bill letting home care providers pick their visit-logging system

The text as introduced · 919 words

89R1441 KKR-F

By: Hughes
S.B. No. 1334

A BILL TO BE ENTITLED

AN ACT

relating to the approval, selection, and use of an alternative

electronic visit verification system under Medicaid.

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

SECTION 1. Section 532.0257, Government Code, as effective

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

Sec. 532.0257. HEALTH CARE PROVIDER COMPLIANCE. A health

care provider that provides to recipients personal care services,

attendant care services, or other services the commission

identifies shall:

(1) use the electronic visit verification system or an

alternative [ a proprietary ] system the commission approves

[ allows ] as provided by Section 532.0258 to document the provision

of those services;

(2) comply with all documentation requirements the

commission establishes;

(3) comply with federal and state laws regarding

confidentiality of recipients' information;

(4) ensure that the commission or the Medicaid managed

care organization with which a claim for reimbursement for a

service is filed may review electronic visit verification system

documentation related to the claim or obtain a copy of that

documentation at no charge to the commission or the organization;

and

(5) at any time, allow the commission or a Medicaid

managed care organization with which a health care provider

contracts to provide health care services to recipients enrolled in

the organization's managed care plan to have direct, on-site access

to the electronic visit verification system in use by the health

care provider.

SECTION 2. Section 532.0258, Government Code, as effective

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

Sec. 532.0258. HEALTH CARE PROVIDER: USE OF ALTERNATIVE

[ PROPRIETARY ] SYSTEM. (a) The commission may approve an

alternative [ recognize a health care provider's proprietary ]

electronic visit verification system, including a system [ whether ]

purchased or developed by a health care [ the ] provider, as

complying with this subchapter and allow a [ the ] health care

provider to use the [ that ] system [ for a period the commission

determines ] if the commission determines that the system[ :

[ (1) complies with all necessary data submission,

exchange, and reporting requirements established under this

subchapter; and

[ (2) ] meets all [ other ] standards and requirements ,

including electronic visit verification business rules,

established under this subchapter.

(b) To the extent allowed by federal law [ If feasible ], the

executive commissioner shall ensure the vendor of an approved

alternative electronic visit verification system selected by a

health care provider under this section is reimbursed for any

electronic visit verification visit transaction costs if the [ use

of the provider's proprietary electronic visit verification ]

system maintains the minimum standards and requirements the

commission establishes [ recognizes ].

(b-1) The commission shall:

(1) allow a health care provider to select, on a form

the provider signs and in the manner the commission prescribes, any

alternative electronic visit verification system the commission

approves under this section;

(2) timely approve a provider's signed selection of

the alternative system under Subdivision (1); and

(3) allow the provider a period of 90 days to implement

the selected alternative system.

(b-2) The commission shall maintain a current list of

alternative electronic visit verification systems the commission

has approved. The list must:

(1) include:

(A) each alternative system the commission has

approved under this section;

(B) contact information for the person from whom

the alternative system may be obtained; and

(C) an electronic link to an alternative

electronic visit verification system selection form for use by a

health care provider in making a selection; and

(2) be prominently posted on the Internet website of

the commission or the commission's designee in the same location

that other information on alternative electronic visit

verification systems under this subchapter is posted.

(b-3) The commission may not limit the number of alternative

electronic visit verification systems approved under this section.

(c) For purposes of facilitating the use of alternative

[ proprietary ] electronic visit verification systems by health care

providers and in consultation with industry stakeholders and the

work group established under Section 532.0259, the commission or

the executive commissioner, as appropriate, shall:

(1) develop an open model system that mitigates the

administrative burdens providers required to use electronic visit

verification identify;

(2) allow providers to use emerging technologies,

including Internet-based, mobile telephone-based, and global

positioning-based technologies, in the alternative [ providers'

proprietary ] electronic visit verification systems approved under

this section ;

(2-a) allow providers to choose a system that best meets

the providers' needs, including, if the commission changes the

vendor for the electronic visit verification system under Section

532.0253, continuing to use the previous vendor's system if the

system meets commission standards and requirements; and

(3) adopt rules governing :

(A) data submission ;

(B) [ and provider ] reimbursement of electronic

visit verification visit transaction costs; and

(C) an efficient alternative electronic visit

verification system approval process .

SECTION 3. As soon as possible after the effective date of

this Act, the executive commissioner of the Health and Human

Services Commission shall adopt rules necessary to implement

Section 532.0258, Government Code, as amended by this Act.

SECTION 4. 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 5. This Act takes effect September 1, 2025.