reglab/statecodes huggingface dataset:
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540 - Medicaid Managed Care Program › Subchapter R. Delivery of Services: Star Kids Managed Care Program › Section 540.0852. Care Management and Care Needs Assessment

Text of section effective on April 01, 2025
Sec. 540.0852.  CARE MANAGEMENT AND CARE NEEDS ASSESSMENT.  (a)  The commission may require that care management services made available as provided by Section 540.0851(b)(5)(B):
(1)  incorporate best practices as the commission determines;
(2)  integrate with a nurse advice line to ensure appropriate redirection rates;
(3)  use an identification and stratification methodology that identifies recipients who have the greatest need for services;
(4)  include a care needs assessment for a recipient;
(5)  are delivered through multidisciplinary care teams located in different geographic areas of this state that use in-person contact with recipients and their caregivers;
(6)  identify immediate interventions for transitioning care;
(7)  include monitoring and reporting outcomes that, at a minimum, include:
(A)  recipient quality of life;
(B)  recipient satisfaction; and
(C)  other financial and clinical metrics the commission determines appropriate; and
(8)  use innovations in providing services.
(b)  To improve the care needs assessment tool used for a care needs assessment provided as a component of care management services and to improve the initial assessment and reassessment processes, the commission, in consultation and collaboration with the STAR Kids Managed Care Advisory Committee, shall consider changes that will:
(1)  reduce the amount of time needed to complete the initial care needs assessment and a reassessment; and
(2)  improve training and consistency in the completion of the care needs assessment using the tool and in the initial assessment and reassessment processes across different Medicaid managed care organizations and different service coordinators within the same Medicaid managed care organization.
(c)  To the extent feasible and allowed by federal law, the commission shall streamline the STAR Kids managed care program annual care needs reassessment process for a child who has not had a significant change in function that may affect medical necessity.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540 - Medicaid Managed Care Program › Subchapter R. Delivery of Services: Star Kids Managed Care Program › Section 540.0853. Benefits for Children in Medically Dependent Children (Mdcp) Waiver Program

Text of section effective on April 01, 2025
Sec. 540.0853.  BENEFITS FOR CHILDREN IN MEDICALLY DEPENDENT CHILDREN (MDCP) WAIVER PROGRAM. The commission shall:
(1)  provide Medicaid benefits through the STAR Kids managed care program to children receiving benefits under the medically dependent children (MDCP) waiver program; and
(2)  ensure that the STAR Kids managed care program provides all of the benefits provided under the medically dependent children (MDCP) waiver program to the extent necessary to implement this section.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540 - Medicaid Managed Care Program › Subchapter R. Delivery of Services: Star Kids Managed Care Program › Section 540.0854. Benefits Transition From Star Kids to Star+plus Medicaid Managed Care Program

Text of section effective on April 01, 2025
Sec. 540.0854.  BENEFITS TRANSITION FROM STAR KIDS TO STAR+PLUS MEDICAID MANAGED CARE PROGRAM.  The commission shall ensure that there is a plan for transitioning the provision of Medicaid benefits to recipients 21 years of age or older from the STAR Kids managed care program to the STAR+PLUS Medicaid managed care program in a manner that protects continuity of care.  The plan must ensure that coordination between the programs begins when a recipient reaches 18 years of age.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540 - Medicaid Managed Care Program › Subchapter R. Delivery of Services: Star Kids Managed Care Program › Section 540.0855. Utilization Review of Prior Authorizations

Text of section effective on April 01, 2025
Sec. 540.0855.  UTILIZATION REVIEW OF PRIOR AUTHORIZATIONS.  At least once every two years, the commission shall conduct a utilization review on a sample of cases for children enrolled in the STAR Kids managed care program to ensure that all imposed clinical prior authorizations are based on publicly available clinical criteria and are not being used to negatively impact a recipient's access to care.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540A - Medicaid Managed Transportation Services › Subchapter A. General Provisions › Section 540A.0001. Definitions

