| 1 | 1 | | By: Van de Putte S.B. No. 1841 |
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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 managed care pilot program to prevent high-risk |
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| 7 | 7 | | pregnancies that result in the birth of premature or low birth |
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| 8 | 8 | | 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. BIRTH COST-CONTAINMENT PILOT PROGRAM. |
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| 13 | 13 | | (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 | | weighs 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. |
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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 establish a pilot program under |
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| 22 | 22 | | which health care services are provided for an additional period of |
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| 23 | 23 | | 18 months after the termination of Medicaid for pregnant women |
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| 24 | 24 | | coverage who deliver premature or low birth weight infants. |
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| 25 | 25 | | (c) The health care services required under the pilot |
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| 26 | 26 | | program shall be provided through the Medicaid managed care |
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| 27 | 27 | | organizations. |
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| 28 | 28 | | (d) The pilot program must be established in the service |
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| 29 | 29 | | delivery area that includes Bexar County and its contiguous |
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| 30 | 30 | | counties. |
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| 31 | 31 | | (e) The Medicaid managed care organizations participating |
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| 32 | 32 | | in the pilot program shall develop and implement an outreach |
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| 33 | 33 | | program to identify women who are eligible for participation in the |
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| 34 | 34 | | pilot program and provide those women with information about and |
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| 35 | 35 | | assistance with applying for the pilot program. |
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| 36 | 36 | | (f) The department shall facilitate a seamless transition |
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| 37 | 37 | | from Medicaid for pregnant women coverage into the pilot program. |
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| 38 | 38 | | (g) a woman who received Medicaid for pregnant program |
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| 39 | 39 | | coverage and participates in the pilot program will remain enrolled |
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| 40 | 40 | | in the same Medicaid managed care organization for the duration of |
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| 41 | 41 | | the period during which she receives services under the pilot |
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| 42 | 42 | | program. |
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| 43 | 43 | | (h) The Medicaid managed care organization participating in |
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| 44 | 44 | | the pilot program shall assist a woman who does not become pregnant |
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| 45 | 45 | | during the period of her enrollment in the pilot program with |
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| 46 | 46 | | establishing eligibility for the Women's Health Care Services |
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| 47 | 47 | | Demonstration Project established under Section 32.0248. |
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| 48 | 48 | | (i) The executive commissioner of the Health and Human |
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| 49 | 49 | | Services Commission may adopt rules to implement this section. |
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| 50 | 50 | | (j) Not later than December 1, 2010, the department shall |
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| 51 | 51 | | submit a report to the legislature regarding the department's |
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| 52 | 52 | | progress in establishing and operating the pilot program; and an |
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| 53 | 53 | | evaluation of the budget neutrality of the pilot program. |
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| 54 | 54 | | SECTION 2. If the commission determines that the pilot |
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| 55 | 55 | | program is budget neutral, the commission shall actively seek and |
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| 56 | 56 | | apply for any available federal funds, including Medicaid and |
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| 57 | 57 | | Temporary Assistance for Needy Families (TANF) funds, to assist in |
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| 58 | 58 | | financing the pilot program established under this subchapter. |
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| 59 | 59 | | SECTION 3. This Act takes effect September 1, 2009. |
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