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A BILL TO BE ENTITLED
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AN ACT
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relating to requiring contracts with Medicaid managed care |
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organizations to permit the organizations to offer certain mental |
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health or substance use services or food and nutrition assistance |
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services in lieu of other state Medicaid plan services. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 540.0272, Government Code, as effective |
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April 1, 2025, is amended to read as follows: |
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Sec. 540.0272. CERTAIN SERVICES PERMITTED IN LIEU OF STATE |
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MEDICAID PLAN SERVICES [OTHER MENTAL HEALTH OR SUBSTANCE USE |
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DISORDER SERVICES]; ANNUAL REPORT. A contract to which this |
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subchapter applies must contain language permitting the |
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contracting Medicaid managed care organization to offer recipients |
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enrolled in the organization's managed care plan medically |
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appropriate, cost-effective, evidence-based mental health or |
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substance use services or food and nutrition assistance services |
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from a list of services approved by the state Medicaid managed care |
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advisory committee and included in the contract as services the |
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organization may provide recipients in lieu of [mental health or |
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substance use disorder] services specified in the state Medicaid |
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plan. A recipient is not required to use a service from the list |
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included in the contract in lieu of a [another mental health or |
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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 to the legislature an annual |
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report on the number of times during the preceding year a service |
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from the list included in the contract is used; and |
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(2) consider the actual cost and use of any services |
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from the list included in the contract that are offered by a |
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Medicaid managed care organization when setting the capitation |
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rates for that organization under the contract. |
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SECTION 2. The changes in law made by this Act apply to a |
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contract entered into or renewed on or after the effective date of |
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this Act. A contract entered into or renewed before that date is |
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governed by the law in effect on the date the contract was entered |
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into or renewed, and that law is continued in effect for that |
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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. |