Texas 2009 - 81st Regular

Texas House Bill HB1708 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	81R3558 UM-D
2	2	By: Martinez H.B. No. 1708
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the provision and evaluation of comprehensive substance
8	8	abuse treatment under the state Medicaid program.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subchapter B, Chapter 531, Government Code, is
11	11	amended by adding Section 531.0226 to read as follows:
12	12	Sec. 531.0226. STUDY REGARDING COMPREHENSIVE SUBSTANCE
13	13	ABUSE TREATMENT. (a) The commission shall conduct a study
14	14	regarding the cost-effectiveness of providing comprehensive
15	15	substance abuse treatment, as described by Section 32.024(ff),
16	16	Human Resources Code, to Medicaid recipients who are at least 21
17	17	years of age.
18	18	(b) To evaluate the cost-effectiveness of providing
19	19	comprehensive substance abuse treatment to Medicaid recipients,
20	20	the commission shall identify and use specific outcome measures.
21	21	The outcome measures must be measured in three consecutive years,
22	22	including the year before the year in which the recipient receives
23	23	comprehensive substance abuse treatment, the year in which the
24	24	treatment is first provided to the recipient, and the year
25	25	following the year in which the treatment is first provided to the
26	26	recipient. The study must include, for Medicaid recipients who
27	27	receive comprehensive substance abuse treatment, at least the
28	28	following outcome measures:
29	29	(1) the average annual cost per recipient of a
30	30	recipient's treatment under the Medicaid program, other than the
31	31	comprehensive substance abuse treatment, including inpatient
32	32	services other than inpatient labor and delivery services,
33	33	outpatient services, and pharmaceutical and ancillary services;
34	34	(2) the average annual cost per recipient of the
35	35	comprehensive substance abuse treatment; and
36	36	(3) the average annual number, per recipient, of:
37	37	(A) inpatient days;
38	38	(B) emergency department visits; and
39	39	(C) outpatient visits.
40	40	(c) To evaluate cost and utilization trends among Medicaid
41	41	recipients who are at least 21 years of age and with respect to whom
42	42	there is no evidence of a substance abuse disorder, the commission
43	43	shall collect data regarding the outcome measures listed in
44	44	Subsections (b)(1) and (3) for the same period described by
45	45	Subsection (b).
46	46	(d) In conducting the study, the commission shall ensure
47	47	that outcome data is evaluated using:
48	48	(1) appropriate demographic categories, including
49	49	recipient age, disability, and income; and
50	50	(2) the type of service delivery model through which
51	51	the recipient received services through Medicaid, including the
52	52	fee-for-service, primary care case management, and health
53	53	maintenance organization models.
54	54	(e) Using the data collected during the study, the
55	55	commission shall evaluate cost and utilization trends and whether
56	56	the provision of comprehensive substance abuse treatment through
57	57	the state Medicaid program results in an increase in overall
58	58	Medicaid spending. The commission shall prepare a report of the
59	59	study data and the commission's determination and, not later than
60	60	December 1, 2012, submit the report to the governor, the state
61	61	auditor, and the Legislative Budget Board.
62	62	(f) If the commission determines that the provision of
63	63	comprehensive substance abuse treatment through the state Medicaid
64	64	program has resulted in an increase in overall Medicaid spending,
65	65	the commission:
66	66	(1) may not continue to provide those services to a
67	67	Medicaid recipient who is at least 21 years of age; and
68	68	(2) shall, in the report required by Subsection (e),
69	69	recommend the repeal of Section 32.024(ff), Human Resources Code.
70	70	(g) This section expires January 1, 2013.
71	71	SECTION 2. Section 32.024, Human Resources Code, is amended
72	72	by adding Subsection (ff) to read as follows:
73	73	(ff) Except as otherwise provided by this subsection, the
74	74	department shall provide comprehensive substance abuse treatment
75	75	under the medical assistance program to a person who is at least 21
76	76	years of age, has a substance abuse disorder, and otherwise
77	77	qualifies for medical assistance. The department may not provide
78	78	the treatment if, based on the study conducted under Section
79	79	531.0226, Government Code, a determination is made that the
80	80	treatment resulted in an increase in overall medical assistance
81	81	program spending. Comprehensive substance abuse treatment
82	82	includes assessment, residential detoxification, outpatient
83	83	detoxification, methadone maintenance, residential services,
84	84	specialized residential services for women, outpatient chemical
85	85	dependency counseling, and any other necessary services as
86	86	determined by the department.
87	87	SECTION 3. Not later than December 1, 2009, the Health and
88	88	Human Services Commission shall submit to the Legislative Budget
89	89	Board for approval the commission's proposed methodology,
90	90	including outcome measures selected, for the cost-effectiveness
91	91	study required by Section 531.0226, Government Code, as added by
92	92	this Act.
93	93	SECTION 4. If before implementing any provision of this Act
94	94	a state agency determines that a waiver or authorization from a
95	95	federal agency is necessary for implementation of that provision,
96	96	the agency affected by the provision shall request the waiver or
97	97	authorization and may delay implementing that provision until the
98	98	waiver or authorization is granted.
99	99	SECTION 5. This Act takes effect September 1, 2009.