81R3929 UM-F
By: McReynolds H.B. No. 1990
A BILL TO BE ENTITLED
AN ACT
relating to a diabetes self-management training pilot program under
the state Medicaid program.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter B, Chapter 531, Government Code, is
amended by adding Section 531.0319 to read as follows:
Sec. 531.0319. DIABETES SELF-MANAGEMENT TRAINING PILOT
PROGRAM. (a) Notwithstanding Section 32.057, Human Resources
Code, or Section 533.009 and to the extent allowed by federal law,
the commission shall establish a pilot program to provide diabetes
self-management training services to selected Medicaid recipients.
(b) The commission may select a person to participate in the
pilot program if the person is:
(1) a recipient of Medicaid under the fee-for-service
or primary care case management delivery model;
(2) diagnosed with diabetes; and
(3) enrolled in a disease management program available
to Medicaid recipients.
(c) In establishing the pilot program the commission shall
ensure that:
(1) a provider of diabetes self-management training
under the program is certified to provide the training in
accordance with the quality standards for diabetes self-management
training services described by the Medicare Benefit Policy Manual,
Chapter 15, Section 300, as effective on January 1, 2009;
(2) an assessment of a potential participant in the
program is conducted that includes a review of the person's medical
history, risk factors, health status, resource utilization,
knowledge and skill level, and cultural barriers to effective
diabetes self-management;
(3) a participant receives a minimum of:
(A) 10 hours of initial self-management training
with a diabetes educator; and
(B) three hours of initial nutrition education
with a registered dietitian or with a diabetes educator if a
registered dietitian is not available;
(4) after receipt of the initial self-management
training and nutrition education, the participant receives each
year a minimum of:
(A) two hours of self-management training with a
diabetes educator; and
(B) two hours of nutrition education with a
registered dietitian or with a diabetes educator if a registered
dietitian is not available;
(5) if diabetes self-management training is provided
in group sessions, the participant has direct, face-to-face
interaction with the diabetes educator and is offered a sufficient
number of individual sessions to meet the participant's cultural
and educational needs; and
(6) the participant may repeat all or part of the
self-management training as necessary, regardless of whether the
participant is diagnosed with a new health condition or experiences
a change in health status.
(d) The commission shall ensure that the pilot program
measures the progress of program participants while enrolled in the
program using specific health outcomes for diabetes disease
management.
(e) Information collected by the commission during the
pilot program is confidential and may be disclosed only as
authorized by this section in a manner that prevents disclosure of
individually identifiable information.
(f) Not later than December 1, 2012, the commission shall
submit a report to the governor, lieutenant governor, speaker of
the house of representatives, standing committees of the
legislature with appropriate subject matter jurisdiction, and
Texas Diabetes Council regarding:
(1) the data and outcomes that result from the
diabetes self-management training pilot program; and
(2) any other relevant information as determined by
the commission.
(g) This section expires September 1, 2013.
SECTION 2. 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 3. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2009.