2023 Texas Statutes › Human Resources Code › Title 2 - Human Services and Protective Services in General › Subtitle C - Assistance Programs › Chapter 32 - Medical Assistance Program › Subchapter B. Administrative Provisions › Section 32.027. Selection of Provider of Medical Assistance

Sec. 32.027.  SELECTION OF PROVIDER OF MEDICAL ASSISTANCE.  (a)  Except as provided by Subsections (f) and (g), a recipient of medical assistance authorized in this chapter may select any provider authorized by the commission to provide medical assistance.
(b)  Repealed by Acts 2015, 84th Leg., R.S., Ch. 1, Sec. 4.465(a)(38), eff. April 2, 2015.
(c)  Repealed by Acts 2003, 78th Leg., ch. 1167, Sec. 4.
(d)  The commission shall permit a recipient of medical assistance under this chapter to receive services relating to physical therapy from any person authorized to practice physical therapy under Chapter 453, Occupations Code.
(e)  Repealed by Acts 2003, 78th Leg., ch. 198, Sec. 2.156(a)(2).
(e)  Repealed by Acts 2005, 79th Leg., Ch. 349, Sec. 7(b), eff. September 1, 2005.
(f)  The executive commissioner by rule may develop a system of selective contracting with health care providers for the provision of nonemergency inpatient hospital services to a recipient of medical assistance under this chapter.  In implementing this subsection, the executive commissioner shall:
(1)  seek input from consumer representatives and from representatives of hospitals licensed under Chapter 241, Health and Safety Code, and from organizations representing those hospitals; and
(2)  ensure that providers selected under the system meet the needs of a recipient of medical assistance under this chapter.
(g)  The process to select a hospital must afford each disproportionate share hospital an opportunity to negotiate for a contract.  The process will take into account the special circumstances of disproportionate share hospitals when evaluating proposals.
(h)  A proposal or bid submitted by a hospital and any work papers, cost reports, or other financial data used to prepare the proposal or bid shall be confidential and not subject to required disclosure by the commission or the hospital under any other statute until the executed contracts have been awarded.
(i)  In its establishment of provider criteria for hospitals, home health providers, or hospice providers, the commission shall accept licensure by the Department of Aging and Disability Services or the Department of State Health Services, as appropriate, or certification by the Medicare program, Title XVIII of the Social Security Act (42 U.S.C. Section 1395 et seq.).
(j)  The commission shall assure that a recipient of medical assistance under this chapter may select a nurse first assistant, as defined by Section 301.354, Occupations Code, to perform any health care service or procedure covered under the medical assistance program if:
(1)  the selected nurse first assistant is authorized by law to perform the service or procedure; and
(2)  the physician requests that the service or procedure be performed by the nurse first assistant.
(k)  The commission shall assure that a recipient of medical assistance under this chapter may select a surgical assistant licensed under Chapter 206, Occupations Code, to perform any health care service or procedure covered under the medical assistance program if:
(1)  the selected surgical assistant is authorized by law to perform the service or procedure; and
(2)  the physician requests that the service or procedure be performed by the surgical assistant.
(l)  Subject to appropriations, the commission shall assure that a recipient of medical assistance under this chapter may select a licensed psychologist, a licensed marriage and family therapist, as defined by Section 502.002, Occupations Code, a licensed professional counselor, as defined by Section 503.002, Occupations Code, or a licensed master social worker, as defined by Section 505.002, Occupations Code, to perform any health care service or procedure covered under the medical assistance program if the selected person is authorized by law to perform the service or procedure.  This subsection shall be liberally construed.
Acts 1979, 66th Leg., p. 2351, ch. 842, art. 1, Sec. 1, eff. Sept. 1, 1979.  Amended by Acts 1989, 71st Leg., ch. 1085, Sec. 4, eff. Sept. 1, 1989;  Acts 1989, 71st Leg., ch. 1173, Sec. 1, eff. Aug. 28, 1989;  Acts 1990, 71st Leg., 6th C.S., ch. 12, Sec. 2(14), eff. Sept. 6, 1990;  Acts 1993, 73rd Leg., ch. 390, Sec. 1, 2, eff. Sept. 1, 1993;  Acts 1995, 74th Leg., ch. 965, Sec. 57, eff. June 16, 1995;  Acts 1999, 76th Leg., ch. 930, Sec. 1, eff. Jan. 1, 2000;  Acts 2001, 77th Leg., ch. 812, Sec. 4, eff. Sept. 1, 2001;  Acts 2001, 77th Leg., ch. 1014, Sec. 6, eff. Sept. 1, 2001;  Acts 2001, 77th Leg., ch. 1420, Sec. 14.813, eff. Sept. 1, 2001;  Acts 2003, 78th Leg., ch. 198, Sec. 2.156(a)(2), eff. Sept. 1, 2003;  Acts 2003, 78th Leg., ch. 1167, Sec. 4, eff. Sept. 1, 2003;  Acts 2003, 78th Leg., ch. 1251, Sec. 9, eff. June 20, 2003.
Amended by:
Acts 2005, 79th Leg., Ch. 349 (S.B. 1188), Sec. 7(a), eff. September 1, 2005.
Acts 2005, 79th Leg., Ch. 349 (S.B. 1188), Sec. 7(b), eff. September 1, 2005.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.093, eff. April 2, 2015.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.094, eff. April 2, 2015.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.095, eff. April 2, 2015.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.465(a)(38), eff. April 2, 2015.