Text of section effective on April 01, 2025
Sec. 540A.0001.  DEFINITIONS.  In this chapter:
(1)  Notwithstanding Section 521.0001(2), "commission" means the Health and Human Services Commission or an agency operating part of the Medicaid managed care program, as appropriate.
(2)  "Managed care plan" means a plan under which a person undertakes to provide, arrange for, pay for, or reimburse any part of the cost of any health care service.  A part of the plan must consist of arranging for or providing health care services as distinguished from indemnification against the cost of those services on a prepaid basis through insurance or otherwise.  The term includes a primary care case management provider network.  The term does not include a plan that indemnifies a person for the cost of health care services through insurance.
(3)  "Managed transportation organization" means:
(A)  a rural or urban transit district created under Chapter 458, Transportation Code;
(B)  a public transportation provider as defined by Section 461.002, Transportation Code;
(C)  a regional contracted broker as defined by Section 526.0351;
(D)  a local private transportation provider the commission approves to provide Medicaid nonemergency medical transportation services; or
(E)  any other entity the commission determines meets the requirements of Subchapter B.
(4)  "Medical transportation program" has the meaning assigned by Section 526.0351.
(5)  "Nonemergency transportation service" has the meaning assigned by Section 526.0351.
(6)  "Nonmedical transportation service" means:
(A)  curb-to-curb transportation to or from a medically necessary, nonemergency covered health care service in a standard passenger vehicle that is scheduled not more than 48 hours before the transportation occurs, that is provided to a recipient enrolled in a Medicaid managed care plan offered by a Medicaid managed care organization, and that the organization determines meets the level of care that is medically appropriate for the recipient, including transportation related to:
(i)  discharging a recipient from a health care facility;
(ii)  receiving urgent care; and
(iii)  obtaining pharmacy services and prescription drugs; and
(B)  any other transportation to or from a medically necessary, nonemergency covered health care service the commission considers appropriate to be provided by a transportation vendor, as determined by commission rule or policy.
(7)  "Recipient" means a Medicaid recipient.
(8)  "Transportation network company" has the meaning assigned by Section 2402.001, Occupations Code.
(9)  "Transportation vendor" means an entity, including a transportation network company, that contracts with a Medicaid managed care organization to provide nonmedical transportation services.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540A - Medicaid Managed Transportation Services › Subchapter B. Medical Transportation Program Services Through Managed Transportation Delivery Model › Section 540A.0051. Delivery of Medical Transportation Program Services Through Managed Transportation Organization

Text of section effective on April 01, 2025
Sec. 540A.0051.  DELIVERY OF MEDICAL TRANSPORTATION PROGRAM SERVICES THROUGH MANAGED TRANSPORTATION ORGANIZATION.  (a)  The commission may provide medical transportation program services on a regional basis through a managed transportation delivery model using managed transportation organizations and providers, as appropriate, that:
(1)  operate under a capitated rate system;
(2)  assume financial responsibility under a full-risk model;
(3)  operate a call center;
(4)  use fixed routes when available and appropriate; and
(5)  agree to provide data to the commission if the commission determines that the data is required to receive federal matching funds.
(b)  The commission shall procure managed transportation organizations under the medical transportation program through a competitive bidding process for each managed transportation region as determined by the commission.
(c)  The commission may not delay providing medical transportation program services through a managed transportation delivery model in:
(1)  a county with a population of 750,000 or more:
(A)  in which all or part of a municipality with a population of one million or more is located; and
(B)  that is located adjacent to a county with a population of two million or more; or
(2)  a county with a population of at least 55,000 but not more than 65,000 that is located adjacent to a county with a population of at least 500,000 but not more than 1.5 million.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540A - Medicaid Managed Transportation Services › Subchapter B. Medical Transportation Program Services Through Managed Transportation Delivery Model › Section 540A.0052. Minimum Quality and Efficiency Measures

Text of section effective on April 01, 2025
Sec. 540A.0052.  MINIMUM QUALITY AND EFFICIENCY MEASURES.  Except as provided by Sections 540A.0054, 540A.0057, and 540A.0058, the commission shall require that managed transportation organizations and providers participating in the medical transportation program meet minimum quality and efficiency measures the commission determines.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540A - Medicaid Managed Transportation Services › Subchapter B. Medical Transportation Program Services Through Managed Transportation Delivery Model › Section 540A.0053. Managed Transportation Organization: Contract With Medical Transportation Provider

Text of section effective on April 01, 2025
Sec. 540A.0053.  MANAGED TRANSPORTATION ORGANIZATION: CONTRACT WITH MEDICAL TRANSPORTATION PROVIDER.  Except as provided by Sections 540A.0054, 540A.0057, and 540A.0058, a managed transportation organization that participates in the medical transportation program must attempt to contract with medical transportation providers that:
(1)  are significant traditional providers, as the executive commissioner defines by rule;
(2)  meet the minimum quality and efficiency measures required under Section 540A.0052 and other requirements that the managed transportation organization may impose; and
(3)  agree to accept the managed transportation organization's prevailing contract rate.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540A - Medicaid Managed Transportation Services › Subchapter B. Medical Transportation Program Services Through Managed Transportation Delivery Model › Section 540A.0054. Managed Transportation Organization: Subcontract With Transportation Network Company

