Bill Text: TX SB1545 | 2015-2016 | 84th Legislature | Introduced
Bill Title: Relating to the establishment of an advisory committee to develop a process for the collection of information necessary to facilitate physician credentialing by Medicaid managed care organizations.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2015-03-23 - Referred to Health & Human Services [SB1545 Detail]
Download: Texas-2015-SB1545-Introduced.html
84R6164 EES-D | ||
By: Perry | S.B. No. 1545 |
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relating to the establishment of an advisory committee to develop a | ||
process for the collection of information necessary to facilitate | ||
physician credentialing by Medicaid managed care organizations. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subchapter B, Chapter 531, Government Code, is | ||
amended by adding Section 531.0975 to read as follows: | ||
Sec. 531.0975. ADVISORY COMMITTEE ON PHYSICIAN | ||
CREDENTIALING BY MEDICAID MANAGED CARE ORGANIZATIONS. (a) The | ||
executive commissioner shall establish an advisory committee to | ||
assist the commission in developing and maintaining a process for | ||
the collection of information from physicians to facilitate the | ||
performance of the credentialing and recredentialing processes by | ||
Medicaid managed care organizations. | ||
(b) The advisory committee shall be composed of nine members | ||
appointed by the executive commissioner as follows: | ||
(1) four members who are physicians; | ||
(2) four members who are representatives of managed | ||
care organizations; and | ||
(3) one member who is a representative of the | ||
commission. | ||
(c) In order to be eligible for appointment to the advisory | ||
committee under Subsection (b), a person must be knowledgeable | ||
about national standards relating to the credentialing process for | ||
physicians. | ||
(d) The executive commissioner shall designate one advisory | ||
committee member to serve as presiding officer. | ||
(e) The advisory committee shall develop and the executive | ||
commissioner shall adopt rules for the establishment of a process | ||
through which the commission collects from a physician seeking to | ||
be included in or remain in the provider network of a Medicaid | ||
managed care organization all of the necessary information for the | ||
organization to perform a sufficient credentialing or | ||
recredentialing process to determine if the physician is qualified | ||
to be included in or remain in the organization's provider network. | ||
The rules must include the content and format of the form that a | ||
physician must use to submit information to the commission for | ||
purposes of the credentialing or recredentialing process. | ||
(f) The advisory committee shall meet at least once each | ||
calendar year at the call of the presiding officer to review the | ||
information that the commission collects and to determine if that | ||
information is sufficient to enable a Medicaid managed care | ||
organization to perform credentialing and recredentialing | ||
processes for physicians that comply with federal and state law and | ||
standards developed by relevant national accreditation | ||
organizations. The advisory committee shall submit to the executive | ||
commissioner recommendations for any necessary changes to | ||
commission rules as a result of this review. | ||
(g) Nothing in this section shall be construed to: | ||
(1) prohibit a Medicaid managed care organization from | ||
requesting additional information from a physician for the purposes | ||
of the credentialing or recredentialing process; or | ||
(2) require a Medicaid managed care organization to | ||
include in the organization's provider network a physician who | ||
submits information to the commission as part of the process | ||
established under this section. | ||
(h) The advisory committee members shall serve staggered | ||
three-year terms. | ||
(i) An advisory committee member who no longer meets the | ||
qualifications for service on the advisory committee must resign | ||
from the advisory committee. | ||
(j) The executive commissioner shall fill a vacancy on the | ||
advisory committee in the same manner as other appointments to the | ||
advisory committee. | ||
(k) An advisory committee member may not receive | ||
compensation for serving on the advisory committee and may not be | ||
reimbursed for expenses incurred while conducting the business of | ||
the advisory committee. | ||
(l) The commission shall provide administrative support to | ||
the advisory committee. | ||
(m) Chapter 2110 does not apply to the advisory committee. | ||
SECTION 2. (a) Not later than October 1, 2015, the | ||
executive commissioner of the Health and Human Services Commission | ||
shall establish the advisory committee and appoint the advisory | ||
committee members for terms beginning September, 1, 2015, as | ||
required by Section 531.0975, Government Code, as added by this | ||
Act. | ||
(b) In making the initial appointments and notwithstanding | ||
Section 531.0975(h), Government Code, as added by this Act, the | ||
executive commissioner shall designate one-third of the members to | ||
serve for terms expiring August 31, 2016, one-third of the members | ||
to serve for terms expiring August 31, 2017, and the remaining | ||
one-third of the members to serve for terms expiring August 31, | ||
2018. | ||
SECTION 3. Not later than January 1, 2016, the advisory | ||
committee established under Section 531.0975, Government Code, as | ||
added by this Act, shall make initial recommendations and the | ||
executive commissioner of the Health and Human Services Commission | ||
shall adopt or amend rules as necessary in accordance with Section | ||
531.0975(e), Government Code, as added by this Act. | ||
SECTION 4. 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, 2015. |