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A BILL TO BE ENTITLED
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AN ACT
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relating to a study and pilot program to evaluate the provision of |
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prenatal and well child care in a group clinical setting and |
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authority to take related action. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter B, Chapter 531, Government Code, is |
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amended by adding Section 531.02493 to read as follows: |
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Sec. 531.02493. CURRICULUM-BASED GROUP WELL CHILD CARE |
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PILOT PROGRAM. (a) The commission shall develop and, not later |
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than March 1, 2022, implement a pilot program to increase the rate |
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at which recipients attend well child health care visits, |
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developmental screenings, and immunizations by providing those |
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services through a curriculum-based group well child care model in |
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a clinical setting. |
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(b) The commission shall operate the pilot program in one or |
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more geographic areas of this state. |
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(c) In implementing the pilot program, the commission |
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shall: |
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(1) require a Medicaid managed care organization to |
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provide enhanced reimbursement in an amount determined by the |
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commission to a health care provider for providing curriculum-based |
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group well child care to recipients; and |
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(2) evaluate whether the enhanced reimbursement |
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increases the rate of children receiving well child visits, |
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developmental screenings, and immunizations. |
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(d) The commission shall operate the pilot program for two |
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years. |
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(e) Not later than September 1, 2024, the commission shall |
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submit to the governor, the lieutenant governor, the speaker of the |
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house of representatives, and each standing committee of the |
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legislature having primary jurisdiction over health and human |
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services a written report that: |
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(1) summarizes the results of the pilot program; and |
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(2) recommends whether the pilot program should |
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continue, be expanded, or terminate or if the commission should |
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permanently implement enhanced reimbursement to health care |
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providers for providing curriculum-based group well child care in a |
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clinical setting. |
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(f) The executive commissioner may adopt rules as necessary |
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to implement this section. |
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(g) This section expires September 1, 2025. |
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SECTION 2. (a) In this section: |
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(1) "Commission" means the Health and Human Services |
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Commission. |
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(2) "Medicaid" means the medical assistance program |
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established under Chapter 32, Human Resources Code. |
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(3) "Medicaid managed care organization" means a |
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managed care organization as defined by Section 533.001, Government |
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Code, that contracts with the commission under Chapter 533, |
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Government Code, to provide health care services to Medicaid |
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recipients. |
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(b) The commission shall conduct a study regarding the |
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provision of curriculum-based prenatal care and curriculum-based |
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well child care offered in a group clinical setting. The study |
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must: |
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(1) evaluate the health benefits and potential cost |
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savings to Medicaid that would result from implementing |
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curriculum-based group prenatal care models, including |
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implementation of those models using virtual modalities similar to |
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those used during the COVID-19 pandemic; |
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(2) evaluate the use of procedure codes under Medicaid |
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for curriculum-based group prenatal care in a clinical setting; |
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(3) reassess the provider types authorized to provide |
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prenatal benefits in a group clinical setting under Medicaid by |
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identifying provider types that deliver curriculum-based group |
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prenatal care, including federally qualified health centers, |
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hospitals, rural health clinics, and individual health care |
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providers; and |
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(4) explore options for promoting curriculum-based |
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group well child care models under Medicaid, including by: |
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(A) assessing the need for establishing a |
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procedure code under Medicaid for the provision of curriculum-based |
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group well child care in a clinical setting; and |
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(B) promoting value-based payment arrangements |
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between providers and Medicaid managed care organizations. |
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(c) Not later than September 1, 2022, the commission shall: |
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(1) prepare and submit a report on the findings of the |
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study conducted under Subsection (b) of this section to the |
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standing committees of the senate and house of representatives |
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having jurisdiction over Medicaid; and |
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(2) based on the assessment under Subsection (b)(3) of |
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this section, update the health care provider types that may |
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provide prenatal benefits in a group clinical setting under |
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Medicaid. |
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(d) This section expires September 1, 2023. |
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SECTION 3. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 4. This Act takes effect September 1, 2021. |