Text of section effective on April 01, 2025
Sec. 540A.0054.  MANAGED TRANSPORTATION ORGANIZATION: SUBCONTRACT WITH TRANSPORTATION NETWORK COMPANY.  A managed transportation organization may subcontract with a transportation network company to provide services under this subchapter. A rule or other requirement the executive commissioner adopts under this subchapter or Subchapter H, Chapter 526, does not apply to the subcontracted transportation network company or a motor vehicle operator who is part of the company's network.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540A - Medicaid Managed Transportation Services › Subchapter B. Medical Transportation Program Services Through Managed Transportation Delivery Model › Section 540A.0055. Managed Transportation Organization: Vehicle Fleets

Text of section effective on April 01, 2025
Sec. 540A.0055.  MANAGED TRANSPORTATION ORGANIZATION: VEHICLE FLEETS.  (a)  To the extent allowed under federal law, a managed transportation organization may own, operate, and maintain a fleet of vehicles or contract with an entity that owns, operates, and maintains a fleet of vehicles. The commission shall seek an appropriate federal waiver or other authorization to implement this subsection as necessary.
(b)  The commission shall consider a managed transportation organization's ownership, operation, and maintenance of a fleet of vehicles to be a related-party transaction for purposes of applying experience rebates, administrative costs, and other administrative controls the commission determines.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540A - Medicaid Managed Transportation Services › Subchapter B. Medical Transportation Program Services Through Managed Transportation Delivery Model › Section 540A.0056. Periodic Screening of Transportation Network Company or Motor Vehicle Operator Authorized

Text of section effective on April 01, 2025
Sec. 540A.0056.  PERIODIC SCREENING OF TRANSPORTATION NETWORK COMPANY OR MOTOR VEHICLE OPERATOR AUTHORIZED.  The commission or a managed transportation organization that subcontracts with a transportation network company under Section 540A.0054 may require the transportation network company or a motor vehicle operator who provides services under this subchapter to be periodically screened against the list of excluded individuals and entities the Office of Inspector General of the United States Department of Health and Human Services maintains.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540A - Medicaid Managed Transportation Services › Subchapter B. Medical Transportation Program Services Through Managed Transportation Delivery Model › Section 540A.0057. Enrollment as Medicaid Provider by Certain Motor Vehicle Operators Not Required

Text of section effective on April 01, 2025
Sec. 540A.0057.  ENROLLMENT AS MEDICAID PROVIDER BY CERTAIN MOTOR VEHICLE OPERATORS NOT REQUIRED.  The commission or a managed transportation organization that subcontracts with a transportation network company under Section 540A.0054 may not require a motor vehicle operator who is part of the subcontracted transportation network company's network to enroll as a Medicaid provider to provide services under this subchapter.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540A - Medicaid Managed Transportation Services › Subchapter B. Medical Transportation Program Services Through Managed Transportation Delivery Model › Section 540A.0058. Driver Requirements for Certain Motor Vehicle Operators

Text of section effective on April 01, 2025
Sec. 540A.0058.  DRIVER REQUIREMENTS FOR CERTAIN MOTOR VEHICLE OPERATORS.  Notwithstanding any other law, a motor vehicle operator who is part of the network of a transportation network company that subcontracts with a managed transportation organization under Section 540A.0054 and who satisfies the driver requirements in Section 2402.107, Occupations Code, is qualified to provide services under this subchapter.  The commission and the managed transportation organization may not impose any additional requirements on a motor vehicle operator who satisfies the driver requirements in Section 2402.107, Occupations Code, to provide services under this subchapter.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540A - Medicaid Managed Transportation Services › Subchapter B. Medical Transportation Program Services Through Managed Transportation Delivery Model › Section 540A.0059. Motor Vehicle Operator: Vehicle Accessibility

Text of section effective on April 01, 2025
Sec. 540A.0059.  MOTOR VEHICLE OPERATOR: VEHICLE ACCESSIBILITY.  For purposes of this subchapter and notwithstanding Section 2402.111(a)(2)(A), Occupations Code, a motor vehicle operator who provides a service under this subchapter may use a wheelchair-accessible vehicle equipped with a lift or ramp that is capable of transporting a passenger using a fixed-frame wheelchair in the cabin of the vehicle if the vehicle otherwise meets the requirements of Section 2402.111, Occupations Code.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540A - Medicaid Managed Transportation Services › Subchapter C. Nonemergency Transportation Services Through Medicaid Managed Care Organization › Section 540A.0101. Delivery of Nonemergency Transportation Services Through Medicaid Managed Care Organization

