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A BILL TO BE ENTITLED
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AN ACT
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relating to making supplemental appropriations and giving |
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direction and adjustment authority regarding appropriations. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. APPROPRIATION REDUCTION: PUBLIC FINANCE |
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AUTHORITY. The unencumbered appropriations from the general |
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revenue fund to the Public Finance Authority made by Chapter 1281 |
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(H.B. 1), Acts of the 84th Legislature, Regular Session, 2015 (the |
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General Appropriations Act), for use during the state fiscal |
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biennium ending August 31, 2017, for bond debt service payments, |
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including appropriations subject to Rider 2, page I-47, Chapter |
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1281 (H.B. 1), Acts of the 84th Legislature, Regular Session, 2015 |
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(the General Appropriations Act), to the bill pattern of the |
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appropriations to the authority, are reduced by a total aggregate |
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of $53,636,997. The Public Finance Authority shall identify the |
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strategies and objectives to which the reduction is to be allocated |
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and the amount of the reduction for each of those strategies and |
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objectives. |
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SECTION 2. HEALTH AND HUMAN SERVICES COMMISSION: MEDICAID |
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SHORTFALL. (a) In addition to amounts previously appropriated for |
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the state fiscal biennium ending August 31, 2017, $930,733,818 is |
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appropriated from the general revenue fund, and $1,705,243,901 is |
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appropriated from federal funds, to the Health and Human Services |
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Commission for the state fiscal year ending August 31, 2017, for |
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Medicaid services under Goal B, Medicaid, as listed in Chapter 1281 |
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(H.B. 1), Acts of the 84th Legislature, Regular Session, 2015 (the |
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General Appropriations Act). |
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(b) The expenditure or emergency transfer of money |
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appropriated under Subsection (a) of this section is subject to the |
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prior written approval of the Legislative Budget Board in |
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accordance with Section 69, Article XVI, Texas Constitution. |
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SECTION 3. HEALTH AND HUMAN SERVICES COMMISSION: MEDICAID |
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ACUTE CARE THERAPY SERVICES. In addition to amounts previously |
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appropriated for the state fiscal biennium ending August 31, 2017, |
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$21,500,000 is appropriated from the general revenue fund, and |
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$29,800,000 is appropriated from federal funds, to the Health and |
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Human Services Commission for the state fiscal year ending August |
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31, 2017, for Medicaid acute care therapy services, to be allocated |
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among provider types and procedure codes for those services to |
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preserve access to care. |
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SECTION 4. HEALTH AND HUMAN SERVICES COMMISSION: CERTAIN |
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RIDERS. Subsection (c), Rider 50, page II-97, Chapter 1281 (H.B. |
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1), Acts of the 84th Legislature, Regular Session, 2015 (the |
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General Appropriations Act), to the bill pattern of the |
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appropriations to the Health and Human Services Commission is |
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amended to read as follows: |
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c. HHSC shall reform reimbursement methodology to be in line |
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with industry standards[, policies,] and utilization for acute care |
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therapy services (including physical, occupational, and speech |
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therapies) while considering stakeholder input and access to care. |
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In state fiscal year 2017, $28,500,000 [Out of the amount in
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subsection (a), in each fiscal year at least $50,000,000] in |
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General Revenue Funds savings should be achieved through rate |
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reductions [and $25,000,000 in General Revenue Funds savings may be
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achieved through various medical policy initiatives listed in items
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(1)-(10), below. If $25,000,000 in savings is not achieved through
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various medical policy initiatives in fiscal year 2016, the amount
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of unrealized savings (the difference between $25,000,000 in
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General Revenue Funds and savings actually achieved in fiscal year
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2016) should be achieved through additional rate reductions in
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fiscal year 2017 while continuing any initiatives implemented in
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fiscal year 2016 that have been found to produce savings. HHSC may
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achieve savings through various medical policy initiatives, taking
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into consideration the following:
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[(1)
Clarifying policy language regarding co-therapy
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definition, documentation, and billing requirements,
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[(2)
Clarifying who can participate in therapy
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sessions in policy that interns, aides, students, orderlies and
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technicians can participate in therapy sessions when they are
