1-1     By:  Janek (Senate Sponsor - Nelson)                  H.B. No. 1516
 1-2           (In the Senate - Received from the House April 23, 2001;
 1-3     April 24, 2001, read first time and referred to Committee on Health
 1-4     and Human Services; May 4, 2001, reported favorably by the
 1-5     following vote:  Yeas 6, Nays 0; May 4, 2001, sent to printer.)
 1-6                            A BILL TO BE ENTITLED
 1-7                                   AN ACT
 1-8     relating to the provision of catastrophic case management services
 1-9     under the medical assistance program.
1-10           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-11           SECTION 1. Subchapter B, Chapter 32, Human Resources Code, is
1-12     amended by adding Section 32.053 to read as follows:
1-13           Sec. 32.053.  CATASTROPHIC CASE MANAGEMENT. (a)  The
1-14     department shall develop and implement a catastrophic case
1-15     management system to be used in providing medical assistance to
1-16     persons with catastrophic health problems.
1-17           (b)  The system must provide for the assignment of a case
1-18     manager to a recipient of medical assistance with catastrophic
1-19     health problems that are likely to:
1-20                 (1)  require the services of multiple, specialized
1-21     health care providers; and
1-22                 (2)  result in major medical costs.
1-23           (c)  The department shall identify the services to be
1-24     provided by a case manager assigned under the system.  The services
1-25     must include assessment of the recipient's needs and coordination
1-26     of all available medical services and payment options.  The
1-27     services may include other support services such as:
1-28                 (1)  assistance with making arrangements to receive
1-29     care from medical facilities;
1-30                 (2)  assistance with travel and lodging in connection
1-31     with receipt of medical care;
1-32                 (3)  education of the recipient and the recipient's
1-33     family members regarding the nature of the recipient's health
1-34     problems;
1-35                 (4)  referral to appropriate support groups; and
1-36                 (5)  any other service likely to result in better care
1-37     provided in a cost-effective manner.
1-38           (d)  Not later than January 15 of each odd-numbered year, the
1-39     department shall report to the legislature on the implementation of
1-40     the system.  The report must include a statement of:
1-41                 (1)  the number of recipients of medical assistance who
1-42     received catastrophic case management services under the system
1-43     during the preceding two years; and
1-44                 (2)  the estimated savings under the medical assistance
1-45     program resulting from implementation of the system during the
1-46     preceding two years.
1-47           SECTION 2.  If before implementing any provision of this Act
1-48     a state agency determines that a waiver or authorization from a
1-49     federal agency is necessary for implementation of that provision,
1-50     the agency affected by the provision shall request the waiver or
1-51     authorization and may delay implementing that provision until the
1-52     waiver or authorization is granted.
1-53           SECTION 3. This Act takes effect September 1, 2001.
1-54                                  * * * * *