BG C.S.H.B. 1939 75(R)BILL ANALYSIS


PUBLIC HEALTH
C.S.H.B. 1939
By: Coleman
4-25-97
Committee Report (Substituted)


BACKGROUND 

Early intervention and treatment of patients with medical nutritional
products has shown to improve the nutritional status of these patients.
Currently, there are three states that do not provide coverage for medical
nutritional products for outpatient Medicaid recipients. Texas is one of
them.  This nutrition intervention is critical to a patient's care.  It
reduces the risks of complications from illnesses or medical conditions,
and as a result, lowers the cost of treatment of these individuals. 

PURPOSE

CSHB 1939 requires the state to provide coverage for nutritional products
deemed necessary for the nutritional management of an illness, injury,
disorder, or other health condition. 

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly grant any
additional rulemaking authority to a state officer, department, agency or
institution. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Section 32.024, Human Resources Code, by adding
Subsection (t) as follows: 

Subsection (t)  requires the state to provide coverage under the state
Medicaid program for medically necessary enteral nutrition therapy and
related nutrition services as specified. Stipulates that nutrition
services must be provided by a licensed dietician. Allows the Texas
Department of Health to require prior authorization as a condition for
coverage of therapy or services. Defines "enteral nutrition formula,"
"enteral nutrition therapy," Licensed dietician," "nutrition services,"
and "physician"  as specified. 

SECTION 2.  Requires a state agency to request a waiver or authorization
from a federal agency, if determined to be necessary, before implementing
a provision of the Act.  Allows the state agency to delay implementing
that provision until the waiver or authorization is granted. 

SECTION 3.  Establishes the effective date of this Act to be September 1,
1997. 

SECTION 4.  Emergency Clause.

COMPARISON OF ORIGINAL TO SUBSTITUTE

CSHB 1939 revises the original bill's SECTION 1, by modifying the new Sec.
32.024(t), Human Resources Code. The substitute removes references to
parenteral feedings and further clarifies the meaning, purpose and
procedures for the provision of medically prescribed enteral nutrition and
related nutrition services.