By: Van de Putte S.B. No. 1842
A BILL TO BE ENTITLED
AN ACT
relating to a Medicaid 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. HIGH-RISK PREGNANCY PREVENTION 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; and
(3) "Premature infant" means an infant born before
completing 37 weeks of gestation.
(b) The department shall, in coordination with the work
group created under Subdivision 2(e)(1):
(1) develop a concept paper for submission to the
Centers for Medicare and Medicaid Services (CMS) for a pilot
program under which medical assistance is provided for an
additional period of 18 months after delivery to women who deliver
premature or low birth weight infants while receiving medical
assistance; and
(2) if feasible, develop and seek a waiver or
authorization from a federal agency to establish a pilot program
under which medical assistance is provided for an additional period
of 18 months after delivery to women who deliver premature or low
birth weight infants while receiving medical assistance.
(c) Medical assistance required under the pilot program
shall be provided through the Medicaid managed care program
implemented under Chapter 533, Government Code.
(d) The pilot program must be established in the service
delivery area that includes Bexar County.
(e) The department shall:
(1) create a work group to provide recommendations
regarding the development of the concept paper and waiver required
by Subdivision (1) that includes the following members:
(A) representatives of state agencies that
provide services to women, pregnant women, and children;
(B) representatives of the managed care
organizations involved in providing medical assistance under the
pilot program;
(C) outreach providers that contract with the
medical assistance program; and
(D) representatives from other entities as
determined by the executive commissioner of the Health and Human
Service Commission.
(f) The executive commissioner of the Health and Human
Services Commission may adopt rules to implement this section.
(g) Not later than December 1, 2010, the department shall
submit a report to the legislature regarding the department's
progress in developing the concept paper and waiver for
establishing and operating the pilot program.
(h) This section expires September 1, 2011.
SECTION 2. This Act takes effect September 1, 2009.