Texas 2015 - 84th Regular

Texas House Bill HB3445 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	84R10169 KFF-F
2	2	By: Laubenberg H.B. No. 3445
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to implementing certain incentives and cost-sharing
8	8	requirements under the Medicaid program.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subchapter B, Chapter 531, Government Code, is
11	11	amended by adding Section 531.098 to read as follows:
12	12	Sec. 531.098. INCENTIVES TO PROMOTE HEALTHY BEHAVIORS. (a)
13	13	If the commission determines that it is feasible and
14	14	cost-effective, the commission shall develop and implement
15	15	incentives to encourage Medicaid recipients to engage in healthy
16	16	behaviors.
17	17	(b) Incentives implemented under Subsection (a) may include
18	18	enhanced benefit accounts, health opportunity accounts, health
19	19	savings accounts, or other similar rewards accounts that allow
20	20	Medicaid recipients who engage in prescribed health-related
21	21	activities to earn credits to the accounts that may be used to
22	22	obtain additional benefits.
23	23	SECTION 2. Section 32.0641, Human Resources Code, is
24	24	amended by amending Subsection (a) and adding Subsection (a-1) to
25	25	read as follows:
26	26	(a) To the extent permitted under and in a manner that is
27	27	consistent with Title XIX, Social Security Act (42 U.S.C. Section
28	28	1396 et seq.), and any other applicable law or regulation or under a
29	29	federal waiver or other authorization, the executive commissioner
30	30	of the Health and Human Services Commission shall adopt, after
31	31	consulting with the Medicaid and CHIP Quality-Based Payment
32	32	Advisory Committee established under Section 536.002, Government
33	33	Code, cost-sharing provisions that encourage personal
34	34	accountability and appropriate utilization of health care
35	35	services.
36	36	(a-1) The executive commissioner of the Health and Human
37	37	Services Commission shall seek to adopt [, including] a
38	38	cost-sharing provision under this section that requires
39	39	[applicable to] a recipient who chooses to receive a nonemergency
40	40	medical service through a hospital emergency room to pay a
41	41	copayment or premium payment for the high-cost medical service if:
42	42	(1) the hospital from which the recipient seeks
43	43	service:
44	44	(A) performs an appropriate medical screening
45	45	and determines that the recipient does not have a condition
46	46	requiring emergency medical services;
47	47	(B) informs the recipient:
48	48	(i) that the recipient does not have a
49	49	condition requiring emergency medical services;
50	50	(ii) that, if the hospital provides the
51	51	nonemergency service, the hospital may require payment of a
52	52	copayment, premium payment, or other cost-sharing payment by the
53	53	recipient in advance; and
54	54	(iii) of the name and address of a
55	55	nonemergency Medicaid provider who can provide the appropriate
56	56	medical service without imposing a cost-sharing payment; and
57	57	(C) offers to provide the recipient with a
58	58	referral to the nonemergency provider to facilitate scheduling of
59	59	the service; and
60	60	(2) after receiving the information and assistance
61	61	described by Subdivision (1) from the hospital, the recipient
62	62	chooses to obtain emergency medical services despite having access
63	63	to medically acceptable, lower-cost medical services.
64	64	SECTION 3. If before implementing any provision of this Act
65	65	a state agency determines that a waiver or authorization from a
66	66	federal agency is necessary for implementation of that provision,
67	67	the agency affected by the provision shall request the waiver or
68	68	authorization and may delay implementing that provision until the
69	69	waiver or authorization is granted.
70	70	SECTION 4. This Act takes effect September 1, 2015.