88R23963 JG-D
 
  By: Bernal, Bonnen, et al. H.B. No. 134
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to Medicaid and child health plan program coverage and
  reimbursement for childhood cranial remolding orthosis.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter D, Chapter 62, Health and Safety
  Code, is amended by adding Section 62.1512 to read as follows:
         Sec. 62.1512.  COVERAGE FOR CHILDHOOD CRANIAL REMOLDING
  ORTHOSIS. (a) In this section, "cranial remolding orthosis" has
  the meaning assigned by Section 32.03126, Human Resources Code.
         (b)  The child health plan must cover in full the cost of a
  cranial remolding orthosis for an enrollee in the same manner that
  Medicaid coverage is provided for that treatment under Section
  32.03126, Human Resources Code.
         SECTION 2.  Subchapter B, Chapter 32, Human Resources Code,
  is amended by adding Section 32.03126 to read as follows:
         Sec. 32.03126.  REIMBURSEMENT FOR CHILDHOOD CRANIAL
  REMOLDING ORTHOSIS.  (a)  In this section, "cranial remolding
  orthosis" means a custom-fitted or custom-fabricated medical
  device that is applied to the head to correct a deformity, improve
  function, or relieve symptoms of a structural cranial disease.
         (b)  The commission shall ensure medical assistance
  reimbursement is provided to cover in full the cost of a cranial
  remolding orthosis for a child who is a medical assistance
  recipient and has been diagnosed with:
               (1)  craniosynostosis; or
               (2)  plagiocephaly or brachycephaly if the child:
                     (A)  is not less than three months of age and not
  more than 18 months of age;
                     (B)  has had documented failure to respond to
  conservative therapy for at least two months; and
                     (C)  has one of the following sets of measurements
  or indications:
                           (i)  asymmetrical appearance confirmed by a
  right/left discrepancy of greater than six millimeters in a
  craniofacial anthropometric measurement; or
                           (ii)  brachycephalic or dolichocephalic
  disproportion in the comparison of head length to head width
  confirmed by a cephalic index of two standard deviations above or
  below mean.
         (c)  The coverage required under this section may not be less
  favorable than the coverage required for other orthotics under the
  medical assistance program.
         SECTION 3.  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 4.  This Act takes effect September 1, 2023.