules
  that allow a managed transportation organization described by
  Subsection (a)(1)(A) to provide medical transportation program
  services through another provider with whom the organization
  contracts if the organization is not otherwise able to provide the
  services to a person at a particular time.
         SECTION 4.  As soon as practicable after the effective date
  of this Act, the executive commissioner of the Health and Human
  Services Commission shall adopt rules as necessary to implement the
  changes in law made by this Act.
         SECTION 5.  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 6.  This Act takes effect September 1, 2019.