By: Van de Putte S.B. No. 1841
A BILL TO BE ENTITLED
AN ACT
relating to a managed care pilot program to prevent high-risk
pregnancies that result in the birth of premature or low birth
weight infants.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter B, Chapter 32, Human Resources Code,
is amended by adding Section 32.02491 to read as follows:
Sec. 32.02491. BIRTH COST-CONTAINMENT PILOT PROGRAM.
(a) In this section:
(1) "Low birth weight infant" means an infant who
weighs less than 5.5 pounds or 2,500 grams at birth.
(2) "Managed care organization" and "managed care
plan" have the meanings assigned by Section 533.001, Government
Code.
(3) "Premature infant" means an infant born before
completing 37 weeks of gestation.
(b) The department shall establish a pilot program under
which health care services are provided for an additional period of
18 months after the termination of Medicaid for pregnant women
coverage who deliver premature or low birth weight infants.
(c) The health care services required under the pilot
program shall be provided through the Medicaid managed care
organizations.
(d) The pilot program must be established in the service
delivery area that includes Bexar County and its contiguous
counties.
(e) The Medicaid managed care organizations participating
in the pilot program shall develop and implement an outreach
program to identify women who are eligible for participation in the
pilot program and provide those women with information about and
assistance with applying for the pilot program.
(f) The department shall facilitate a seamless transition
from Medicaid for pregnant women coverage into the pilot program.
(g) a woman who received Medicaid for pregnant program
coverage and participates in the pilot program will remain enrolled
in the same Medicaid managed care organization for the duration of
the period during which she receives services under the pilot
program.
(h) The Medicaid managed care organization participating in
the pilot program shall assist a woman who does not become pregnant
during the period of her enrollment in the pilot program with
establishing eligibility for the Women's Health Care Services
Demonstration Project established under Section 32.0248.
(i) The executive commissioner of the Health and Human
Services Commission may adopt rules to implement this section.
(j) Not later than December 1, 2010, the department shall
submit a report to the legislature regarding the department's
progress in establishing and operating the pilot program; and an
evaluation of the budget neutrality of the pilot program.
SECTION 2. If the commission determines that the pilot
program is budget neutral, the commission shall actively seek and
apply for any available federal funds, including Medicaid and
Temporary Assistance for Needy Families (TANF) funds, to assist in
financing the pilot program established under this subchapter.
SECTION 3. This Act takes effect September 1, 2009.