Hinojosa Bill Gives Public Benefit Corporations A 5% Medicaid Edge

The text as introduced · 346 words

89R13756 SCF-D

By: Hinojosa
H.B. No. 5284

A BILL TO BE ENTITLED

AN ACT

relating to considerations in awarding contracts under the Medicaid

managed care program to managed care organizations that are public

benefit corporations.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 540.0204, Government Code, as effective

April 1, 2025, is amended to read as follows:

Sec. 540.0204. CONTRACT CONSIDERATIONS RELATING TO MANAGED

CARE ORGANIZATIONS. (a) In awarding contracts to managed care

organizations, the commission shall:

(1) give preference to an organization that has

significant participation in the organization's provider network

from each health care provider in the region who has traditionally

provided care to Medicaid and charity care patients;

(2) give extra consideration to an organization that

agrees to assure continuity of care for at least three months beyond

a recipient's Medicaid eligibility period;

(3) consider the need to use different managed care

plans to meet the needs of different populations; and

(4) consider the ability of an organization to process

Medicaid claims electronically.

(b) In awarding contracts to managed care organizations,

the commission shall:

(1) if an organization is a public benefit

corporation, as defined by Section 21.952, Business Organizations

Code, apply a five percent increase to the bid score assigned to the

organization for purposes of awarding a contract under this

chapter; and

(2) if two or more bids receive the same score, give

preference to the organization that is a public benefit

corporation.

SECTION 2. Section 540.0204, Government Code, as amended by

this Act, applies only to a contract awarded by the Health and Human

Services Commission to a managed care organization on or after the

effective date of this Act.

SECTION 3. 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 4. This Act takes effect September 1, 2025.