BILL ANALYSIS

C.S.H.B. 1647

By: Deshotel

Human Services

Committee Report (Substituted)

BACKGROUND AND PURPOSE

It has been suggested that the lack of dental care available to certain Medicaid recipients leads these individuals to seek oral pain relief from emergency rooms where, while they are treated for the pain, the real dental issue remains unaddressed. There are concerns that this unnecessary use of emergency rooms results in unnecessary state spending and potential negative impacts on these individuals, such as opioid addiction, and does not improve their health. C.S.H.B. 1647 seeks to address these concerns by requiring the Health and Human Services Commission to develop a Medicaid dental services benefit for adult recipients with disabilities.

CRIMINAL JUSTICE IMPACT

It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision.

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.

ANALYSIS

C.S.H.B. 1647 amends the Human Resources Code to require the Health and Human Services Commission (HHSC) to develop a Medicaid dental services benefit for adult recipients with disabilities. The bill requires the dental services benefit to be:

· cost-effective and designed to achieve cost savings;

· designed to reduce emergency room visits by or hospitalizations of adult recipients with disabilities resulting from a lack of access to dental services; and

· designed to meet the individual needs of adult recipients with disabilities.

C.S.H.B. 1647 requires HHSC, in developing the dental services benefit, to evaluate dental services benefits provided under Section 1115 Medicaid waiver programs and dental services benefits provided as a value-added service under the Medicaid managed care delivery model. The bill requires HHSC, not later than September 1, 2020, to prepare and submit to the legislature a written report on the dental services benefit. The bill authorizes HHSC to establish and operate a pilot program to provide the dental services benefit in one or more geographic areas of Texas. The bill requires the pilot program, if established, to conclude not later than September 1, 2022, and requires HHSC, if applicable, to prepare and submit to the legislature a written report that summarizes the results of the pilot program not later than December 1, 2022. The bill's provisions expire September 1, 2023. 

EFFECTIVE DATE

September 1, 2019.

COMPARISON OF ORIGINAL AND SUBSTITUTE

While C.S.H.B. 1647 may differ from the original in minor or nonsubstantive ways, the following summarizes the substantial differences between the introduced and committee substitute versions of the bill.

The substitute does not require HHSC to provide Medicaid reimbursement for dental services for an adult recipient with a disability but does require HHSC to develop a Medicaid dental services benefit for such adult recipients.

The substitute includes the following:

· certain requirements for the dental services benefit;

· a requirement for HHSC, in developing the dental services benefit, to evaluate existing dental services benefits provided under Section 1115 Medicaid waiver programs and the Medicaid managed care delivery model;

· a reporting requirement regarding the dental services benefit;

· an authorization to establish a pilot program for the dental services benefit in one or more geographic areas of Texas;

· a reporting requirement regarding the pilot program, if established;

· an expiration date for the bill's provisions.