Texas Statutes
Subchapter B. Administrative Provisions
Section 32.027. Selection of Provider of Medical Assistance

Sec. 32.027. SELECTION OF PROVIDER OF MEDICAL ASSISTANCE. (a) Except as provided by Subsections (f) and (g), a recipient of medical assistance authorized in this chapter may select any provider authorized by the commission to provide medical assistance.
(b) Repealed by Acts 2015, 84th Leg., R.S., Ch. 1, Sec. 4.465(a)(38), eff. April 2, 2015.
(c) Repealed by Acts 2003, 78th Leg., ch. 1167, Sec. 4.
(d) The commission shall permit a recipient of medical assistance under this chapter to receive services relating to physical therapy from any person authorized to practice physical therapy under Chapter 453, Occupations Code.
(e) Repealed by Acts 2003, 78th Leg., ch. 198, Sec. 2.156(a)(2).
(e) Repealed by Acts 2005, 79th Leg., Ch. 349, Sec. 7(b), eff. September 1, 2005.
(f) The executive commissioner by rule may develop a system of selective contracting with health care providers for the provision of nonemergency inpatient hospital services to a recipient of medical assistance under this chapter. In implementing this subsection, the executive commissioner shall:
(1) seek input from consumer representatives and from representatives of hospitals licensed under Chapter 241, Health and Safety Code, and from organizations representing those hospitals; and
(2) ensure that providers selected under the system meet the needs of a recipient of medical assistance under this chapter.
(g) The process to select a hospital must afford each disproportionate share hospital an opportunity to negotiate for a contract. The process will take into account the special circumstances of disproportionate share hospitals when evaluating proposals.
(h) A proposal or bid submitted by a hospital and any work papers, cost reports, or other financial data used to prepare the proposal or bid shall be confidential and not subject to required disclosure by the commission or the hospital under any other statute until the executed contracts have been awarded.
(i) In its establishment of provider criteria for hospitals, home health providers, or hospice providers, the commission shall accept licensure by the Department of Aging and Disability Services or the Department of State Health Services, as appropriate, or certification by the Medicare program, Title XVIII of the Social Security Act (42 U.S.C. Section 1395 et seq.).
(j) The commission shall assure that a recipient of medical assistance under this chapter may select a nurse first assistant, as defined by Section 301.354, Occupations Code, to perform any health care service or procedure covered under the medical assistance program if:
(1) the selected nurse first assistant is authorized by law to perform the service or procedure; and
(2) the physician requests that the service or procedure be performed by the nurse first assistant.
(k) The commission shall assure that a recipient of medical assistance under this chapter may select a surgical assistant licensed under Chapter 206, Occupations Code, to perform any health care service or procedure covered under the medical assistance program if:
(1) the selected surgical assistant is authorized by law to perform the service or procedure; and
(2) the physician requests that the service or procedure be performed by the surgical assistant.
(l) Subject to appropriations, the commission shall assure that a recipient of medical assistance under this chapter may select a licensed psychologist, a licensed marriage and family therapist, as defined by Section 502.002, Occupations Code, a licensed professional counselor, as defined by Section 503.002, Occupations Code, or a licensed master social worker, as defined by Section 505.002, Occupations Code, to perform any health care service or procedure covered under the medical assistance program if the selected person is authorized by law to perform the service or procedure. This subsection shall be liberally construed.
Acts 1979, 66th Leg., p. 2351, ch. 842, art. 1, Sec. 1, eff. Sept. 1, 1979. Amended by Acts 1989, 71st Leg., ch. 1085, Sec. 4, eff. Sept. 1, 1989; Acts 1989, 71st Leg., ch. 1173, Sec. 1, eff. Aug. 28, 1989; Acts 1990, 71st Leg., 6th C.S., ch. 12, Sec. 2(14), eff. Sept. 6, 1990; Acts 1993, 73rd Leg., ch. 390, Sec. 1, 2, eff. Sept. 1, 1993; Acts 1995, 74th Leg., ch. 965, Sec. 57, eff. June 16, 1995; Acts 1999, 76th Leg., ch. 930, Sec. 1, eff. Jan. 1, 2000; Acts 2001, 77th Leg., ch. 812, Sec. 4, eff. Sept. 1, 2001; Acts 2001, 77th Leg., ch. 1014, Sec. 6, eff. Sept. 1, 2001; Acts 2001, 77th Leg., ch. 1420, Sec. 14.813, eff. Sept. 1, 2001; Acts 2003, 78th Leg., ch. 198, Sec. 2.156(a)(2), eff. Sept. 1, 2003; Acts 2003, 78th Leg., ch. 1167, Sec. 4, eff. Sept. 1, 2003; Acts 2003, 78th Leg., ch. 1251, Sec. 9, eff. June 20, 2003.
Amended by:
Acts 2005, 79th Leg., Ch. 349 (S.B. 1188), Sec. 7(a), eff. September 1, 2005.
Acts 2005, 79th Leg., Ch. 349 (S.B. 1188), Sec. 7(b), eff. September 1, 2005.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.093, eff. April 2, 2015.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.094, eff. April 2, 2015.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.095, eff. April 2, 2015.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.465(a)(38), eff. April 2, 2015.

