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Relating to Medicaid reimbursement for the provision of certain behavioral health and physical health services.
The fiscal implications of the bill cannot be determined at this time because the impact on the scope of services provided and the number of providers eligible to receive reimbursement is unknown.
The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill. The Health and Human Services Commission is required to implement a provision of this Act only if the legislature appropriates money specifically for that purpose. If the legislature does not appropriate money specifically for that purpose, the commission may, but is not required to, implement a provision of this Act using other appropriations available for that purpose.
SB 1921 would require the Health and Human Services Commission to provide to a public or private provider of behavioral health services medical assistance reimbursement through a free-for-service delivery model for behavioral health or physical health services. Such services would have been provided to a recipient before that recipient's enrollment with and receipt of medical assistance services through a managed care organization.
SB 1921 would require the commission to ensure that a public or private provider of behavioral health services who is reimbursed through a fee-for-service delivery model is provided medical assistance reimbursement through a managed care model for behavioral health or physical health services after the enrollment of those receiving services through a managed care organization.
SB 1921 would fill the gap of medical coverage between a person qualifying for Medicaid and then enrolling in a managed care organization for physical and psychological services. SB 1921 would help to ensure coverage and provide that coverage for patients while allowing providers to be reimbursed for the services they provide. While ensuring coverage through a period of transition is not a bad thing, it is very concerning that the bill does not have a known cost and yet allows for appropriations. This in effect would give government a blank check to provide these services. For this reason, Texas Action remains neutral.