SB236 - Relating to certain evidence-based health-related non-medical services offered by a Medicaid managed care organization in lieu of other services.

      By: Johnson S.B. No. 236               A BILL TO BE ENTITLED   AN ACT   relating to certain evidence-based health-related non-medical   services offered by a Medicaid managed care organization in lieu of   other services.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 533.005(h), Government Code, is amended   to read as follows:          (h)  In addition to the requirements specified by Subsection   (a), a contract described by that subsection must contain language   permitting a managed care organization to offer medically   appropriate, cost-effective, evidence-based mental health or   substance use disorder  services and health-related non-medical   services  from a list [ approved by the state Medicaid managed care   advisory committee and ] included in the contract in lieu of [ mental   health or substance use disorder ] services specified in the state   Medicaid plan.  A recipient is not required to use a service from   the list included in the contract in lieu of another [ mental health   or substance use disorder ] service specified in the state Medicaid   plan.  The commission shall:                (1)  prepare and submit an annual report to the   legislature on the number of times during the preceding year a   service from the list included in the contract is used; and                (2)  take into consideration the actual cost and use of   any services from the list included in the contract that are offered   by a managed care organization when setting the capitation rates   for that organization under the contract.          SECTION 2.  Section 533.005(h), Government Code, as amended   by this Act, applies to a contract entered into or renewed on or   after the effective date of this Act.  A contract entered into or   renewed before that date is governed by the law in effect on the   date the contract was entered into or renewed, and that law is   continued in effect for that purpose.          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.