84R22157 SCL-D
By: Miller of Fort Bend, Sheffield, Cyrier, H.B. No. 175
Zerwas, Farias, et al.
Substitute the following for H.B. No. 175:
By: Crownover C.S.H.B. No. 175
A BILL TO BE ENTITLED
AN ACT
relating to the establishment of the Veterans Recovery Pilot
Program to provide certain veterans with hyperbaric oxygen
treatment.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle B, Title 2, Health and Safety Code, is
amended by adding Chapter 49 to read as follows:
CHAPTER 49. VETERANS RECOVERY PILOT PROGRAM
Sec. 49.001. DEFINITIONS. In this chapter:
(1) "Facility" includes a hospital, public health
clinic, outpatient health clinic, community health center, and any
other facility authorized under department rules to provide
hyperbaric oxygen treatment under this chapter.
(2) "Health care practitioner" means a person who is
licensed to provide medical or other health care in this state and
who has prescriptive authority, including a physician.
(3) "Hyperbaric oxygen treatment" means treatment for
traumatic brain injury or post-traumatic stress disorder
prescribed by a health care practitioner and delivered in:
(A) a hyperbaric chamber approved by the United
States Food and Drug Administration; or
(B) a hyperbaric oxygen device that is approved
by the United States Food and Drug Administration for
investigational use under the direction of an institutional review
board with a national clinical trial number.
(4) "Physician" means a person licensed to practice
medicine by the Texas Medical Board.
(5) "Pilot program" means the Veterans Recovery Pilot
Program established under this chapter.
(6) "Traumatic brain injury" means an acquired injury
to the brain. The term does not include brain dysfunction caused by
congenital or degenerative disorders or birth trauma.
(7) "Veteran" means an individual who has served in:
(A) the army, navy, air force, coast guard, or
marine corps of the United States;
(B) the state military forces as defined by
Section 431.001, Government Code; or
(C) an auxiliary service of one of those branches
of the armed forces.
Sec. 49.002. ESTABLISHMENT AND OPERATION OF PILOT PROGRAM.
(a) The department shall establish and operate the Veterans
Recovery Pilot Program to provide diagnostic services, hyperbaric
oxygen treatment, and support services to eligible veterans who
have post-traumatic stress disorder or a traumatic brain injury.
(b) The commissioner may appoint an advisory board to assist
the department in developing the pilot program.
Sec. 49.003. RULES. The executive commissioner shall adopt
rules to implement this chapter, including standards for veteran
and facility eligibility under the pilot program and standards to
ensure patient confidentiality is protected under the pilot
program. The standards must require that:
(1) eligible facilities comply with applicable fire
codes, oversight requirements, and any treatment protocols
provided in department rules; and
(2) eligible participants in the pilot program reside
in this state.
Sec. 49.004. VETERANS RECOVERY ACCOUNT. (a) The veterans
recovery account is a dedicated account in the general revenue
fund.
(b) The veterans recovery account consists of:
(1) gifts, grants, and other donations received for
the account; and
(2) interest earned on the investment of money in the
fund.
(c) Section 403.071, Government Code, does not apply to the
veterans recovery account.
(d) The commissioner shall administer the veterans recovery
account. Money in the account may be used only to pay for:
(1) expenses of administering the pilot program;
(2) diagnostic testing and treatment of a veteran with
post-traumatic stress disorder or a traumatic brain injury under
the pilot program; and
(3) a veteran's necessary travel and living expenses
for a veteran required to travel to obtain treatment under the pilot
program.
(e) The commissioner shall seek reimbursement for payments
made under the pilot program from the Medicaid and Medicare
programs, the TRICARE program of the United States Department of
Defense, appropriate federal agencies, and any other responsible
third party payor.
Sec. 49.005. HYPERBARIC OXYGEN TREATMENT; RESERVATION OF
FUNDS. (a) The executive commissioner by rule shall adopt
standards for the provision of hyperbaric oxygen treatment under
the pilot program to veterans who have been diagnosed with
post-traumatic stress disorder or a traumatic brain injury, have
been prescribed hyperbaric oxygen treatment by a health care
practitioner, and voluntarily agree to treatment under the pilot
program.
(b) A facility providing medical care to a veteran who is
eligible for hyperbaric oxygen treatment under the pilot program
may apply for reimbursement for treatment under the pilot program.
