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A BILL TO BE ENTITLED
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AN ACT
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relating to a Medicaid managed care pilot program to prevent |
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high-risk pregnancies that result in the birth of premature or low |
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birth 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. HIGH-RISK PREGNANCY PREVENTION PILOT |
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PROGRAM. (a) In this section: |
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(1) "Low birth weight infant" means an infant who |
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weights 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; and |
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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, in coordination with the work |
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group created under Subdivision 2(e)(1): |
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(1) develop a concept paper for submission to the |
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Centers for Medicare and Medicaid Services (CMS) for a pilot |
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program under which medical assistance is provided for an |
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additional period of 18 months after delivery to women who deliver |
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premature or low birth weight infants while receiving medical |
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assistance; and |
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(2) if feasible, develop and seek a waiver or |
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authorization from a federal agency to establish a pilot program |
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under which medical assistance is provided for an additional period |
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of 18 months after delivery to women who deliver premature or low |
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birth weight infants while receiving medical assistance. |
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(c) Medical assistance required under the pilot program |
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shall be provided through the Medicaid managed care program |
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implemented under Chapter 533, Government Code. |
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(d) The pilot program must be established in the service |
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delivery area that includes Bexar County. |
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(e) The department shall: |
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(1) create a work group to provide recommendations |
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regarding the development of the concept paper and waiver required |
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by Subdivision (1) that includes the following members: |
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(A) representatives of state agencies that |
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provide services to women, pregnant women, and children; |
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(B) representatives of the managed care |
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organizations involved in providing medical assistance under the |
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pilot program; |
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(C) outreach providers that contract with the |
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medical assistance program; and |
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(D) representatives from other entities as |
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determined by the executive commissioner of the Health and Human |
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Services Commission. |
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(f) 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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(g) 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 developing the concept paper and waiver for |
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establishing and operating the pilot program. |
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(h) This section expires September 1, 2011. |
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SECTION 2. This Act takes effect September 1, 2009. |