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A BILL TO BE ENTITLED
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AN ACT
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relating to Medicaid reimbursement for services provided to certain |
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recipients under a nurse home visiting program. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter B, Chapter 32, Human Resources Code, |
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is amended by adding Section 32.02482 to read as follows: |
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Sec. 32.02482. REIMBURSEMENT FOR SERVICES PROVIDED UNDER |
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NURSE HOME VISITING PROGRAM. (a) In this section: |
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(1) "Nurse home visiting program" means a program |
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that: |
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(A) provides through a registered nurse weekly or |
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monthly pregnancy- and postpartum-related services to certain |
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individuals primarily in the home; |
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(B) offers individualized health and education |
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services to promote healthy birth outcomes and positive child |
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health and development outcomes; and |
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(C) conforms to a nurse home visit model that: |
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(i) is research-based and grounded in |
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empirical knowledge; |
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(ii) is associated with a national |
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organization, higher education institution, or other organization |
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with comprehensive home visit program standards to ensure superior |
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service delivery and program improvement; and |
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(iii) satisfies evidence of effectiveness |
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criteria based on a Home Visiting Evidence of Effectiveness review |
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administered by the United States Department of Health and Human |
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Services. |
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(2) "Recipient" means a medical assistance program |
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recipient. |
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(b) The commission shall provide medical assistance |
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reimbursement to a provider who provides services under a nurse |
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home visiting program to a recipient who: |
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(1) is pregnant; |
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(2) is not more than 24 months postpartum; or |
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(3) is a child 24 months of age or younger. |
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(c) The executive commissioner by rule shall establish a |
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bundled medical assistance program reimbursement rate for the |
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reimbursement of services provided to a recipient under a nurse |
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home visiting program, including education, screening, counseling, |
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and resource referral services related to: |
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(1) healthy pregnancy; |
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(2) child development; |
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(3) diet and nutrition; |
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(4) stress management; |
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(5) sexually transmitted diseases; |
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(6) tobacco use screening and cessation; |
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(7) alcohol and substance use; |
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(8) antenatal and postpartum depression; |
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(9) domestic and intimate partner violence; |
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(10) breastfeeding support; |
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(11) annual well woman visits and recommended |
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preventive services; |
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(12) maternal-infant safety assessment; |
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(13) postpartum recovery, family planning, and |
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newborn needs; |
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(14) selection of a primary care provider; |
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(15) development of parenting skills, parent-child |
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relationship building, and confidence building; |
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(16) child development screening at major |
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developmental milestones from birth to two years of age; |
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(17) maternal vitals sign screening, including blood |
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pressure; |
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(18) well newborn care; and |
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(19) facilitation of access to community or other |
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resources, including: |
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(A) transportation; |
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(B) housing; and |
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(C) assistance under: |
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(i) the child health plan program under |
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Chapters 62 and 63, Health and Safety Code; |
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(ii) the financial assistance program under |
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Chapter 31; |
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(iii) the nutritional assistance programs |
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under Chapter 33, including the supplemental nutrition assistance |
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program under that chapter; and |
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(iv) any other public assistance program |
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the commission administers. |
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(d) If a recipient described by Subsection (b) becomes |
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ineligible for medical assistance, the managed care organization |
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through which the recipient received benefits under the medical |
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assistance program shall coordinate with the nurse home visiting |
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program providing services to the recipient to: |
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(1) arrange for the transfer of the recipient's plan of |
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care; and |
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(2) ensure the recipient continues to receive coverage |
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for the nurse home visiting program services. |
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(e) Any telehealth services provided to a recipient under a |
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nurse home visiting program must be provided in a manner that |
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complies with telehealth requirements the commission establishes. |
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SECTION 2. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 3. This Act takes effect September 1, 2025. |