78R6877 KLA-D
By: Coleman H.B. No. 1555
A BILL TO BE ENTITLED
AN ACT
relating to a demonstration project to provide certain medications
and related services through the medical assistance program.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter B, Chapter 32, Human Resources Code,
is amended by adding Section 32.061 to read as follows:
Sec. 32.061. DEMONSTRATION PROJECT FOR CERTAIN MEDICATIONS
AND RELATED SERVICES. (a) The department shall establish a
demonstration project to provide to a person through the medical
assistance program psychotropic medications and related laboratory
and physician services necessary to conform to a prescribed medical
regimen for those medications.
(b) A person is eligible to participate in the demonstration
project if the person:
(1) has been diagnosed as having a mental impairment,
including schizophrenia or bipolar disorder, that is expected to
cause the person to become a disabled individual, as defined by
Section 1614(a) of the federal Social Security Act (42 U.S.C.
Section 1382c(a)), as amended;
(2) is at least 19 years of age, but not more than 64
years of age;
(3) has a net family income that is at or below 200
percent of the federal poverty level;
(4) is not covered by a health benefits plan offering
adequate coverage, as determined by the department; and
(5) is not otherwise eligible for medical assistance
at the time the person's eligibility for participation in the
demonstration project is determined.
(c) Notwithstanding any other provision of this section,
the department shall provide each participant in the demonstration
project with a 12-month period of continuous eligibility for
participation in the project.
(d) Participation in the demonstration project does not
entitle a participant to other services provided under the medical
assistance program.
(e) The department shall establish an appropriate
enrollment limit for the demonstration project and may not allow
participation in the project to exceed that limit. Once the limit
is reached, the department shall establish a waiting list for
enrollment in the demonstration project.
(f) To the extent permitted by federal law, the department
may require a participant in the demonstration project to make
cost-sharing payments for services provided through the project.
(g) To the maximum extent possible, the department shall use
existing resources to fund the demonstration project.
(h) Not later than December 1 of each even-numbered year,
the department shall submit a biennial report to the legislature
regarding the department's progress in establishing and operating
the demonstration project.
(i) Not later than December 1, 2008, the department shall
evaluate the cost-effectiveness of the demonstration project,
including whether the preventive drug treatments and related
services provided under the project offset future long-term care
costs for project participants. If the results of the evaluation
indicate that the project is cost-effective, the department shall
incorporate a request for funding for the continuation of the
program in the department's budget request for the next state
fiscal biennium.
(j) This section expires September 1, 2011.
SECTION 2. The state agency responsible for implementing
the demonstration project required by Section 32.061, Human
Resources Code, as added by this Act, shall request and actively
pursue any necessary waivers or authorizations from the Centers for
Medicare and Medicaid Services or other appropriate entities to
enable the agency to implement the demonstration project not later
than September 1, 2004. The agency may delay implementing the
demonstration project until the necessary waivers or
authorizations are granted.
SECTION 3. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2003.