Text of section effective on April 01, 2025
Sec. 540A.0101.  DELIVERY OF NONEMERGENCY TRANSPORTATION SERVICES THROUGH MEDICAID MANAGED CARE ORGANIZATION.  (a)  The commission shall require each Medicaid managed care organization to arrange and provide nonemergency transportation services to a recipient enrolled in a Medicaid managed care plan offered by the organization using the most cost-effective and cost-efficient method of delivery, including by delivering nonmedical transportation services through a transportation network company or other transportation vendor as provided by Section 540A.0151, if available and medically appropriate. The commission shall supervise the provision of the services.
(b)  The commission may temporarily waive the applicability of Subsection (a) to a Medicaid managed care organization as necessary based on the results of a review conducted under Sections 540.0207 and 540.0209 and until enrollment of recipients in a Medicaid managed care plan offered by the organization is permitted under that section.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540A - Medicaid Managed Transportation Services › Subchapter C. Nonemergency Transportation Services Through Medicaid Managed Care Organization › Section 540A.0102. Rules for Nonemergency Transportation Services

Text of section effective on April 01, 2025
Sec. 540A.0102.  RULES FOR NONEMERGENCY TRANSPORTATION SERVICES.  Subject to Sections 540A.0103 and 540A.0105, the executive commissioner shall adopt rules as necessary to ensure the safe and efficient provision of nonemergency transportation services by a Medicaid managed care organization under this subchapter.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540A - Medicaid Managed Transportation Services › Subchapter C. Nonemergency Transportation Services Through Medicaid Managed Care Organization › Section 540A.0103. Medicaid Managed Care Organization: Subcontract With Transportation Network Company

Text of section effective on April 01, 2025
Sec. 540A.0103.  MEDICAID MANAGED CARE ORGANIZATION: SUBCONTRACT WITH TRANSPORTATION NETWORK COMPANY.  A Medicaid managed care organization may subcontract with a transportation network company to provide nonemergency transportation services under this subchapter.  A rule or other requirement the executive commissioner adopts under Section 540A.0102 or Subchapter H, Chapter 526, does not apply to the subcontracted transportation network company or a motor vehicle operator who is part of the company's network.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540A - Medicaid Managed Transportation Services › Subchapter C. Nonemergency Transportation Services Through Medicaid Managed Care Organization › Section 540A.0104. Periodic Screening of Transportation Network Company or Motor Vehicle Operator Authorized

Text of section effective on April 01, 2025
Sec. 540A.0104.  PERIODIC SCREENING OF TRANSPORTATION NETWORK COMPANY OR MOTOR VEHICLE OPERATOR AUTHORIZED.  The commission or a Medicaid managed care organization that subcontracts with a transportation network company under Section 540A.0103 may require the transportation network company or a motor vehicle operator who provides services under this subchapter to be periodically screened against the list of excluded individuals and entities the Office of Inspector General of the United States Department of Health and Human Services maintains.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540A - Medicaid Managed Transportation Services › Subchapter C. Nonemergency Transportation Services Through Medicaid Managed Care Organization › Section 540A.0105. Enrollment as Medicaid Provider by Certain Motor Vehicle Operators Not Required

Text of section effective on April 01, 2025
Sec. 540A.0105.  ENROLLMENT AS MEDICAID PROVIDER BY CERTAIN MOTOR VEHICLE OPERATORS NOT REQUIRED.  The commission or a Medicaid managed care organization that subcontracts with a transportation network company under Section 540A.0103 may not require a motor vehicle operator who is part of the subcontracted transportation network company's network to enroll as a Medicaid provider to provide services under this subchapter.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540A - Medicaid Managed Transportation Services › Subchapter C. Nonemergency Transportation Services Through Medicaid Managed Care Organization › Section 540A.0106. Driver Requirements for Certain Motor Vehicle Operators

Text of section effective on April 01, 2025
Sec. 540A.0106.  DRIVER REQUIREMENTS FOR CERTAIN MOTOR VEHICLE OPERATORS.  Notwithstanding any other law, a motor vehicle operator who is part of the network of a transportation network company that subcontracts with a Medicaid managed care organization under Section 540A.0103 and who satisfies the driver requirements in Section 2402.107, Occupations Code, is qualified to provide services under this subchapter. The commission and the Medicaid managed care organization may not impose any additional requirements on a motor vehicle operator who satisfies the driver requirements in Section 2402.107, Occupations Code, to provide services under this subchapter.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540A - Medicaid Managed Transportation Services › Subchapter C. Nonemergency Transportation Services Through Medicaid Managed Care Organization › Section 540A.0107. Motor Vehicle Operator: Vehicle Accessibility