Structure Texas Statutes

Texas Statutes

Human Resources Code

Title 2 - Human Services and Protective Services in General

Subtitle C - Assistance Programs

Chapter 32 - Medical Assistance Program

Subchapter B. Administrative Provisions

Section 32.021. Administration of the Program

Section 32.0211. Restrictions on Executive Commissioners, Former Members of a Board, Commissioners, and Their Business Partners

Section 32.0212. Delivery of Medical Assistance

Section 32.0213. Nursing Facility Bed Certification and Decertification

Section 32.0214. Designations of Primary Care Provider by Certain Recipients

Section 32.0215. Home or Community Care Providers: Civil Monetary Penalties

Section 32.022. Medical and Hospital Care Advisory Committees

Section 32.023. Cooperation With Other State Agencies

Section 32.0231. Announcement of Funding or Program Change

Section 32.024. Authority and Scope of Program; Eligibility

Section 32.0241. Review of Waiver Request

Section 32.0242. Verification of Certain Information

Section 32.0244. Nursing Facility Beds in Certain Counties

Section 32.0245. Nursing Facility Beds for Certain Facilities Treating Alzheimer's Disease

Section 32.02451. Additional Personal Needs Allowance for Guardianship Expenses of Certain Recipients

Section 32.0246. Medical Assistance Reimbursement for Certain Behavioral Health and Physical Health Services

Section 32.02471. Medical Assistance for Certain Former Foster Care Adolescents Enrolled in Higher Education

Section 32.024715. Streamlined Eligibility Determination Process for Certain Former Foster Care Youth

Section 32.0249. Mental Health Screenings in Texas Health Steps Program

Section 32.025. Application for Medical Assistance

Section 32.0251. Eligibility Notification and Review for Certain Children

Section 32.0255. Transitional Medical Assistance

Section 32.0256. Continuation of Medical Assistance for Certain Individuals

Section 32.026. Certification of Eligibility and Need for Medical Assistance

Section 32.0261. Continuous Eligibility

Section 32.026101. Determination of Eligibility by Health Care Exchanges Prohibited

Section 32.02611. Exclusion of Assets in Prepaid Tuition Programs and Higher Education Savings Plans

Section 32.02613. Life Insurance Assets; Life Insurance Policy Conversion

Section 32.0262. Eligibility Transition

Section 32.0263. Health Care Orientation

Section 32.0264. Suspension and Reinstatement of Eligibility for Children in Juvenile Facilities

Section 32.0265. Notice of Certain Placements in Juvenile Facilities

Section 32.0266. Suspension, Termination, and Automatic Reinstatement of Eligibility for Individuals Confined in County Jails

Section 32.027. Selection of Provider of Medical Assistance

Section 32.0275. Military Medical Treatment Facilities and Affiliated Health Care Providers; Reimbursement

Section 32.028. Fees, Charges, and Rates

Section 32.0281. Rules and Notice Relating to Payment Rates

Section 32.0282. Public Hearing on Rates

Section 32.0284. Calculation of Payments Under Certain Supplemental Hospital Payment Programs

Section 32.0285. Calculation of Medical Education Add-on for Reimbursement of Teaching Hospitals That Provide Behavioral Health and Physical Health Services

