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A BILL TO BE ENTITLED
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AN ACT
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relating to reimbursement for health care services provided at |
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certain times to persons enrolled in the Medicaid managed care |
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program. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 533.01315, Government Code, is amended |
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by amending Subsection (b) and adding Subsection (b-1) to read as |
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follows: |
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(b) Subject to Subsection (b-1), the [The] commission shall |
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ensure that a federally qualified health center, physician office, |
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urgent care facility, rural health clinic, or municipal health |
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department's public clinic is reimbursed for health care services |
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provided to a recipient outside of regular business hours, |
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including on a weekend or holiday, at a rate that is equal to the |
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allowable rate for those services as determined under Section |
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32.028, Human Resources Code, regardless of whether the recipient |
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has a referral from the recipient's primary care provider. |
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(b-1) A physician who is a specialist may not be reimbursed |
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under this section for the provision of specialty services. |
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SECTION 2. 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 3. This Act takes effect on the 91st day after the |
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last day of the legislative session. |