Text of section effective on April 01, 2025
Sec. 540A.0107.  MOTOR VEHICLE OPERATOR: VEHICLE ACCESSIBILITY.  For purposes of this subchapter and notwithstanding Section 2402.111(a)(2)(A), Occupations Code, a motor vehicle operator who provides a service under this subchapter may use a wheelchair-accessible vehicle equipped with a lift or ramp that is capable of transporting a passenger using a fixed-frame wheelchair in the cabin of the vehicle if the vehicle otherwise meets the requirements of Section 2402.111, Occupations Code.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540A - Medicaid Managed Transportation Services › Subchapter D. Nonmedical Transportation Services Through Medicaid Managed Care Organization › Section 540A.0151. Delivery of Nonmedical Transportation Services Through Medicaid Managed Care Organization

Text of section effective on April 01, 2025
Sec. 540A.0151.  DELIVERY OF NONMEDICAL TRANSPORTATION SERVICES THROUGH MEDICAID MANAGED CARE ORGANIZATION.  (a)  The commission shall require each Medicaid managed care organization to arrange for the provision of nonmedical transportation services to a recipient enrolled in a Medicaid managed care plan offered by the organization.
(b)  A Medicaid managed care organization may contract with a transportation vendor or other third party to arrange for the provision of nonmedical transportation services. If a Medicaid managed care organization contracts with a third party that is not a transportation vendor to arrange for the provision of nonmedical transportation services, the third party shall contract with a transportation vendor to deliver the nonmedical transportation services.
(c)  A Medicaid managed care organization that contracts with a transportation vendor or other third party to arrange for the provision of nonmedical transportation services shall ensure the effective sharing and integration of service coordination, service authorization, and utilization management data between the managed care organization and the transportation vendor or third party.
(d)  The commission may waive the applicability of Subsection (a) to a Medicaid managed care organization for not more than three months as necessary based on the results of a review conducted under Sections 540.0207 and 540.0209 and until enrollment of recipients in a Medicaid managed care plan offered by the organization is permitted under that section.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540A - Medicaid Managed Transportation Services › Subchapter D. Nonmedical Transportation Services Through Medicaid Managed Care Organization › Section 540A.0153. Periodic Screening of Transportation Vendor or Motor Vehicle Operator Authorized

Text of section effective on April 01, 2025
Sec. 540A.0153.  PERIODIC SCREENING OF TRANSPORTATION VENDOR OR MOTOR VEHICLE OPERATOR AUTHORIZED.  The commission or a Medicaid managed care organization that contracts with a transportation vendor may require the transportation vendor or a motor vehicle operator who provides services under this subchapter to be periodically screened against the list of excluded individuals and entities the Office of Inspector General of the United States Department of Health and Human Services maintains.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540A - Medicaid Managed Transportation Services › Subchapter D. Nonmedical Transportation Services Through Medicaid Managed Care Organization › Section 540A.0154. Enrollment as Medicaid Provider By, or Credentialing Of, Motor Vehicle Operator Not Required

Text of section effective on April 01, 2025
Sec. 540A.0154.  ENROLLMENT AS MEDICAID PROVIDER BY, OR CREDENTIALING OF, MOTOR VEHICLE OPERATOR NOT REQUIRED.  (a)  The commission or a Medicaid managed care organization may not require a motor vehicle operator to enroll as a Medicaid provider to provide nonmedical transportation services.
(b)  The commission may not require a Medicaid managed care organization to credential a motor vehicle operator to provide nonmedical transportation services, and the organization may not require the credentialing of a motor vehicle operator to provide those services.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540A - Medicaid Managed Transportation Services › Subchapter D. Nonmedical Transportation Services Through Medicaid Managed Care Organization › Section 540A.0155. Driver Requirements for Certain Motor Vehicle Operators

Text of section effective on April 01, 2025
Sec. 540A.0155.  DRIVER REQUIREMENTS FOR CERTAIN MOTOR VEHICLE OPERATORS.  Notwithstanding any other law, a motor vehicle operator who is part of a transportation network company's network and who satisfies the driver requirements in Section 2402.107, Occupations Code, is qualified to provide nonmedical transportation services. The commission and a Medicaid managed care organization may not impose any additional requirements on a motor vehicle operator who satisfies the driver requirements in Section 2402.107, Occupations Code, to provide nonmedical transportation services.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 540A - Medicaid Managed Transportation Services › Subchapter D. Nonmedical Transportation Services Through Medicaid Managed Care Organization › Section 540A.0156. Motor Vehicle Operator: Vehicle Accessibility

