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A BILL TO BE ENTITLED
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AN ACT
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relating to the inclusion of enteral nutrition therapy providers in |
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Medicaid managed care organizations' provider networks. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 533.006, Government Code, is amended by |
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adding Subsection (c) to read as follows: |
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(c) The commission shall require that each managed care |
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organization that contracts with the commission to provide health |
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care services to recipients in a region allow a supplier of durable |
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medical equipment and other supplies used specifically for enteral |
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nutrition therapy to participate as a provider in the managed care |
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organization's provider network if the supplier: |
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(1) agrees to comply with the financial terms and |
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conditions of the managed care organization's provider contract as |
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well as other reasonable administrative and professional terms of |
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that contract; and |
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(2) is not prohibited from participating as a Medicaid |
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provider by Section 32.047, Human Resources Code, or any other |
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provision excluding the provider based on conduct that constitutes |
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fraud, waste, or abuse. |
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SECTION 2. The Health and Human Services Commission shall, |
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in a contract between the commission and a managed care |
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organization under Chapter 533, Government Code, that is entered |
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into or renewed on or after the effective date of this Act, require |
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that the managed care organization comply with Section 533.006(c), |
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Government Code, as amended by this Act. |
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SECTION 3. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 4. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2013. |