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.