| 1 | 1 | | By: Villarreal H.B. No. 3363 |
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| 2 | 2 | | |
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| 3 | 3 | | |
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| 4 | 4 | | A BILL TO BE ENTITLED |
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| 5 | 5 | | AN ACT |
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| 6 | 6 | | relating to a Medicaid managed care pilot program to prevent |
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| 7 | 7 | | high-risk pregnancies that result in the birth of premature or low |
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| 8 | 8 | | birth weight infants. |
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| 9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 10 | 10 | | SECTION 1. Subchapter B, Chapter 32, Human Resources Code, |
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| 11 | 11 | | is amended by adding Section 32.02491 to read as follows: |
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| 12 | 12 | | Sec. 32.02491. HIGH-RISK PREGNANCY PREVENTION PILOT |
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| 13 | 13 | | PROGRAM. (a) In this section: |
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| 14 | 14 | | (1) "Low birth weight infant" means an infant who |
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| 15 | 15 | | weights less than 5.5 pounds or 2,500 grams at birth; |
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| 16 | 16 | | (2) "Managed care organization" and "managed care |
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| 17 | 17 | | plan" have the meanings assigned by Section 533.001, Government |
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| 18 | 18 | | Code; and |
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| 19 | 19 | | (3) "Premature infant" means an infant born before |
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| 20 | 20 | | completing 37 weeks of gestation. |
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| 21 | 21 | | (b) The department shall, in coordination with the work |
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| 22 | 22 | | group created under Subdivision 2(e)(1): |
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| 23 | 23 | | (1) develop a concept paper for submission to the |
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| 24 | 24 | | Centers for Medicare and Medicaid Services (CMS) for a pilot |
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| 25 | 25 | | program under which medical assistance is provided for an |
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| 26 | 26 | | additional period of 18 months after delivery to women who deliver |
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| 27 | 27 | | premature or low birth weight infants while receiving medical |
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| 28 | 28 | | assistance; and |
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| 29 | 29 | | (2) if feasible, develop and seek a waiver or |
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| 30 | 30 | | authorization from a federal agency to establish a pilot program |
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| 31 | 31 | | under which medical assistance is provided for an additional period |
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| 32 | 32 | | of 18 months after delivery to women who deliver premature or low |
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| 33 | 33 | | birth weight infants while receiving medical assistance. |
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| 34 | 34 | | (c) Medical assistance required under the pilot program |
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| 35 | 35 | | shall be provided through the Medicaid managed care program |
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| 36 | 36 | | implemented under Chapter 533, Government Code. |
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| 37 | 37 | | (d) The pilot program must be established in the service |
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| 38 | 38 | | delivery area that includes Bexar County. |
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| 39 | 39 | | (e) The department shall: |
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| 40 | 40 | | (1) create a work group to provide recommendations |
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| 41 | 41 | | regarding the development of the concept paper and waiver required |
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| 42 | 42 | | by Subdivision (1) that includes the following members: |
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| 43 | 43 | | (A) representatives of state agencies that |
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| 44 | 44 | | provide services to women, pregnant women, and children; |
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| 45 | 45 | | (B) representatives of the managed care |
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| 46 | 46 | | organizations involved in providing medical assistance under the |
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| 47 | 47 | | pilot program; |
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| 48 | 48 | | (C) outreach providers that contract with the |
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| 49 | 49 | | medical assistance program; and |
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| 50 | 50 | | (D) representatives from other entities as |
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| 51 | 51 | | determined by the executive commissioner of the Health and Human |
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| 52 | 52 | | Services Commission. |
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| 53 | 53 | | (f) The executive commissioner of the Health and Human |
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| 54 | 54 | | Services Commission may adopt rules to implement this section. |
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| 55 | 55 | | (g) Not later than December 1, 2010, the department shall |
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| 56 | 56 | | submit a report to the legislature regarding the department's |
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| 57 | 57 | | progress in developing the concept paper and waiver for |
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| 58 | 58 | | establishing and operating the pilot program. |
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| 59 | 59 | | (h) This section expires September 1, 2011. |
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| 60 | 60 | | SECTION 2. This Act takes effect September 1, 2009. |
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