By: Kolkhorst, Gutierrez S.B. No. 1149
      Zaffirini
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the transition of case management for children and
  pregnant women program services and Healthy Texas Women program
  services to a managed care program.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter A, Chapter 533, Government Code, is
  amended by adding Section 533.002555 to read as follows:
         Sec. 533.002555.  TRANSITION OF CASE MANAGEMENT FOR CHILDREN
  AND PREGNANT WOMEN PROGRAM RECIPIENTS TO MANAGED CARE PROGRAM. (a)  
  In this section, "children and pregnant women program" means the
  benefits program provided under Medicaid and administered by the
  Department of State Health Services that provides case management
  services to children who have a health condition or health risk and
  pregnant women who have a high-risk condition.
         (b)  The commission shall transition to a Medicaid managed
  care model for case management services provided to recipients
  under the children and pregnant women program. In transitioning
  services under this section, the commission shall ensure a
  recipient is provided case management services through the managed
  care plan in which the recipient is enrolled.
         (c)  In implementing this section, the commission shall
  ensure:
               (1)  a seamless transition in case management for
  recipients receiving benefits under the children and pregnant women
  program; and
               (2)  case management services provided under the
  program are not interrupted.
         SECTION 2.  Subchapter F, Chapter 32, Health and Safety
  Code, is amended by amending Section 32.152 and adding Sections
  32.156 and 32.157 to read as follows:
         Sec. 32.152.  [ASSESSING] PROVISION OF HEALTHY TEXAS WOMEN
  PROGRAM SERVICES THROUGH MANAGED CARE. [(a)]  The commission shall
  contract [assess:
               [(1)  the feasibility and cost-effectiveness of
  contracting] with Medicaid managed care organizations to provide
  Healthy Texas Women program services [through managed care in one
  or more health care service regions in this state if the Healthy
  Texas Women Section 1115 Demonstration Waiver is approved; and
               [(2)  the potential impact of that delivery model on
  women receiving services under the program].
         [(b)  This section expires September 1, 2021.]
         Sec. 32.156.  INFORMATION ABOUT AVAILABILITY OF SUBSIDIZED
  HEALTH INSURANCE COVERAGE. (a)  The commission and each managed
  care organization participating in the Healthy Texas Women program
  shall provide a written notice containing information about
  eligibility requirements for and enrollment in a health benefit
  plan for which an enrollee receives a premium subsidy under the
  Patient Protection and Affordable Care Act (Pub. L. No. 111-148),
  based on family income, to a woman who:
               (1)  is enrolled in the Healthy Texas Women program;
  and 
               (2)  has a household income that is more than 100
  percent but not more than 200 percent of the federal poverty level.
         (b)  The commission, in consultation with the Texas
  Department of Insurance, shall develop the form and content of the
  notice required under this section.  The notice must include:
               (1)  the latest information written in clear and easily
  understood language on available options for obtaining a subsidized
  health benefit plan described by Subsection (a); and
               (2)  resources for receiving assistance applying for
  and enrolling in that health benefit plan.
         Sec. 32.157.  ASSESSING AUTOMATIC ENROLLMENT OF CERTAIN
  WOMEN IN MANAGED CARE. (a)  Not later than January 1, 2023, the
  commission shall assess the feasibility, cost-effectiveness, and
  benefits of automatically enrolling in managed care the women who
  become pregnant while receiving services through the Healthy Texas
  Women program.  The assessment must examine whether automatically
  enrolling those women leads to the delivery of prenatal care and
  services earlier in the women's pregnancies.
         (b)  This section expires September 1, 2023.
         SECTION 3.  As soon as practicable after the effective date
  of this Act, the executive commissioner of the Health and Human
  Services Commission shall adopt rules necessary to implement the
  changes in law made by this Act.
         SECTION 4.  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 5.  The Health and Human Services Commission is
  required to implement a provision of this Act only if the
  legislature appropriates money specifically for that purpose.  If
  the legislature does not appropriate money specifically for that
  purpose, the Health and Human Services Commission may, but is not
  required to, implement a provision of this Act using other
  appropriations available for that purpose.
         SECTION 6.  This Act takes effect September 1, 2021.