87R2838 BDP-D
 
  By: Hinojosa S.B. No. 951
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to improvements to the Texas Medicaid Provider Procedures
  Manual designed to prevent fraud, waste, or abuse in the provision
  of Medicaid dental services.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  DEFINITIONS. In this Act:
               (1)  "Commission" means the Health and Human Services
  Commission.
               (2)  "Executive commissioner" means the executive
  commissioner of the commission.
               (3)  "Medicaid" means the medical assistance program
  established under Chapter 32, Human Resources Code.
               (4)  "Work group" means the work group established
  under Section 2 of this Act.
         SECTION 2.  WORK GROUP ON IMPROVING TEXAS MEDICAID PROVIDER
  PROCEDURES MANUAL PROVISIONS RELATING TO DENTAL SERVICES. (a)  The
  executive commissioner shall establish a work group for the purpose
  of providing recommendations to improve the Texas Medicaid Provider
  Procedures Manual in a manner that prevents the incidence of fraud,
  waste, or abuse in the provision of Medicaid dental services.
         (b)  The executive commissioner shall appoint the members of
  the work group, which must include:
               (1)  a representative of the commission;
               (2)  the dental director appointed under Section
  531.02114, Government Code;
               (3)  a representative of the commission's office of
  inspector general;
               (4)  at least one stakeholder to represent each of the
  following interests:
                     (A)  managed care organizations that contract
  with the commission to provide Medicaid dental services;
                     (B)  providers of Medicaid dental services; and
                     (C)  dental academia; and
               (5)  additional stakeholders or other persons the
  executive commissioner determines appropriate.
         (c)  The commission shall provide administrative support to
  the work group.
         (d)  The executive commissioner shall appoint a member of the
  work group to serve as the presiding officer.
         (e)  The work group shall meet at the call of the presiding
  officer.
         (f)  The work group shall:
               (1)  review all provisions in the Texas Medicaid
  Provider Procedures Manual related to the provision of dental
  services;
               (2)  determine which provisions can be eliminated or
  changed to prevent fraud, waste, or abuse in the provision of dental
  services, including changes related to the use of dental procedure
  codes by providers; and
               (3)  make recommendations to the executive
  commissioner for improving the Texas Medicaid Provider Procedures
  Manual to prevent fraud, waste, or abuse in the provision of dental
  services under Medicaid.
         SECTION 3.  REPORT. Not later than December 31, 2022, the
  work group shall submit a report on the work group's
  recommendations to the executive commissioner.
         SECTION 4.  ACTION ON REPORT. On receiving the work group's
  recommendations, the executive commissioner shall:
               (1)  consider immediately adopting the recommendations
  of the work group that do not require legislative action; and
               (2)  if implementation of a recommendation requires
  legislative action, submit to the legislature a copy of the report
  described by Section 3 of this Act together with the executive
  commissioner's recommendations for any legislative action.
         SECTION 5.  ABOLISHMENT OF WORK GROUP; EXPIRATION. On
  January 1, 2023:
               (1)  the work group is abolished; and
               (2)  this Act expires.
         SECTION 6.  FEDERAL AUTHORIZATION. If before implementing
  any provision of this Act a state agency determines that a waiver or
  authorization from a federal agency is necessary for implementation
  of that provision, the agency affected by the provision shall
  request the waiver or authorization and may delay implementing that
  provision until the waiver or authorization is granted.
         SECTION 7.  EFFECTIVE DATE.  This Act takes effect September
  1, 2021.