HB 5284

relating to considerations in awarding contracts under the Medicaid
managed care program to managed care organizations that are public
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1.  Section 540.0204, Government Code, as effective
April 1, 2025, is amended to read as follows:
Sec. 540.0204.  CONTRACT CONSIDERATIONS RELATING TO MANAGED
CARE ORGANIZATIONS.  (a)  In awarding contracts to managed care
organizations, the commission shall:
(1)  give preference to an organization that has
significant participation in the organization's provider network
from each health care provider in the region who has traditionally
provided care to Medicaid and charity care patients;
(2)  give extra consideration to an organization that
agrees to assure continuity of care for at least three months beyond
a recipient's Medicaid eligibility period;
(3)  consider the need to use different managed care
plans to meet the needs of different populations; and
(4)  consider the ability of an organization to process
Medicaid claims electronically.
(b)  In awarding contracts to managed care organizations,
(1)  if an organization is a public benefit
corporation, as defined by Section 21.952, Business Organizations
Code, apply a five percent increase to the bid score assigned to the
organization for purposes of awarding a contract under this
(2)  if two or more bids receive the same score, give
preference to the organization that is a public benefit
SECTION 2.  Section 540.0204, Government Code, as amended by
this Act, applies only to a contract awarded by the Health and Human
Services Commission to a managed care organization on or after the
SECTION 3.  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 4.  This Act takes effect September 1, 2025.