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directly and appropriately supervised according to provider
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licensure requirements, but they are not eligible to enroll as
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providers and bill Texas Medicaid for services,
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[(3)
Consolidate Traditional, Comprehensive Care
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Program and Home Health Agency therapy policies into one policy,
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[(4)
Require a primary care or treating physician to
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initiate a signed order or referral prior to an initial therapy
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evaluation. The initial evaluation may require prior authorization
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and the signed order or referral must be dated prior to the
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evaluation,
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[(5)
Require a primary care or treating physician to
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order the therapy services based on the outcomes of the evaluation,
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[(6)
Clarify medical necessity for therapy services to
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ensure prior authorization staff who are reviewing requests are
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using guidelines based on the nationally recognized standards of
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care,
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[(7)
Require licensed Medicaid enrolled therapists to
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document and support decisions for continued therapy based on
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professional assessment of a client's progress relative to their
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individual treatment plan and in concert with the client's primary
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care physician and the individual and/or family,
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[(8)
Ensure appropriate duration of services by
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aligning authorization periods with national standards,
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[(9) Streamline prior authorization processes, and
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[(10)
Implement policies that ensure services are
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provided in the most cost-efficient and medically appropriate
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setting, and implementation of other medical or billing policy
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changes]. |
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SECTION 5. DEPARTMENT OF FAMILY AND PROTECTIVE SERVICES: |
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ADDITIONAL APPROPRIATIONS. In addition to amounts previously |
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appropriated for the state fiscal biennium ending August 31, 2017, |
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the following amounts are appropriated from the general revenue |
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fund to the Department of Family and Protective Services for the |
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state fiscal year ending August 31, 2017, for the following |
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purposes as listed in Chapter 1281 (H.B. 1), Acts of the 84th |
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Legislature, Regular Session, 2015 (the General Appropriations |
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Act): |
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(1) $12,740,200 for Strategy B.1.3., TWC Contracted |
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Day Care; |
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(2) $31,993,283 for Strategy B.1.9., Foster Care |
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Payments; and |
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(3) $1,576,783 for Strategy B.1.10., Adoption/PCA |
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Payments. |
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SECTION 6. DEPARTMENT OF FAMILY AND PROTECTIVE SERVICES: |
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CERTAIN TRANSFERS. Notwithstanding the limitations of Rider 32, |
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page II-43, Chapter 1281 (H.B. 1), Acts of the 84th Legislature, |
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Regular Session, 2015 (the General Appropriations Act), to the bill |
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pattern of the appropriations to the Department of Family and |
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Protective Services, the department shall transfer $435,475 from |
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Strategy B.1.11., Relative Caregiver Payments, to Strategy B.1.9., |
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Foster Care Payments, as listed in Chapter 1281 (H.B. 1), Acts of |
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the 84th Legislature, Regular Session, 2015 (the General |
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Appropriations Act). |
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SECTION 7. DEPARTMENT OF FAMILY AND PROTECTIVE SERVICES: |
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ADDITIONAL APPROPRIATIONS FOR AGENCY CRITICAL NEEDS. In addition |
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to amounts previously appropriated for the state fiscal biennium |
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ending August 31, 2017, the Department of Family and Protective |
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Services is appropriated for the state fiscal year ending August |
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31, 2017, the following amounts from the general revenue fund for |
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the following strategies as listed in Chapter 1281 (H.B. 1), Acts of |
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the 84th Legislature, Regular Session, 2015 (the General |
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Appropriations Act), to address critical needs of the agency with |
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respect to those strategies: |
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(1) $75,521,204 for Strategy B.1.1., CPS Direct |
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Delivery Staff; |
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(2) $613,174 for Strategy B.1.2., CPS Program Support; |
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(3) $21,000,000 for Strategy B.1.9., Foster Care |
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Payments; |
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(4) $138,854 for Strategy D.1.1., APS Direct Delivery |
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Staff; |
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(5) $6,703 for Strategy D.1.2., APS Program Support; |
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(6) $376,259 for Strategy F.1.1., Central |
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Administration; |
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(7) $33,546 for Strategy F.1.2., Other Support |
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Services; |