Text of section effective on April 01, 2025
Sec. 540A.0156.  MOTOR VEHICLE OPERATOR: VEHICLE ACCESSIBILITY.  For purposes of this subchapter and notwithstanding Section 2402.111(a)(2)(A), Occupations Code, a motor vehicle operator who provides a service under this subchapter may use a wheelchair-accessible vehicle equipped with a lift or ramp that is capable of transporting a passenger using a fixed-frame wheelchair in the cabin of the vehicle if the vehicle otherwise meets the requirements of Section 2402.111, Occupations Code.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 541 - Pediatric Tele-Connectivity Resource Program for Rural Texas › Section 541.001. Definitions

Text of section effective until April 01, 2025
Sec. 541.001.  DEFINITIONS.  In this chapter:
(1)  "Nonurban health care facility" means a hospital licensed under Chapter 241, Health and Safety Code, or other licensed health care facility in this state that is located in a rural area as defined by Section 845.002, Insurance Code.
(2)  "Pediatric specialist" means a physician who is certified in general pediatrics by the American Board of Pediatrics or American Osteopathic Board of Pediatrics.
(3)  "Pediatric subspecialist" means a physician who is certified in a pediatric subspecialty by a member board of the American Board of Medical Specialties or American Osteopathic Board of Pediatrics.
(4)  "Pediatric tele-specialty provider" means a pediatric health care facility in this state that offers continuous access to telemedicine medical services provided by pediatric subspecialists.
(5)  "Physician" means a person licensed to practice medicine in this state.
(6)  "Program" means the pediatric tele-connectivity resource program for rural Texas established under this chapter.
(7)  "Telemedicine medical services" means health care services delivered to a patient:
(A)  by a physician acting within the scope of the physician's license or a health professional acting under the delegation and supervision of a physician and within the scope of the health professional's license;
(B)  from a physical location that is different from the patient's location; and
(C)  using telecommunications or information technology.
Added by Acts 2017, 85th Leg., R.S., Ch. 148 (H.B. 1697), Sec. 1, eff. September 1, 2017.
Repealed by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 3.01(3), eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 541 - Pediatric Tele-Connectivity Resource Program for Rural Texas › Section 541.002. Pediatric Tele-Connectivity Resource Program for Rural Texas

Text of section effective until April 01, 2025
Sec. 541.002.  PEDIATRIC TELE-CONNECTIVITY RESOURCE PROGRAM FOR RURAL TEXAS.  The commission with any necessary assistance of pediatric tele-specialty providers shall establish a pediatric tele-connectivity resource program for rural Texas to award grants to nonurban health care facilities to connect the facilities with pediatric specialists and pediatric subspecialists who provide telemedicine medical services.
Added by Acts 2017, 85th Leg., R.S., Ch. 148 (H.B. 1697), Sec. 1, eff. September 1, 2017.
Repealed by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 3.01(3), eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 541 - Pediatric Tele-Connectivity Resource Program for Rural Texas › Section 541.003. Use of Grant

Text of section effective until April 01, 2025
Sec. 541.003.  USE OF GRANT.  A nonurban health care facility awarded a grant under this chapter may use grant money to:
(1)  purchase equipment necessary for implementing a telemedicine medical service;
(2)  modernize the facility's information technology infrastructure and secure information technology support to ensure an uninterrupted two-way video signal that is compliant with the Health Insurance Portability and Accountability Act of 1996 (Pub. L. No. 104-191);
(3)  pay a service fee to a pediatric tele-specialty provider under an annual contract with the provider; or
(4)  pay for other activities, services, supplies, facilities, resources, and equipment the commission determines necessary for the facility to use a telemedicine medical service.
Added by Acts 2017, 85th Leg., R.S., Ch. 148 (H.B. 1697), Sec. 1, eff. September 1, 2017.
Repealed by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 3.01(3), eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 541 - Pediatric Tele-Connectivity Resource Program for Rural Texas › Section 541.004. Selection of Grant Recipients

