TITLE: Relating to reimbursement for ambulance services provided to persons enrolled in the Medicaid managed care program.

SUMMARY: Relating to reimbursement for ambulance services provided to persons enrolled in the Medicaid managed care program.

FULL TEXT:
AN ACT relating to reimbursement for ambulance services provided to persons enrolled in the Medicaid managed care program. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Subchapter A, Chapter 533, Government Code, is amended by adding Section 533.01316 to read as follows: Sec. 533.01316. REIMBURSEMENT FOR AMBULANCE SERVICES. (a) This section applies with respect to a recipient of medical assistance who is an enrollee in a managed care plan under any Medicaid managed care model or arrangement. (b) The commission shall ensure that a person providing ambulance services to a Medicaid managed care enrollee is reimbursed for emergency and nonemergency services provided to the enrollee at a rate that is equal to 100 percent of the allowable rate for those services as determined under Section 32.028, Human Resources Code, regardless of whether the services are provided by a provider in the applicable Medicaid managed care plan's network of providers. SECTION 2. If before implementing any provision of this Act a state agency determines that a waiver or authorization from a federal agency is necessary for implementation of that provision, the agency affected by the provision shall request the waiver or authorization and may delay implementing that provision until the waiver or authorization is granted. SECTION 3. This Act takes effect September 1, 2015.