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A BILL TO BE ENTITLED
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AN ACT
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relating to certain evidence-based health-related non-medical |
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services offered by a Medicaid managed care organization in lieu of |
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other services. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 533.005(h), Government Code, is amended |
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to read as follows: |
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(h) In addition to the requirements specified by Subsection |
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(a), a contract described by that subsection must contain language |
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permitting a managed care organization to offer medically |
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appropriate, cost-effective, evidence-based mental health or |
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substance use disorder services and health-related non-medical |
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services from a list [approved by the state Medicaid managed care |
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advisory committee and] included in the contract in lieu of [mental |
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health or substance use disorder] services specified in the state |
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Medicaid plan. A recipient is not required to use a service from |
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the list included in the contract in lieu of another [mental health |
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or substance use disorder] service specified in the state Medicaid |
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plan. The commission shall: |
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(1) prepare and submit an annual report to the |
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legislature on the number of times during the preceding year a |
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service from the list included in the contract is used; and |
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(2) take into consideration the actual cost and use of |
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any services from the list included in the contract that are offered |
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by a managed care organization when setting the capitation rates |
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for that organization under the contract. |
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SECTION 2. Section 533.005(h), Government Code, as amended |
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by this Act, applies to a contract entered into or renewed on or |
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after the effective date of this Act. A contract entered into or |
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renewed before that date is governed by the law in effect on the |
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date the contract was entered into or renewed, and that law is |
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continued in effect for that purpose. |
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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 September 1, 2025. |