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