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(8) $3,067,626 for Strategy F.1.4., IT Program |
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Support; and |
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(9) $940,108 for Strategy G.1.1., Agency-Wide |
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Automated Systems. |
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SECTION 8. DEPARTMENT OF FAMILY AND PROTECTIVE SERVICES: |
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CERTAIN TRANSFERS. (a) Notwithstanding any transfer limitation |
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specified in Chapter 1281 (H.B. 1), Acts of the 84th Legislature, |
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Regular Session, 2015 (the General Appropriations Act), the |
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Department of Family and Protective Services shall transfer to the |
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Health and Human Services Commission the following amounts: |
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(1) $29,247,213 of general revenue funds; and |
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(2) $72,450,261 of Temporary Assistance for Needy |
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Families (TANF) program federal funds. |
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(b) The Health and Human Services Commission may spend |
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Temporary Assistance for Needy Families (TANF) program federal |
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funds transferred under Subsection (a)(2) of this section during |
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the state fiscal year ending August 31, 2017, only with the prior |
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written approval of the Legislative Budget Board in accordance with |
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Section 69, Article XVI, Texas Constitution. |
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SECTION 9. TEXAS A&M FOREST SERVICE: APPROPRIATION FOR |
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GENERAL COSTS CAUSED BY VARIOUS EMERGENCY WEATHER-RELATED |
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RESPONSES. In addition to amounts previously appropriated for the |
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state fiscal biennium ending August 31, 2017, $5,100,000 is |
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appropriated from the general revenue fund to the Texas A&M Forest |
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Service for the state fiscal year ending August 31, 2017, for the |
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purpose of paying for, or reimbursing payments made for, costs |
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incurred by the forest service associated with responding to |
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various weather-related emergencies. |
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SECTION 10. DEPARTMENT OF CRIMINAL JUSTICE: CORRECTIONAL |
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MANAGED HEALTH CARE SHORTFALL. In addition to amounts previously |
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appropriated for the state fiscal biennium ending August 31, 2017, |
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$80,000,000 is appropriated from the general revenue fund to the |
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Department of Criminal Justice for the state fiscal year ending |
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August 31, 2017, for correctional managed health care under |
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Strategy C.1.9., Hospital and Clinical Care, as listed in Chapter |
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1281 (H.B. 1), Acts of the 84th Legislature, Regular Session, 2015 |
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(the General Appropriations Act). |
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SECTION 11. JUVENILE JUSTICE DEPARTMENT: OPERATIONAL |
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SHORTFALL. In addition to amounts previously appropriated for the |
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state fiscal biennium ending August 31, 2017, $4,469,257 is |
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appropriated from the general revenue fund to the Juvenile Justice |
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Department for the state fiscal year ending August 31, 2017, for an |
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operational shortfall. |
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SECTION 12. ANIMAL HEALTH COMMISSION: CATTLE FEVER TICKS. |
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In addition to amounts previously appropriated for the state fiscal |
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biennium ending August 31, 2017, $649,987 is appropriated from the |
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general revenue fund to the Animal Health Commission for the state |
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fiscal year ending August 31, 2017, for preparedness for, response |
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to, and mitigation of cattle fever ticks under Strategy A.1.1., |
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Field Operations, as listed in Chapter 1281 (H.B. 1), Acts of the |
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84th Legislature, Regular Session, 2015 (the General |
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Appropriations Act). |
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SECTION 13. |
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TEXAS ALCOHOLIC BEVERAGE COMMISSION. (a) The |
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Texas Alcoholic Beverage Commission may not spend money |
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appropriated to the agency by Chapter 1281 (H.B. 1), Acts of the |
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84th Legislature, Regular Session, 2015 (the General |
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Appropriations Act), for use during the state fiscal biennium |
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ending August 31, 2017: |
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(1) for travel outside the state, other than for bona |
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fide and documented law enforcement or investigative activities; or |
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(2) to attend or participate in an event, training, |
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conference, class, or similar activity outside the state. |
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(b) The Texas Alcoholic Beverage Commission and employees |
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of the commission may not accept payments from or spending |
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authority on behalf of any trade, professional, or industry |
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organization for any purpose or in any form, including a travel |
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subsidy, payment of travel or other expenses for conference |
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presenters, prepaid meals, or lodging. |
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SECTION 14. EFFECTIVE DATE. This Act takes effect |
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immediately. |