Tex. Gov't Code § 543A.0005 · Subchapter A. GENERAL PROVISIONS
PAYMENT METHODOLOGY CONVERSION.
Text — Current through the 89th 2nd Called Legislative Session, 2025
(a) To the extent possible, the commission shall convert hospital reimbursement systems under the child health plan program and Medicaid to a diagnosis-related groups (DRG) methodology that will allow the commission to more accurately classify specific patient populations and account for the severity of patient illness and mortality risk.
(b) Subsection (a) does not authorize the commission to direct a managed care organization to compensate a physician or other health care provider providing services under the organization's managed care plan based on a diagnosis-related groups (DRG) methodology.
(c) Notwithstanding Subsection (a) and to the extent possible, the commission shall convert outpatient hospital reimbursement systems under the child health plan program and Medicaid to an appropriate prospective payment system that will allow the commission to:
(1) more accurately classify the full range of outpatient service episodes;
(2) more accurately account for the intensity of services provided; and
(3) motivate outpatient service providers to increase efficiency and effectiveness.
Notes and commentary — not statutory text
History
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
Source of truth
- Edition
- Current through the 89th 2nd Called Legislative Session, 2025
- Official file
- https://statutes.capitol.texas.gov/Docs/GV/htm/GV.543A.htm
- Text hash
- sha256 36bf72446635550eb07fa5e0a34e7fdb17305aa8f30b48c1b32a2a9b729b031e
- Composed by
- compose_tx.py 2026-10-05: the Legislative Council's chapter files read in document order; verify_tx.py's independent reading (lxml DOM walk) agrees character for character
Cited by 1 provision
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