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A BILL TO BE ENTITLED
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AN ACT
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relating to the program of all-inclusive care for the elderly. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 32.053, Human Resources Code, is amended |
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by amending Subsections (a), (b), and (e) and adding Subsections |
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(f), (g), and (h) to read as follows: |
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(a) The department, as an integral [a] part of the medical |
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assistance program, shall develop and implement a program of |
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all-inclusive care for the elderly (PACE) in accordance with |
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Section 4802 of the Balanced Budget Act of 1997 (Pub. L. No. |
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105-33), as amended. The department shall provide medical |
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assistance to a participant in the PACE program in the manner and to |
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the extent authorized by federal law. |
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(b) The executive commissioner of the Health and Human |
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Services Commission [department] shall adopt rules as necessary to |
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implement this section. In adopting rules, the executive |
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commissioner [department] shall: |
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(1) use the Bienvivir Senior Health Services of El |
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Paso initiative as a model for the program; [and] |
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(2) ensure that a person is not required to hold a |
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certificate of authority as a health maintenance organization under |
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Chapter 843, Insurance Code, [the Texas Health Maintenance
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Organization Act (Chapter 20A, Vernon's Texas Insurance Code)] to |
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provide services under the PACE program; |
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(3) ensure that participation in the PACE program is |
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available as an alternative to enrollment in a Medicaid managed |
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care plan under Chapter 533, Government Code, for eligible |
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recipients, including recipients eligible for assistance under |
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both the medical assistance and Medicare programs; |
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(4) ensure that managed care organizations that |
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contract under Chapter 533, Government Code, consider the |
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availability of the PACE program when considering whether to refer |
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a recipient to a nursing home or other long-term care facility; and |
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(5) establish protocols for the referral of eligible |
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persons to the PACE program. |
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(e) The [department, with the cooperation of the Texas] |
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Department of [on] Aging and Disability Services and area agencies |
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on aging[,] shall develop and implement a coordinated plan to |
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promote PACE program sites operating under this section. The |
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department shall adopt policies and procedures, including |
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operating guidelines, to ensure that caseworkers and any other |
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appropriate department staff discuss the benefits of participating |
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in the PACE program with long-term care clients. |
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(f) The department shall consider the PACE program as a |
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community-based service option under any "Money Follows the Person" |
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demonstration project or other initiative that is designed to |
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eliminate barriers or mechanisms that prevent or restrict the |
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flexible use of funds under the medical assistance program to |
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enable a recipient to receive long-term services or supports in a |
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setting of the recipient's choice. |
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(g) A PACE program site may coordinate with entities that |
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are eligible to obtain discount prescription drug prices under |
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Section 340B, Public Health Service Act (42 U.S.C. Section 256b), |
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as necessary to enable the PACE program site to obtain those |
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discounts. |
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(h) The commission shall adopt a standard reimbursement |
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methodology for the payment of all PACE organizations for purposes |
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of encouraging a natural increase in the number of PACE program |
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sites throughout the state. |
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SECTION 2. Subchapter B, Chapter 32, Human Resources Code, |
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is amended by adding Section 32.0531 to read as follows: |
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Sec. 32.0531. PACE PROGRAM TEAM. (a) The Department of |
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Aging and Disability Services shall establish a PACE program team |
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composed of experienced personnel. The team is responsible for: |
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(1) increasing public attention and awareness of the |
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availability of PACE program sites; |
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(2) increasing the number of PACE program sites |
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operating in this state; and |
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(3) serving as a liaison with the state and federal |
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agencies responsible for administering the PACE program, |
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participants in the program, and PACE program sites. |
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(b) The PACE program team shall conduct a study to evaluate |
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the feasibility of implementing a statewide standard reimbursement |
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rate for all PACE organizations. Not later than September 1, 2012, |
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the PACE program team shall submit to the Health and Human Services |
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Commission a written report containing the findings of the study |
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conducted under this subsection and the team's recommendations. |
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This subsection expires September 2, 2012. |
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SECTION 3. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 4. This Act takes effect September 1, 2011. |
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* * * * * |