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89(R) SB 963 - Enrolled version - Bill Text
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