Text of section effective until April 01, 2025
Sec. 541.004.  SELECTION OF GRANT RECIPIENTS.  (a)  The commission with any necessary assistance of pediatric tele-specialty providers may select an eligible nonurban health care facility to receive a grant under this chapter.
(b)  To be eligible for a grant under this chapter, a nonurban health care facility must have:
(1)  a quality assurance program that measures the compliance of the facility's health care providers with the facility's medical protocols;
(2)  on staff at least one full-time equivalent physician who has training and experience in pediatrics and one person who is responsible for ongoing nursery and neonatal support and care;
(3)  a designated neonatal intensive care unit or an emergency department;
(4)  a commitment to obtaining neonatal or pediatric education from a tertiary facility to expand the facility's depth and breadth of telemedicine medical service capabilities; and
(5)  the capability of maintaining records and producing reports that measure the effectiveness of a grant received by the facility under this chapter.
Added by Acts 2017, 85th Leg., R.S., Ch. 148 (H.B. 1697), Sec. 1, eff. September 1, 2017.
Repealed by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 3.01(3), eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 541 - Pediatric Tele-Connectivity Resource Program for Rural Texas › Section 541.005. Gifts, Grants, and Donations

Text of section effective until April 01, 2025
Sec. 541.005.  GIFTS, GRANTS, AND DONATIONS.  (a)  The commission may solicit and accept gifts, grants, and donations from any public or private source for the purposes of this chapter.
(b)  A political subdivision that participates in the program may pay part of the costs of the program.
Added by Acts 2017, 85th Leg., R.S., Ch. 148 (H.B. 1697), Sec. 1, eff. September 1, 2017.
Repealed by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 3.01(3), eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 541 - Pediatric Tele-Connectivity Resource Program for Rural Texas › Section 541.006. Work Group

Text of section effective until April 01, 2025
Sec. 541.006.  WORK GROUP.  (a)  The commission may establish a program work group to:
(1)  assist the commission with developing, implementing, or evaluating the program; and
(2)  prepare a report on the results and outcomes of the grants awarded under this chapter.
(b)  A member of a program work group established under this section is not entitled to compensation for serving on the program work group and may not be reimbursed for travel or other expenses incurred while conducting the business of the program work group.
(c)  A program work group established under this section is not subject to Chapter 2110.
Added by Acts 2017, 85th Leg., R.S., Ch. 148 (H.B. 1697), Sec. 1, eff. September 1, 2017.
Repealed by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 3.01(3), eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 541 - Pediatric Tele-Connectivity Resource Program for Rural Texas › Section 541.007. Report to Governor and Legislature

Text of section effective until April 01, 2025
Sec. 541.007.  REPORT TO GOVERNOR AND LEGISLATURE.  Not later than December 1 of each even-numbered year, the commission shall submit a report to the governor and members of the legislature regarding the activities of the program and grant recipients, including the results and outcomes of grants awarded under this chapter.
Added by Acts 2017, 85th Leg., R.S., Ch. 148 (H.B. 1697), Sec. 1, eff. September 1, 2017.
Repealed by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 3.01(3), eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 541 - Pediatric Tele-Connectivity Resource Program for Rural Texas › Section 541.008. Rules

Text of section effective until April 01, 2025
Sec. 541.008.  RULES.  The executive commissioner may adopt rules necessary to implement this chapter.
Added by Acts 2017, 85th Leg., R.S., Ch. 148 (H.B. 1697), Sec. 1, eff. September 1, 2017.
Repealed by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 3.01(3), eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 541 - Pediatric Tele-Connectivity Resource Program for Rural Texas › Section 541.009. Specific Appropriation Required

Text of section effective until April 01, 2025
Sec. 541.009.  SPECIFIC APPROPRIATION REQUIRED.  The commission may not spend state funds to accomplish the purposes of this chapter and is not required to award a grant under this chapter unless money is appropriated for the purposes of this chapter.
Added by Acts 2017, 85th Leg., R.S., Ch. 148 (H.B. 1697), Sec. 1, eff. September 1, 2017.
Repealed by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 3.01(3), eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 542 - System Redesign for Delivery of Medicaid Acute Care Services and Long-Term Services and Supports to Individuals With an Intellectual or Developmental Disability › Subchapter A. General Provisions › Section 542.0002. Conflict With Other Law

Text of section effective on April 01, 2025
Sec. 542.0002.  CONFLICT WITH OTHER LAW.  To the extent of a conflict between a provision of this chapter and another state law, the provision of this chapter controls.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 542 - System Redesign for Delivery of Medicaid Acute Care Services and Long-Term Services and Supports to Individuals With an Intellectual or Developmental Disability › Subchapter A. General Provisions › Section 542.0003. Delayed Implementation Authorized

