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A BILL TO BE ENTITLED
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AN ACT
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relating to the provision and evaluation of Medicaid reimbursement |
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for dental services provided to certain Medicaid recipients. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 32.054, Human Resources Code, is amended |
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by adding Subsections (g) and (h) to read as follows: |
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(g) In addition to dental services already covered under the |
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medical assistance program, the commission shall provide medical |
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assistance reimbursement for recipients who are 21 years of age or |
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older, including recipients with a disability, for dental services |
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needed for pain relief, infections, restoration of teeth, and |
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maintenance of dental health, including: |
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(1) preventative services; and |
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(2) therapeutic services for dental disease that, if |
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left untreated, may become acute dental problems or may cause |
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irreversible damage to the teeth or supporting structures. |
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(h) Notwithstanding Subsection (g), the commission may not |
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provide medical assistance reimbursement for the provision of |
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dental services under that subsection if, based on the data |
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evaluated under Section 32.0545, the Legislative Budget Board finds |
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that the provision of medical assistance reimbursement for those |
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services resulted in an increase in overall spending under the |
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medical assistance program. |
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SECTION 2. Subchapter B, Chapter 32, Human Resources Code, |
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is amended by adding Section 32.0545 to read as follows: |
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Sec. 32.0545. EVALUATION OF REIMBURSEMENT FOR CERTAIN |
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DENTAL SERVICES. (a) The commission shall: |
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(1) analyze data related to the provision of medical |
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assistance reimbursement for dental services provided to |
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recipients under Section 32.054(g); and |
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(2) provide to the Legislative Budget Board the data |
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described by Subdivision (1) in the form and manner the board |
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requires. |
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(b) The data analyzed by the commission and provided to the |
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Legislative Budget Board under Subsection (a) must: |
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(1) relate to three consecutive years, beginning with |
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the year immediately preceding the year in which medical assistance |
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reimbursement for the provision of dental services under Section |
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32.054(g) is initially provided; and |
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(2) include at least the following: |
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(A) the number of recipients who received those |
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dental services; and |
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(B) the type of dental services for which medical |
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assistance reimbursement was provided. |
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(c) The commission shall ensure the analysis under |
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Subsection (a) includes: |
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(1) appropriate demographic categories, including |
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recipient age, disability, and income; and |
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(2) the average cost per recipient for providing |
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dental services under the medical assistance program. |
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(d) Using the data the commission provides under Subsection |
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(a), the Legislative Budget Board shall evaluate cost and |
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utilization trends to determine whether providing medical |
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assistance reimbursement for the provision of dental services to |
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recipients under Section 32.054(g) resulted in an increase in |
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overall spending on the provision of dental services under the |
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medical assistance program. |
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(e) Not later than February 1, 2029, the Legislative Budget |
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Board shall: |
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(1) prepare and publish on the board's Internet |
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website a written report of its evaluation under Subsection (d); |
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and |
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(2) publish a summary of its findings, including a |
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specific finding regarding whether providing medical assistance |
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reimbursement for the provision of dental services to recipients |
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under Section 32.054(g) resulted in an increase in overall spending |
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on the provision of dental services under the medical assistance |
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program. |
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(f) The Legislative Budget Board shall provide to the |
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commission a draft of the report described by Subsection (e)(1) not |
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later than the 30th day before the date the board publishes the |
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report on the board's Internet website. |
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(g) If the Legislative Budget Board finds that: |
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(1) providing medical assistance reimbursement for |
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the provision of dental services under Section 32.054(g) resulted |
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in an increase in overall spending on the provision of dental |
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services under the medical assistance program: |
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(A) the commission shall immediately discontinue |
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providing reimbursement for those services; and |
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(B) Sections 32.054(g) and (h) and this section |
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expire; or |
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(2) providing medical assistance reimbursement for |
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the provision of dental services under Section 32.054(g) did not |
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result in an increase in overall spending on the provision of dental |
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services under the medical assistance program, Section 32.054(h) |
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and this section expire. |
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SECTION 3. 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 4. This Act takes effect September 1, 2025. |