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A BILL TO BE ENTITLED
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AN ACT
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relating to a managed care pilot program to prevent high-risk |
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pregnancies that result in the birth of premature or low birth |
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weight infants. |
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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 32.02491 to read as follows: |
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Sec. 32.02491. BIRTH COST-CONTAINMENT PILOT PROGRAM. (a) |
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In this section: |
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(1) "Low birth weight infant" means an infant who |
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weighs less than 5.5 pounds or 2,500 grams at birth. |
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(2) "Managed care organization" and "managed care |
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plan" have the meanings assigned by Section 533.001, Government |
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Code. |
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(3) "Premature infant" means an infant born before |
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completing 37 weeks of gestation. |
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(b) The department shall establish a pilot program under |
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which health care services are provided for an additional period of |
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18 months after the termination of Medicaid for pregnant women |
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coverage who deliver premature or low birth weight infants. |
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(c) The health care services required under the pilot |
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program shall be provided through the Medicaid managed care |
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organizations. |
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(d) The pilot program must be established in the service |
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delivery area that includes Bexar County and its contiguous |
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counties. |
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(e) The Medicaid managed care organizations participating |
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in the pilot program shall develop and implement an outreach |
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program to identify women who are eligible for participation in the |
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pilot program and provide those women with information about and |
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assistance with applying for the pilot program. |
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(f) The department shall facilitate a seamless transition |
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from Medicaid for pregnant women coverage into the pilot program. |
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(g) a woman who received Medicaid for pregnant program |
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coverage and participates in the pilot program will remain enrolled |
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in the same Medicaid managed care organization for the duration of |
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the period during which she receives services under the pilot |
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program. |
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(h) The Medicaid managed care organization participating in |
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the pilot program shall assist a woman who does not become pregnant |
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during the period of her enrollment in the pilot program with |
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establishing eligibility for the Women's Health Care Services |
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Demonstration Project established under Section 32.0248. |
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(i) The executive commissioner of the Health and Human |
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Services Commission may adopt rules to implement this section. |
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(j) Not later than December 1, 2010, the department shall |
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submit a report to the legislature regarding the department's |
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progress in establishing and operating the pilot program; and an |
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evaluation of the budget neutrality of the pilot program. |
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SECTION 2. If the commission determines that the pilot |
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program is budget neutral, the commission shall actively seek and |
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apply for any available federal funds, including Medicaid and |
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Temporary Assistance for Needy Families (TANF) funds, to assist in |
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financing the pilot program established under this subchapter. |
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SECTION 3. This Act takes effect September 1, 2009. |