88R14929 SCP-F

By: Guerra H.B. No. 5024

A BILL TO BE ENTITLED

AN ACT

relating to establishing the Medicaid home health efficiency technologies pilot program.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Subchapter B, Chapter 32, Human Resources Code, is amended by adding Section 32.077 to read as follows:

Sec. 32.077. MEDICAID HOME HEALTH EFFICIENCY TECHNOLOGIES PILOT PROGRAM. (a) In this section:

(1) "Efficiency technology" includes:

(A) location-aware AI-assisted home health scheduling software;

(B) telemedicine medical services software;

(C) logistics or route-optimization software; and

(D) additional categories of technology that the commission determines may significantly improve the efficiency and capacity of home health services providers.

(2) "Home and community support services agency" and "home health service" have the meanings assigned by Section 142.001, Health and Safety Code.

(3) "Home health provider" means a home and community support services agency that provides home health services to recipients under Medicaid.

(4) "Pilot program" means the Medicaid home health efficiency technologies pilot program established under this section.

(b) The executive commissioner by rule shall develop and implement a pilot program to increase access to and the capacity of home health services under Medicaid. Under the program, the commission shall incentivize home and community support services agencies to adopt efficiency technologies by reimbursing those providers for purchases of efficiency technologies.

(c) The pilot program shall operate for 20 months in the following phases:

(1) an initial planning phase, not to exceed four months, for designing the program;

(2) a 12-month operational phase that begins immediately after the conclusion of the planning phase, during which the commission shall:

(A) reimburse home health providers for the purchase of efficiency technologies; and

(B) monitor reimbursements in a manner that ensures there is sufficient data to evaluate the program's success; and

(3) a wind-up phase, not to exceed four months, that begins immediately after the conclusion of the operational phase, during which the commission shall analyze data collected during the operational phase and prepare and submit a report to the legislature.

(d) The commission shall provide up to $9,500 as reimbursement for the one-time purchase of an efficiency technology to the first 250 home health providers who:

(1) apply during the operational phase described by Subsection (c)(2); and

(2) meet eligibility requirements.

(e) To be eligible for reimbursement under Subsection (d), a home health services provider must:

(1) be in good standing with the commission; and

(2) submit an application in the form and manner prescribed by the commission that includes:

(A) proof that the provider purchased an efficiency technology after the commencement date of the pilot program, including a copy of the paid invoice or receipt showing the seller's name and address, the efficiency technology purchased, the date of purchase, and the amount paid by the provider; and

(B) a statement from the provider that the provider:

(i) has not purchased or used the same efficiency technology from the same seller within the preceding 12 months; and

(ii) agrees to provide any data required by the commission that is not accessible through Medicaid claims data.

(f) The commission may contract with a private entity to assist the commission in implementing the pilot program, monitoring reimbursements, collecting data during the operational phase, and analyzing that data during the wind-up phase to evaluate and measure the success of the program.

(g) The commission shall prepare and submit to the legislature at least one report during the operational phase of the pilot program that describes the program's progress and includes any other information the commission determines appropriate.

(h) Not later than the 60th day after the date the pilot program ceases operation, the commission shall prepare and submit to the legislature a report on the program that contains:

(1) an objective evaluation of the program's effect on:

(A) quality measures and outcomes for Medicaid recipients;

(B) patient capacity, denial rates, and timeliness of care after a home health provider receives a request or referral for the provision of services by the provider; and

(C) home health providers' efficiency in providing services, including:

(i) staff utilization and efficiency; and

(ii) cost of and miles driven for each home visit to a Medicaid recipient by the provider;

(2) a comparison of the effectiveness and relative benefit for each category of efficiency technology used during the program;

(3) a cost benefit analysis of the program; and

(4) recommendations on the feasibility of continuation and expansion of the program to all Medicaid recipients and home health providers.

(i) The commission shall make the report prepared under Subsection (g) available on the commission's publicly accessible Internet website.

(j) This section expires September 1, 2025.

SECTION 2. 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 Section 32.077, Human Resources Code, as added by this Act.

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 immediately if it receives a vote of two-thirds of all the members elected to each house, as provided by Section 39, Article III, Texas Constitution. If this Act does not receive the vote necessary for immediate effect, this Act takes effect September 1, 2023.