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A BILL TO BE ENTITLED
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AN ACT
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relating to Medicaid reimbursement for the costs of cognitive |
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assessment and care planning services provided to certain patients. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter D, Chapter 532, Government Code, as |
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effective April 1, 2025, is amended by adding Section 532.0158 to |
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read as follows: |
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Sec. 532.0158. REIMBURSEMENT SYSTEM FOR COGNITIVE CARE |
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PLANNING. (a) The executive commissioner by rule shall develop and |
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the commission shall implement a system to provide Medicaid |
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reimbursement to a health care provider, including a physician, for |
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the assessment of and care planning services provided to patients |
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with a cognitive impairment, including dementia or Alzheimer's |
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disease. |
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(b) To be eligible for reimbursement under this section, the |
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health care provider's care planning services must include: |
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(1) assessment of the patient's cognition, function, |
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and safety; |
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(2) an evaluation of the patient's neuropsychiatric |
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and behavioral symptoms; |
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(3) a review of the patient's medications; |
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(4) a needs assessment for the patient's caregiver; |
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(5) a comprehensive clinical visit for the patient; |
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and |
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(6) a complete written care plan for the patient. |
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(c) The executive commissioner shall prepare and seek a |
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waiver to the state Medicaid plan under Section 1115 of the Social |
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Security Act (42 U.S.C. Section 1315) or other applicable federal |
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law to obtain any federal money available for implementing the |
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system to assist eligible individuals in obtaining care planning |
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services. |
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SECTION 2. (a) As soon as practicable after the effective |
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date of this Act, the executive commissioner of the Health and Human |
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Services Commission shall adopt the rules necessary to implement |
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Section 532.0158, Government Code, as added by this Act. |
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(b) As soon as practicable after the effective date of this |
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Act, the executive commissioner of the Health and Human Services |
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Commission shall apply for and actively pursue from the federal |
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Centers for Medicare and Medicaid Services or another appropriate |
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federal agency the waiver required by Section 532.0158, Government |
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Code, as added by this Act. The commission may delay implementing |
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Section 532.0158, Government Code, until the waiver applied for |
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under this section is granted. |
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SECTION 3. This Act takes effect September 1, 2025. |