Section 32.029. Methods of Payment

Section 32.0291. Prepayment Reviews and Payment Holds

Section 32.031. Receipt and Expenditure of Funds

Section 32.0311. Drug Reimbursement Under Certain Programs

Section 32.03115. Reimbursement for Medication-Assisted Treatment for Opioid or Substance Use Disorder

Section 32.0312. Reimbursement for Services Associated With Preventable Adverse Events

Section 32.0313. Induced Deliveries or Cesarean Sections Before 39th Week

Section 32.0314. Reimbursement for Durable Medical Equipment and Supplies

Section 32.03141. Authority of Advanced Practice Registered Nurses and Physician Assistants Regarding Durable Medical Equipment and Supplies

Section 32.0315. Funds for Graduate Medical Education

Section 32.0316. Electronic Transactions; Medicaid

Section 32.0317. Reimbursement for Services Provided Under School Health and Related Services Program

Section 32.032. Prevention and Detection of Fraud and Abuse

Section 32.0321. Surety Bond

Section 32.0322. Criminal History Record Information; Enrollment of Providers

Section 32.033. Subrogation

Section 32.034. Contract Cancellation; Notice and Hearing

Section 32.035. Appeals

Section 32.036. Program Payments Nonassignable and Exempt From Legal Process

Section 32.038. Collection of Insurance Payments

Section 32.0381. Icf-Iid Payment Rates

Section 32.039. Damages and Penalties

Section 32.0391. Criminal Offense

Section 32.040. Identification of Husband or Alleged Father

Section 32.042. Information Required From Health Insurers

Section 32.0421. Administrative Penalty for Failure to Provide Information

Section 32.0422. Health Insurance Premium Payment Reimbursement Program for Medical Assistance Recipients

Section 32.0423. Recovery of Reimbursements From Health Coverage Providers

Section 32.0424. Requirements of Third-Party Health Insurers

Section 32.04242. Payor of Last Resort

Section 32.0425. Reimbursement for Wheeled Mobility Systems

Section 32.043. Procurement Rules for Public Disproportionate Share Hospitals

Section 32.044. Group Purchasing for Disproportionate Share Hospitals

Section 32.045. Enhanced Reimbursement

Section 32.046. Sanctions and Penalties Related to the Provision of Pharmacy Products

Section 32.0461. Vendor Drug Program; Competitive Bidding

Section 32.0462. Vendor Drug Program; Pricing Standard

Section 32.0463. Medications and Medical Supplies

Section 32.047. Prohibition of Certain Health Care Service Providers

Section 32.048. Managed Care Information and Training Plan

Section 32.049. Managed Care Contract Compliance

Section 32.050. Dual Medicaid and Medicare Coverage

Section 32.051. Misdirected Billing

Section 32.052. Waiver Programs for Children With Disabilities or Special Health Care Needs

Section 32.0531. Pace Program Team

Section 32.0532. Pace Program Reimbursement Methodology

Section 32.0533. Data Collection: Pace and Star + Plus Medicaid Managed Care Programs

Section 32.054. Dental Services

Section 32.055. Catastrophic Case Management

Section 32.0551. Optimization of Case Management Systems

Section 32.056. Compliance With Texas Health Steps Comprehensive Care Program

Section 32.0561. Maternal Depression Screening

Section 32.057. Contracts for Disease Management Programs

Section 32.058. Limitation on Medical Assistance in Certain Alternative Community-Based Care Settings

Section 32.059. Use of Respiratory Therapists for Respiratory Therapy Services

Section 32.061. Community Attendant Services Program

Section 32.062. Admissibility of Certain Evidence Relating to Nursing Institutions

Section 32.063. Third-Party Billing Vendors

Section 32.0641. Recipient Accountability Provisions; Cost-Sharing Requirement to Improve Appropriate Utilization of Services

Section 32.067. Delivery of Comprehensive Care Services to Certain Recipients of Medical Assistance

Section 32.068. In-Person Evaluation Required for Certain Services

Section 32.069. Chronic Kidney Disease Management Initiative

Section 32.070. Audits of Providers

Section 32.0705. External Audits of Certain Medicaid Contractors Based on Risk

Section 32.071. Recipient and Provider Education

Section 32.072. Direct Access to Eye Health Care Services

Section 32.073. Health Information Technology Standards

Section 32.074. Access to Personal Emergency Response System

Section 32.075. Employment Assistance and Supported Employment

Section 32.076. Substitute Dentists