SB963 - Relating to allowing Medicaid managed care organizations to engage in marketing about the availability of certain private health benefit plan coverage.

      S.B. No. 963         AN ACT   relating to allowing Medicaid managed care organizations to engage   in marketing about the availability of certain private health   benefit plan coverage.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 540.0055, Government Code, as effective   April 1, 2025, is amended by adding Subsections (c) and (d) to read   as follows:           (c)     The marketing guidelines the commission establishes   under this section may not prohibit a Medicaid managed care   organization from:                 (1)     informing an individual, including a current or   former recipient, about the availability of qualified health plans   offered through an exchange, as the terms "exchange"   and "qualified   health plan"   are defined by 45 C.F.R. Section 155.20; or                 (2)     advertising a Medicare Advantage plan or related   benefit offered under Part C of Title XVIII of the Social Security   Act (42 U.S.C. Section 1395w-21 et seq.) at a community enrollment   or other event.           (d)     The marketing guidelines the commission establishes   under this section must require that a Medicaid managed care   organization that informs an individual about the availability of   qualified health plans offered through an exchange, as the terms   "exchange" and "qualified health plan" are defined by 45 C.F.R.   Section 155.20, also inform the individual about the potential   deductibles, copayments, and other cost-sharing requirements under   a qualified health plan. A Medicaid managed care organization   informing an individual about the availability of qualified health   plans offered through the exchange or an affiliate of the   organization may not offer the individual material or financial   gain as an actual or implied incentive for enrolling in a qualified   health plan.          SECTION 2.  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 3.  This Act takes effect September 1, 2025.               ______________________________ ______________________________      President of the Senate Speaker of the House                 I hereby certify that S.B. No. 963 passed the Senate on   April 10, 2025, by the following vote: Yeas 30, Nays 0; and that   the Senate concurred in House amendment on May 21, 2025, by the   following vote: Yeas 31, Nays 0.       ______________________________   Secretary of the Senate                I hereby certify that S.B. No. 963 passed the House, with   amendment, on April 29, 2025, by the following vote: Yeas 119,   Nays 27, two present not voting.       ______________________________   Chief Clerk of the House            Approved:     ______________________________                Date       ______________________________              Governor