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 * * * * *