| |
| |
|
|
A BILL TO BE ENTITLED
|
|
|
AN ACT
|
|
|
relating to the provision of nutrition support services to Medicaid |
|
|
recipients in lieu of other state Medicaid plan services and a |
|
|
report on the health outcomes of providing those services. |
|
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
|
SECTION 1. Section 540.0272, Government Code, as effective |
|
|
April 1, 2025, is amended to read as follows: |
|
|
Sec. 540.0272. CERTAIN SERVICES PERMITTED IN LIEU OF STATE |
|
|
MEDICAID PLAN SERVICES [OTHER MENTAL HEALTH OR SUBSTANCE USE |
|
|
DISORDER SERVICES]; ANNUAL REPORT. (a) A contract to which this |
|
|
subchapter applies must contain language permitting the |
|
|
contracting Medicaid managed care organization to offer recipients |
|
|
enrolled in the organization's managed care plan medically |
|
|
appropriate, cost-effective, evidence-based mental health or |
|
|
substance use services or, subject to Section 540.02721, nutrition |
|
|
support services from a list of services approved by the commission |
|
|
[state Medicaid managed care advisory committee] and included in |
|
|
the contract as services the organization may provide recipients in |
|
|
lieu of [mental health or substance use disorder] services |
|
|
specified in the state Medicaid plan. A recipient is not required |
|
|
to use a service from the list included in the contract in lieu of a |
|
|
[another mental health or substance use disorder] service specified |
|
|
in the state Medicaid plan. |
|
|
(b) The commission shall: |
|
|
(1) not later than November 1 of each year, prepare and |
|
|
submit to the legislature a [an annual] report on the number of |
|
|
times during the preceding year a service from the list included in |
|
|
the contract is used; and |
|
|
(2) consider the actual cost and use of any services |
|
|
from the list included in the contract that are offered by a |
|
|
Medicaid managed care organization when setting the capitation |
|
|
rates for that organization under the contract. |
|
|
SECTION 2. Subchapter F, Chapter 540, Government Code, as |
|
|
effective April 1, 2025, is amended by adding Section 540.02721 to |
|
|
read as follows: |
|
|
Sec. 540.02721. NUTRITION SUPPORT SERVICES; BIENNIAL |
|
|
REPORT. (a) In this section: |
|
|
(1) "Community-based nutrition support organization" |
|
|
means an organization that: |
|
|
(A) provides nutrition support services; |
|
|
(B) has an established agreement with a health |
|
|
care provider to implement nutrition support services under this |
|
|
section; and |
|
|
(C) employs: |
|
|
(i) at least one registered dietitian |
|
|
nutritionist; |
|
|
(ii) culinary personnel; and |
|
|
(iii) support personnel capable of |
|
|
providing patient referrals to a health care provider, sourcing |
|
|
ingredients, and packaging and delivering meals to eligible |
|
|
recipients. |
|
|
(2) "Food prescription program" means a program under |
|
|
which a health care provider prescribes nutritious food, including |
|
|
fresh fruits and vegetables, to an individual who has or is at risk |
|
|
of developing a diet-related chronic disease to, as appropriate, |
|
|
treat the disease or reduce the individual's risk of developing the |
|
|
disease by increasing the patient's access to and consumption of |
|
|
healthy food. |
|
|
(3) "Medically tailored meal" means food prepared as |
|
|
prescribed by a dietician or other health care provider to treat an |
|
|
individual's diet-related chronic disease or health condition and |
|
|
any associated symptoms. |
|
|
(b) In approving the list of nutrition support services that |
|
|
are permitted in lieu of services specified in the state Medicaid |
|
|
plan under Section 540.0272, the commission shall consider |
|
|
including the following services: |
|
|
(1) case management services related to food and |
|
|
nutrition access; |
|
|
(2) nutrition counseling and guidance that is specific |
|
|
to an individual's needs or designed to improve health outcomes; |
|
|
(3) the provision of medically tailored meals; |
|
|
(4) food prescription programs; and |
|
|
(5) any other nutrition support service the commission |
|
|
determines to be appropriate, evidence-based, and cost-effective. |
|
|
(c) In implementing Section 540.0272 as it relates to |
|
|
nutrition support services and this section, the commission shall |
|
|
ensure that: |
|
|
(1) community-based nutrition support organizations |
|
|
may provide nutrition support services to recipients under |
|
|
Medicaid; and |
|
|
(2) a recipient does not receive duplicate services |
|
|
under Medicaid. |
|
|
(d) The executive commissioner shall establish a separate |
|
|
provider type for community-based nutrition support organizations |
|
|
for purposes of enrollment and reimbursement as a provider under |
|
|
Medicaid. |
|
|
(e) Not later than November 1 of each even-numbered year, |
|
|
the commission shall prepare and submit to the legislature a |
|
|
biennial report on the health outcomes of providing nutrition |
|
|
support services in lieu of services specified in the state |
|
|
Medicaid plan. The report must include: |
|
|
(1) the number of recipients receiving nutrition |
|
|
support services during the preceding two-year period; and |
|
|
(2) an assessment of those individuals' health |
|
|
outcomes based on relevant National Committee for Quality Assurance |
|
|
Healthcare Effectiveness Data and Information Set (HEDIS) |
|
|
measures, including: |
|
|
(A) hemoglobin A1c levels; |
|
|
(B) blood pressure control; |
|
|
(C) birth weight, if applicable; |
|
|
(D) emergency room visits; and |
|
|
(E) any other measure of the health outcomes the |
|
|
commission determines relevant to evaluate the effectiveness of |
|
|
nutrition support services. |
|
|
SECTION 3. The changes in law made by this Act apply to a |
|
|
contract entered into or renewed on or after the effective date of |
|
|
this Act. A contract entered into or renewed before that date is |
|
|
governed by the law in effect on the date the contract was entered |
|
|
into or renewed, and that law is continued in effect for that |
|
|
purpose. |
|
|
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. This Act takes effect September 1, 2025. |