(c) The facility must submit a treatment plan to the
department before providing treatment under the pilot program. The
treatment plan must include:
(1) a prescription order for hyperbaric oxygen
treatment issued by a health care practitioner;
(2) verification of facility and veteran eligibility;
(3) an estimate of the treatment costs and of the
veteran's necessary travel and living expenses for a veteran
required to travel to obtain the treatment; and
(4) any other information required by the department.
(d) The department shall approve or disapprove a treatment
plan within a reasonable time as established by department rule.
The department shall notify the facility whether the treatment plan
was approved or disapproved by the department.
(e) The department may not approve the provision of
hyperbaric oxygen treatment under the pilot program unless the
facility is in compliance with applicable department standards and
rules and the veteran is eligible for treatment under the pilot
program.
(f) If there is sufficient money in the veterans recovery
account, the department shall approve each treatment plan that
meets the requirements of this section and the standards adopted
under this chapter.
(g) The commissioner shall reserve in the veterans recovery
account an amount equal to the estimated treatment costs and
necessary travel and living expenses specified in the treatment
plan for each veteran that is approved for treatment under the pilot
program.
Sec. 49.006. PROVISION OF SERVICES; REIMBURSEMENT. (a) A
facility may provide hyperbaric oxygen treatment under the pilot
program to a veteran who has post-traumatic stress disorder or a
traumatic brain injury if the department approved a treatment plan
under Section 49.005 for the veteran.
(b) A facility that elects to provide hyperbaric oxygen
treatment to a veteran under Subsection (a) shall provide the
treatment without charge to the veteran. A veteran receiving
treatment under the pilot program is not liable for the cost of
treatment or expenses incurred under the pilot program. The
facility may submit to the department a request for reimbursement
from the veterans recovery account for expenses incurred for the
treatment.
(c) A facility that elects to provide treatment under the
pilot program shall submit to the department regular reports, in
the form prescribed by the department, of the veteran's measured
health improvements under the treatment plan.
(d) The commissioner shall reimburse a facility for
expenses the facility incurred in providing the hyperbaric oxygen
treatment from the veterans recovery account if:
(1) the treatment was provided according to the
treatment plan approved by the department;
(2) the expenses do not exceed the amount reserved for
the treatment under Section 49.005; and
(3) the facility demonstrates in the reports described
by Subsection (c) that the veteran is making measured health
improvements.
(e) If expenses for the treatment exceed funds reserved for
the treatment under Section 49.005, the state and the veterans
recovery account are not liable for the amount in excess of the
reserved funds.
(f) A facility may submit an updated treatment plan under
Section 49.005 to request the reservation of funds in addition to
funds reserved under the original treatment plan.
(g) From money in the veterans recovery account, the
commissioner shall reimburse a veteran required to travel to obtain
treatment under the pilot program for the travel and living
expenses approved by the department in the treatment plan. The
expenses may not exceed the amount reserved for those expenses
under Section 49.005.
Sec. 49.007. TERMINATION OF RESERVATION OF FUNDS. (a) If
the facility or veteran fails to request reimbursement for
treatment or for travel and living expenses under the pilot program
for at least six months following the conclusion of treatment, the
department shall notify the facility and the veteran receiving
treatment under the facility's treatment plan that the funding
reserved for the treatment and expenses will be terminated on the
90th day after the date the department provides notice under this
subsection unless the facility or veteran notifies the department
of continued treatment and expenses under the pilot program or
requests reimbursement for the treatment already provided or
expenses already incurred under the pilot program.
(b) If a facility or veteran fails to notify the department
of continued treatment and expenses in the time required under
Subsection (a), the commissioner shall terminate the reservation of
funds in the veterans recovery account under the facility's
treatment plan for that veteran.
Sec. 49.008. REPORT. Not later than October 1 of each
even-numbered year, the department shall submit to the governor,
lieutenant governor, speaker of the house of representatives, and
appropriate standing committees of the legislature a report
regarding the pilot program that includes an evaluation of the
effectiveness of the pilot program and the number of veterans and
facilities participating in the pilot program.
Sec. 49.009. EXPIRATION OF CHAPTER. This chapter expires
September 1, 2021. Any remaining balance in the veterans recovery
account on the expiration of this chapter is transferred to the
general revenue fund.
SECTION 2. The executive commissioner of the Health and
Human Services Commission shall adopt the rules necessary to
implement Chapter 49, Health and Safety Code, as added by this Act,
not later than January 1, 2016.
SECTION 3. This Act takes effect September 1, 2015.