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A BILL TO BE ENTITLED
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AN ACT
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relating to the authority of certain medical consenters to assume |
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financial responsibility for certain out-of-network medical care |
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provided to children in foster care. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Chapter 266, Family Code, is amended by adding |
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Section 266.0043 to read as follows: |
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Sec. 266.0043. ASSUMPTION OF FINANCIAL RESPONSIBILITY BY |
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MEDICAL CONSENTERS. (a) In this section: |
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(1) "Health care provider" means an individual who is |
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licensed, certified, or otherwise authorized to provide health care |
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services in this state. The term does not include a pharmacy. |
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(2) "Managed care plan" has the meaning assigned by |
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Section 540.0001, Government Code. |
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(3) "Medicaid" and "Medicaid managed care |
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organization" have the meanings assigned by Section 521.0001, |
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Government Code. |
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(4) "Medicaid managed care plan" means a managed care |
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plan offered by a Medicaid managed care organization. |
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(5) "Medical consenter" means a person authorized to |
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consent to medical care for a foster child under Section |
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266.004(b). |
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(6) "Out-of-network provider" means a health care |
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provider who is not included in the provider network of the Medicaid |
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managed care plan in which a foster child is enrolled. |
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(7) "Pharmacy" has the meaning assigned by Section |
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551.003, Occupations Code. |
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(b) Notwithstanding any other law, a medical consenter |
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other than the department may assume financial responsibility for |
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medical care, including behavioral health services, provided to a |
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foster child by an out-of-network provider engaged by the medical |
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consenter on behalf of the child. For purposes of this section, |
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assuming financial responsibility may include the medical |
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consenter enrolling the child in a health insurance plan. |
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(c) The department is not liable for the cost of medical |
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care described by Subsection (b), unless a court orders the |
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department to cover the cost of the medical care. |
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(d) This section may not be construed to: |
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(1) limit or restrict a foster child's access to |
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Medicaid benefits, including in-network benefits provided under |
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the Medicaid managed care program; |
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(2) change or limit the rights of parents of children |
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in the temporary managing conservatorship of the department; or |
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(3) limit a court's authority to order the department |
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to assume financial responsibility for the cost of services |
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provided to a foster child by an out-of-network provider. |
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(e) Not later than the 10th business day after the date |
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medical care for which a medical consenter assumes financial |
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responsibility under this section is provided, the medical |
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consenter shall notify, in the form and manner prescribed by the |
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department, the child's caseworker of the provision of that care. |
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The department shall ensure the child's health passport includes |
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records of the medical care provided under this section. |
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SECTION 2. Subchapter Q, Chapter 540, Government Code, is |
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amended by adding Section 540.0807 to read as follows: |
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Sec. 540.0807. ACCESS TO CARE PAID FOR BY CERTAIN MEDICAL |
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CONSENTERS. (a) A Medicaid managed care organization may not take |
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adverse action to prevent or discourage a recipient from accessing |
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health care and related services and benefits in accordance with |
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Section 266.0043, Family Code. |
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(b) A STAR Health program managed care contract between a |
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Medicaid managed care organization and the commission must require |
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that the organization comply with Subsection (a). |
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(c) This section may not be construed to confer liability on |
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a Medicaid managed care organization for the cost of health care and |
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related services and benefits described by Section 266.0043(b), |
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Family Code. |
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SECTION 3. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 4. This Act takes effect September 1, 2025. |