By: Van de Putte S.B. No. 1841
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to a managed care pilot program to prevent high-risk
  pregnancies that result in the birth of premature or low birth
  weight infants.
         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 32.02491 to read as follows:
         Sec. 32.02491.  BIRTH COST-CONTAINMENT PILOT PROGRAM.  
  (a)  In this section:
               (1)  "Low birth weight infant" means an infant who
  weighs less than 5.5 pounds or 2,500 grams at birth.
               (2)  "Managed care organization" and "managed care
  plan" have the meanings assigned by Section 533.001, Government
  Code.
               (3)  "Premature infant" means an infant born before
  completing 37 weeks of gestation.
         (b)  The department shall establish a pilot program under
  which health care services are provided for an additional period of
  18 months after the termination of Medicaid for pregnant women
  coverage who deliver premature or low birth weight infants.
         (c)  The health care services required under the pilot
  program shall be provided through the Medicaid managed care
  organizations.
         (d)  The pilot program must be established in the service
  delivery area that includes Bexar County and its contiguous
  counties.
         (e)  The Medicaid managed care organizations participating
  in the pilot program shall develop and implement an outreach
  program to identify women who are eligible for participation in the
  pilot program and provide those women with information about and
  assistance with applying for the pilot program.
         (f)  The department shall facilitate a seamless transition
  from Medicaid for pregnant women coverage into the pilot program.
         (g)  a woman who received Medicaid for pregnant program
  coverage and participates in the pilot program will remain enrolled
  in the same Medicaid managed care organization for the duration of
  the period during which she receives services under the pilot
  program.
         (h)  The Medicaid managed care organization participating in
  the pilot program shall assist a woman who does not become pregnant
  during the period of her enrollment in the pilot program with
  establishing eligibility for the Women's Health Care Services
  Demonstration Project established under Section 32.0248.
         (i)  The executive commissioner of the Health and Human
  Services Commission may adopt rules to implement this section.
         (j)  Not later than December 1, 2010, the department shall
  submit a report to the legislature regarding the department's
  progress in establishing and operating the pilot program; and an
  evaluation of the budget neutrality of the pilot program.
         SECTION 2.  If the commission determines that the pilot
  program is budget neutral, the commission shall actively seek and
  apply for any available federal funds, including Medicaid and
  Temporary Assistance for Needy Families (TANF) funds, to assist in
  financing the pilot program established under this subchapter.
         SECTION 3.  This Act takes effect September 1, 2009.