Texas 2009 - 81st Regular

Texas Senate Bill SB796 Compare Versions

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Old	New	Differences
1	1	81R32858 UM-D
2	2	By: Hinojosa, et al. S.B. No. 796
3	3	Substitute the following for S.B. No. 796:
4	4	By: Kolkhorst C.S.S.B. No. 796
5	5
6	6
7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to the provision and evaluation of comprehensive substance
10	10	abuse treatment under the state Medicaid program.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Subchapter B, Chapter 531, Government Code, is
13	13	amended by adding Section 531.0226 to read as follows:
14	14	Sec. 531.0226. SUBSTANCE ABUSE TREATMENT EVALUATION.
15	15	(a) The commission shall monitor the provision of comprehensive
16	16	substance abuse treatment, as described by Section 32.024(ff),
17	17	Human Resources Code, to Medicaid recipients who are at least 21
18	18	years of age and analyze data relating to the provision of those
19	19	services. The commission shall provide the data to the Legislative
20	20	Budget Board in the format and at the times requested by the
21	21	Legislative Budget Board.
22	22	(b) The data analyzed and provided under Subsection (a)
23	23	must:
24	24	(1) be measured in three consecutive years, including
25	25	the year before the year in which the recipient receives
26	26	comprehensive substance abuse treatment, the year in which the
27	27	treatment is first provided to the recipient, and the year
28	28	following the year in which the treatment is first provided to the
29	29	recipient; and
30	30	(2) include at least the following:
31	31	(A) the number of recipients to whom
32	32	comprehensive substance abuse treatment is provided;
33	33	(B) the type of substance abuse treatment
34	34	provided;
35	35	(C) the average annual cost per recipient of
36	36	treatment under the Medicaid program, other than the comprehensive
37	37	substance abuse treatment, including inpatient services other than
38	38	inpatient labor and delivery services, emergency department
39	39	services, outpatient services, and pharmaceutical and ancillary
40	40	services;
41	41	(D) the average annual cost per recipient of the
42	42	comprehensive substance abuse treatment; and
43	43	(E) the average annual number per recipient of:
44	44	(i) inpatient days;
45	45	(ii) emergency department visits; and
46	46	(iii) outpatient visits.
47	47	(c) The commission shall collect the data listed in
48	48	Subsections (b)(2)(C) and (E) for Medicaid recipients who are at
49	49	least 21 years of age and with respect to whom there is no evidence
50	50	of a substance abuse disorder for the same period described by
51	51	Subsection (b).
52	52	(d) The commission shall ensure that data is analyzed using:
53	53	(1) appropriate demographic categories, including
54	54	recipient age, disability, and income; and
55	55	(2) the type of service delivery model through which
56	56	the recipient received services through Medicaid, including the
57	57	fee-for-service, primary care case management, and health
58	58	maintenance organization models.
59	59	(e) Using the data provided by the commission, the
60	60	Legislative Budget Board shall evaluate cost and utilization trends
61	61	and whether the provision of comprehensive substance abuse
62	62	treatment through the state Medicaid program results in an increase
63	63	in overall Medicaid spending. Not later than February 1, 2013, the
64	64	Legislative Budget Board shall prepare and publish a report of the
65	65	data. The Legislative Budget Board shall provide a draft of the
66	66	report to the commission before publishing the report.
67	67	(f) If the Legislative Budget Board determines that the
68	68	provision of comprehensive substance abuse treatment through the
69	69	state Medicaid program has resulted in an increase in overall
70	70	Medicaid spending, the commission may not continue to provide those
71	71	services to a Medicaid recipient who is at least 21 years of age.
72	72	(g) This section expires March 1, 2013.
73	73	SECTION 2. Section 32.024, Human Resources Code, is amended
74	74	by adding Subsection (ff) to read as follows:
75	75	(ff) Except as otherwise provided by this subsection, the
76	76	department shall provide comprehensive substance abuse treatment
77	77	under the medical assistance program to a person who is at least 21
78	78	years of age, has a substance abuse disorder, and otherwise
79	79	qualifies for medical assistance. The department may not provide
80	80	the treatment if, based on the data evaluated under Section
81	81	531.0226, Government Code, the Legislative Budget Board determines
82	82	that the treatment resulted in an increase in overall medical
83	83	assistance program spending. Comprehensive substance abuse
84	84	treatment includes assessment, residential detoxification,
85	85	outpatient detoxification, medication-assisted treatment,
86	86	residential services, specialized residential services for women,
87	87	outpatient chemical dependency counseling, and any other necessary
88	88	services as determined by the department.
89	89	SECTION 3. If before implementing any provision of this Act
90	90	a state agency determines that a waiver or authorization from a
91	91	federal agency is necessary for implementation of that provision,
92	92	the agency affected by the provision shall request the waiver or
93	93	authorization and may delay implementing that provision until the
94	94	waiver or authorization is granted.
95	95	SECTION 4. This Act takes effect September 1, 2009.