Text of section effective on April 01, 2025
Sec. 542.0003.  DELAYED IMPLEMENTATION AUTHORIZED.  Notwithstanding any other law, the commission may delay implementing a provision of this chapter without additional investigation, adjustment, or legislative action if the commission determines implementing the provision would adversely affect the system of services and supports to persons and programs to which this chapter applies.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 542 - System Redesign for Delivery of Medicaid Acute Care Services and Long-Term Services and Supports to Individuals With an Intellectual or Developmental Disability › Subchapter B. Acute Care Services and Long-Term Services and Supports System Redesign › Section 542.0051. Redesign of Acute Care Services and Long-Term Services and Supports System for Individuals With an Intellectual or Developmental Disability

Text of section effective on April 01, 2025
Sec. 542.0051.  REDESIGN OF ACUTE CARE SERVICES AND LONG-TERM SERVICES AND SUPPORTS SYSTEM FOR INDIVIDUALS WITH AN INTELLECTUAL OR DEVELOPMENTAL DISABILITY.  The commission shall design and implement an acute care services and long-term services and supports system for individuals with an intellectual or developmental disability that supports the following goals:
(1)  provide Medicaid services to more individuals in a cost-efficient manner by providing the type and amount of services most appropriate to an individual's needs and preferences in the most integrated and least restrictive setting;
(2)  improve access to services and supports by ensuring that an individual receives information about all available programs and services, including employment and least restrictive housing assistance, and the manner of applying for the programs and services;
(3)  improve the assessment of an individual's needs and available supports, including the assessment of an individual's functional needs;
(4)  promote person-centered planning, self-direction, self-determination, community inclusion, and customized, integrated, competitive employment;
(5)  promote individualized budgeting based on an assessment of an individual's needs and person-centered planning;
(6)  promote integrated service coordination of acute care services and long-term services and supports;
(7)  improve acute care and long-term services and supports outcomes, including reducing unnecessary institutionalization and potentially preventable events;
(8)  promote high-quality care;
(9)  provide fair hearing and appeals processes in accordance with federal law;
(10)  ensure the availability of a local safety net provider and local safety net services;
(11)  promote independent service coordination and independent ombudsmen services; and
(12)  ensure that individuals with the most significant needs are appropriately served in the community and that processes are in place to prevent the inappropriate institutionalization of an individual.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
For expiration of this section, see Subsection (h).
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 542 - System Redesign for Delivery of Medicaid Acute Care Services and Long-Term Services and Supports to Individuals With an Intellectual or Developmental Disability › Subchapter B. Acute Care Services and Long-Term Services and Supports System Redesign › Section 542.0053. Implementation of System Redesign

Text of section effective on April 01, 2025
Sec. 542.0053.  IMPLEMENTATION OF SYSTEM REDESIGN.   The commission shall, in collaboration with the advisory committee, implement the acute care services and long-term services and supports system for individuals with an intellectual or developmental disability in the manner and in the stages described by this chapter.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
For expiration of this section, see Subsection (b).
2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 542 - System Redesign for Delivery of Medicaid Acute Care Services and Long-Term Services and Supports to Individuals With an Intellectual or Developmental Disability › Subchapter B. Acute Care Services and Long-Term Services and Supports System Redesign › Section 542.0054. Annual Report on Implementation

Text of section effective on April 01, 2025
Sec. 542.0054.  ANNUAL REPORT ON IMPLEMENTATION.  (a)  Not later than September 30 of each year, the commission, in collaboration with the advisory committee, shall prepare and submit to the legislature a report that includes:
(1)  an assessment of the implementation of the system required by this chapter, including appropriate information regarding the provision of acute care services and long-term services and supports to individuals with an intellectual or developmental disability under Medicaid;
(2)  recommendations regarding implementation of and improvements to the system redesign, including recommendations regarding appropriate statutory changes to facilitate the implementation; and
(3)  an assessment of the effect of the system on:
(A)  access to long-term services and supports;
(B)  the quality of acute care services and long-term services and supports;
(C)  meaningful outcomes for Medicaid recipients using person-centered planning, individualized budgeting, and self-determination, including an individual's inclusion in the community;
(D)  the integration of service coordination of acute care services and long-term services and supports;
(E)  the efficiency and use of funding;
(F)  the placement of individuals in housing that is the least restrictive setting appropriate to an individual's needs;
(G)  employment assistance and customized, integrated, competitive employment options; and
(H)  the number and types of fair hearing and appeals processes in accordance with federal law.
(b)  This section expires on the second anniversary of the date the commission completes implementation of the transition required under Section 542.0201.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.