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A BILL TO BE ENTITLED
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AN ACT
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relating to the development and implementation of a plan to |
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increase Medicaid reimbursement rates for dental services. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter B, Chapter 32, Human Resources Code, |
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is amended by adding Section 32.0541 to read as follows: |
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Sec. 32.0541. TASK FORCE ON REIMBURSEMENT RATES FOR DENTAL |
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SERVICES. (a) In this section: |
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(1) "Dental provider" means a dentist who provides |
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services eligible for reimbursement under the medical assistance |
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program and who is in good standing in the dental profession. |
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(2) "Executive commissioner" means the executive |
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commissioner of the Health and Human Services Commission. |
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(3) "Task force" means the task force on medical |
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assistance reimbursement rates for dental services appointed by the |
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executive commissioner under this section. |
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(b) The executive commissioner shall appoint 15 |
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representatives to a task force to develop a plan to increase |
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medical assistance reimbursement rates for dental services in order |
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to: |
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(1) improve basic dental health care for eligible |
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individuals; |
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(2) improve the quality of dental health care provided |
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under the medical assistance program; |
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(3) encourage more dentists to practice in rural areas |
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with a high need for dental health care; and |
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(4) encourage dentists who recently graduated to |
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remain in this state and provide dental services under the medical |
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assistance program by making reimbursement rates in this state |
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competitive with the reimbursement rates in other states. |
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(c) The representatives must include: |
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(1) seven general dental providers; |
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(2) six specialty dental providers, including: |
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(A) three pedodontists; |
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(B) one oral surgeon; |
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(C) one periodontist; and |
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(D) one orthodontist; |
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(3) one additional general or specialty dental |
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provider, as determined by the executive commissioner; and |
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(4) an individual appointed by the executive |
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commissioner to represent the Health and Human Services Commission. |
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(d) In appointing the representatives, the executive |
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commissioner shall ensure a balanced representation of: |
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(1) different regions of this state, based on the |
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number of medical assistance recipients in the region; and |
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(2) rural and urban counties. |
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(e) The Health and Human Services Commission shall provide |
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administrative support and resources to the task force as necessary |
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for the task force to perform the duties under this section. |
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(f) The task force is not subject to Chapter 2110, |
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Government Code. |
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(g) The task force shall elect a chairperson from among the |
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dental provider representatives on the task force. |
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(h) The task force shall create a plan to improve |
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reimbursement rates under the medical assistance program for dental |
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services. The plan must include recommendations of the task force |
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on how to systematically and incrementally raise reimbursement |
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rates to at least the 75th percentile of the usual and customary |
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National Average Marker Rate. |
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(i) In preparing the plan required under Subsection (h), the |
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task force shall: |
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(1) review and study current medical assistance |
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policies and reimbursement methodologies related to dental |
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services and fees; |
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(2) review the reimbursement rates under medical |
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assistance programs for dental services adopted by other states; |
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(3) investigate the effect of medical assistance |
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reimbursement rates for dental services on: |
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(A) the quality of dental care provided; |
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(B) the number of children who receive basic |
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dental health care; |
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(C) the number of new dental providers offering |
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dental services under the medical assistance program; and |
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(D) the number of dental providers in rural |
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areas; |
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(4) develop and recommend procedures and |
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reimbursement methodologies that will address concerns raised |
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under Subdivisions (1) through (3); |
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(5) create a plan to systematically and incrementally |
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increase medical assistance reimbursement rates for dental |
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services to the rates described by Subsection (h); and |
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(6) ensure that the plan includes methods for |
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adjusting reimbursement rates in the future in a manner that |
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addresses the concerns identified by the task force. |
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(j) Not later than December 1, 2008, the task force shall |
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submit the plan required by Subsection (h) to the executive |
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commissioner, the governor, the lieutenant governor, the speaker of |
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the house of representatives, and the clerks of the standing |
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committees of the senate and house of representatives with primary |
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jurisdiction over the medical assistance program. |
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(k) Not later than September 1, 2009, the Health and Human |
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Services Commission shall implement the plan submitted by the task |
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force under Subsection (j), subject to the availability of funds |
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appropriated for that purpose. |
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(l) The task force shall: |
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(1) continue to monitor the information evaluated in |
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creating the plan required under Subsection (h) and any changes in |
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the medical assistance reimbursement rates for dental services |
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adopted by the Health and Human Services Commission; and |
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(2) submit a report with additional recommendations to |
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the executive commissioner, the governor, the lieutenant governor, |
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the speaker of the house of representatives, and the clerks of the |
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standing committees of the senate and house of representatives with |
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primary jurisdiction over the medical assistance program not later |
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than December 1, 2010. |
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(m) This section expires September 1, 2011. |
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SECTION 2. This Act takes effect September 1, 2007. |