75R13088 CLG-F                           

         By Coleman                                            H.B. No. 1939

         Substitute the following for H.B. No. 1939:

         By Berlanga                                       C.S.H.B. No. 1939

                                A BILL TO BE ENTITLED

 1-1                                   AN ACT

 1-2     relating to Medicaid coverage of certain nutrition therapy and

 1-3     nutrition services.

 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

 1-5           SECTION 1.  Section 32.024, Human Resources Code, is amended

 1-6     by adding Subsection (t) to read as follows:

 1-7           (t)  Subject to the availability of funds appropriated by the

 1-8     legislature, the state shall provide coverage under the state

 1-9     Medicaid program for cost-effective and medically necessary enteral

1-10     nutrition therapy, and related nutrition services that are ordered

1-11     by a physician for the nutritional management of an illness,

1-12     injury, disorder, or other condition as prescribed by the Texas

1-13     Board of Health.  The nutrition services must be provided by a

1-14     licensed dietitian.  The department may require prior authorization

1-15     as a condition for coverage of therapy or services under this

1-16     subsection.  In this subsection:

1-17                 (1)  "Enteral nutrition formula" means a medical

1-18     nutritional product that provides complete and balanced nutrition

1-19     to a person and is capable of being the person's only source of

1-20     nutrition.

1-21                 (2)  "Enteral nutrition therapy" means an enteral

1-22     nutrition formula provided orally or by tube feeding or related

1-23     medical supplies or equipment to a malnourished person who has a

1-24     functioning gastrointestinal tract but because of pathology cannot

 2-1     maintain the person's weight or strength in a manner that is

 2-2     commensurate to the person's general health condition.

 2-3                 (3)  "Licensed dietitian" and "nutrition services" have

 2-4     the meanings assigned by Section 2, Licensed Dietitian Act (Article

 2-5     4512h, Vernon's Texas Civil Statutes).

 2-6                 (4)  "Physician" means a physician licensed by the

 2-7     Texas State Board of Medical Examiners.

 2-8           SECTION 2.  If before implementing a provision of this Act a

 2-9     state agency determines that a waiver or authorization from a

2-10     federal agency is necessary for implementation, the agency shall

2-11     request the waiver or authorization and may delay implementing that

2-12     provision until the waiver or authorization is granted.

2-13           SECTION 3.  This Act takes effect September 1, 1997.

2-14           SECTION 4.  The importance of this legislation and the

2-15     crowded condition of the calendars in both houses create an

2-16     emergency and an imperative public necessity that the

2-17     constitutional rule requiring bills to be read on three several

2-18     days in each house be suspended, and this rule is hereby suspended.