Bill Text: TX SB2138 | 2019-2020 | 86th Legislature | Enrolled
Bill Title: Relating to the administration and operation of Medicaid.
Spectrum: Slight Partisan Bill (Democrat 2-1)
Status: (Passed) 2019-06-10 - Effective immediately [SB2138 Detail]
Download: Texas-2019-SB2138-Enrolled.html
S.B. No. 2138 |
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relating to the administration and operation of Medicaid. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subchapter B, Chapter 531, Government Code, is | ||
amended by adding Section 531.021135 to read as follows: | ||
Sec. 531.021135. COMMISSION'S AUTHORITY TO RETAIN CERTAIN | ||
MONEY TO ADMINISTER CERTAIN MEDICAID PROGRAMS; REPORT REQUIRED. | ||
(a) In this section, "directed payment program" means a delivery | ||
system and provider patient initiative implemented by this state | ||
under 42 C.F.R. Section 438.6(c). | ||
(b) This section applies only to money the commission | ||
receives from a source other than the general revenue fund to | ||
operate a waiver program established under Section 1115 of the | ||
federal Social Security Act (42 U.S.C. Section 1315) or a directed | ||
payment program or successor program as determined by the | ||
commission. | ||
(c) Subject to Subsection (e), the commission may retain | ||
from money to which this section applies an amount equal to the | ||
estimated costs necessary to administer the program for which the | ||
money is received, but not to exceed $8 million for a state fiscal | ||
year. | ||
(d) The commission shall spend money retained under this | ||
section to assist in paying the costs necessary to administer the | ||
program for which the money is received, except that the commission | ||
may not use the money to pay any type of administrative cost that, | ||
before June 1, 2019, was funded with general revenue. | ||
(e) If the commission determines that the commission needs | ||
additional money to administer a program described by Subsection | ||
(b), the commission may retain an additional amount with the | ||
approval of the governor and the Legislative Budget Board, but not | ||
to exceed a total retained amount equal to 0.25 percent of the total | ||
amount estimated to be received for the program. | ||
(f) The commission shall submit an annual report to the | ||
governor and the Legislative Budget Board that: | ||
(1) details the amount of money retained and spent by | ||
the commission under this section during the preceding state fiscal | ||
year, including a separate detail of any increase in the amount of | ||
money retained for a program under Subsection (e); | ||
(2) contains a transparent description of how the | ||
commission used the money described by Subdivision (1); and | ||
(3) assesses the extent to which the money retained by | ||
the commission under this section covered the estimated costs to | ||
administer the applicable program and states whether, based on that | ||
assessment, the commission adjusted or considered adjustments to | ||
the amount retained. | ||
(g) The executive commissioner shall adopt rules necessary | ||
to implement this section. | ||
SECTION 2. Section 531.1023, Government Code, is amended to | ||
read as follows: | ||
Sec. 531.1023. COMPLIANCE WITH FEDERAL CODING GUIDELINES. | ||
(a) The commission's office of inspector general, including | ||
office staff and any third party with which the office contracts to | ||
perform coding services, and the commission's medical and | ||
utilization review appeals unit shall comply with federal coding | ||
guidelines, including guidelines for diagnosis-related group (DRG) | ||
validation and related audits. | ||
(b) In this section, "federal coding guidelines" means the | ||
code sets and guidelines adopted by the United States Department of | ||
Health and Human Services in accordance with the Health Insurance | ||
Portability and Accountability Act of 1996 (42 U.S.C. Section 1320d | ||
et seq.). | ||
SECTION 3. Subchapter A, Chapter 533, Government Code, is | ||
amended by adding Section 533.0031 to read as follows: | ||
Sec. 533.0031. MEDICAID MANAGED CARE PLAN ACCREDITATION. | ||
(a) A managed care plan offered by a Medicaid managed care | ||
organization must be accredited by a nationally recognized | ||
accreditation organization. The commission may choose whether to | ||
require all managed care plans offered by Medicaid managed care | ||
organizations to be accredited by the same organization or to allow | ||
for accreditation by different organizations. | ||
(b) The commission may use the data, scoring, and other | ||
information provided to or received from an accreditation | ||
organization in the commission's contract oversight processes. | ||
SECTION 4. The Health and Human Services Commission shall | ||
require that a managed care plan offered by a Medicaid managed care | ||
organization with which the commission enters into or renews a | ||
contract under Chapter 533, Government Code, on or after the | ||
effective date of this Act complies with Section 533.0031, | ||
Government Code, as added by this Act, not later than September 1, | ||
2022. | ||
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 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. | ||
______________________________ | ______________________________ | |
President of the Senate | Speaker of the House | |
I hereby certify that S.B. No. 2138 passed the Senate on | ||
April 29, 2019, by the following vote: Yeas 30, Nays 1; | ||
May 23, 2019, Senate refused to concur in House amendments and | ||
requested appointment of Conference Committee; May 23, 2019, House | ||
granted request of the Senate; May 26, 2019, Senate adopted | ||
Conference Committee Report by the following vote: Yeas 31, | ||
Nays 0. | ||
______________________________ | ||
Secretary of the Senate | ||
I hereby certify that S.B. No. 2138 passed the House, with | ||
amendments, on May 22, 2019, by the following vote: Yeas 131, | ||
Nays 13, two present not voting; May 23, 2019, House granted | ||
request of the Senate for appointment of Conference Committee; | ||
May 26, 2019, House adopted Conference Committee Report by the | ||
following vote: Yeas 125, Nays 21, one present not voting. | ||
______________________________ | ||
Chief Clerk of the House | ||
Approved: | ||
______________________________ | ||
Date | ||
______________________________ | ||
Governor |