85R19733 KLA-F
By: Zerwas H.B. No. 2
Substitute the following for H.B. No. 2:
By: Zerwas C.S.H.B. No. 2
A BILL TO BE ENTITLED
AN ACT
relating to making supplemental appropriations and giving
direction and adjustment authority regarding appropriations.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. APPROPRIATION REDUCTION: PUBLIC FINANCE
AUTHORITY. The unencumbered appropriations from the general
revenue fund to the Public Finance Authority made by Chapter 1281
(H.B. 1), Acts of the 84th Legislature, Regular Session, 2015 (the
General Appropriations Act), for use during the state fiscal
biennium ending August 31, 2017, for bond debt service payments,
including appropriations subject to Rider 2, page I-47, Chapter
1281 (H.B. 1), Acts of the 84th Legislature, Regular Session, 2015
(the General Appropriations Act), to the bill pattern of the
appropriations to the authority, are reduced by a total aggregate
of $53,636,997. The Public Finance Authority shall identify the
strategies and objectives to which the reduction is to be allocated
and the amount of the reduction for each of those strategies and
objectives.
SECTION 2. HEALTH AND HUMAN SERVICES COMMISSION: MEDICAID
SHORTFALL. (a) In addition to amounts previously appropriated for
the state fiscal biennium ending August 31, 2017, $930,733,818 is
appropriated from the general revenue fund, and $1,705,243,901 is
appropriated from federal funds, to the Health and Human Services
Commission for the state fiscal year ending August 31, 2017, for
Medicaid services under Goal B, Medicaid, as listed in Chapter 1281
(H.B. 1), Acts of the 84th Legislature, Regular Session, 2015 (the
General Appropriations Act).
(b) The expenditure or emergency transfer of money
appropriated under Subsection (a) of this section is subject to the
prior written approval of the Legislative Budget Board in
accordance with Section 69, Article XVI, Texas Constitution.
SECTION 3. HEALTH AND HUMAN SERVICES COMMISSION: MEDICAID
ACUTE CARE THERAPY SERVICES. In addition to amounts previously
appropriated for the state fiscal biennium ending August 31, 2017,
$21,500,000 is appropriated from the general revenue fund, and
$29,800,000 is appropriated from federal funds, to the Health and
Human Services Commission for the state fiscal year ending August
31, 2017, for Medicaid acute care therapy services, to be allocated
among provider types and procedure codes for those services to
preserve access to care.
SECTION 4. HEALTH AND HUMAN SERVICES COMMISSION: CERTAIN
RIDERS. Subsection (c), Rider 50, page II-97, Chapter 1281 (H.B.
1), Acts of the 84th Legislature, Regular Session, 2015 (the
General Appropriations Act), to the bill pattern of the
appropriations to the Health and Human Services Commission is
amended to read as follows:
c. HHSC shall reform reimbursement methodology to be in line
with industry standards[, policies,] and utilization for acute care
therapy services (including physical, occupational, and speech
therapies) while considering stakeholder input and access to care.
In state fiscal year 2017, $28,500,000 [Out of the amount in
subsection (a), in each fiscal year at least $50,000,000] in
General Revenue Funds savings should be achieved through rate
reductions [and $25,000,000 in General Revenue Funds savings may be
achieved through various medical policy initiatives listed in items
(1)-(10), below. If $25,000,000 in savings is not achieved through
various medical policy initiatives in fiscal year 2016, the amount
of unrealized savings (the difference between $25,000,000 in
General Revenue Funds and savings actually achieved in fiscal year
2016) should be achieved through additional rate reductions in
fiscal year 2017 while continuing any initiatives implemented in
fiscal year 2016 that have been found to produce savings. HHSC may
achieve savings through various medical policy initiatives, taking
into consideration the following:
[(1) Clarifying policy language regarding co-therapy
definition, documentation, and billing requirements,
[(2) Clarifying who can participate in therapy
sessions in policy that interns, aides, students, orderlies and
technicians can participate in therapy sessions when they are
directly and appropriately supervised according to provider
licensure requirements, but they are not eligible to enroll as
providers and bill Texas Medicaid for services,
[(3) Consolidate Traditional, Comprehensive Care
Program and Home Health Agency therapy policies into one policy,
[(4) Require a primary care or treating physician to
initiate a signed order or referral prior to an initial therapy
evaluation. The initial evaluation may require prior authorization
and the signed order or referral must be dated prior to the
evaluation,
[(5) Require a primary care or treating physician to
order the therapy services based on the outcomes of the evaluation,
[(6) Clarify medical necessity for therapy services to
ensure prior authorization staff who are reviewing requests are
using guidelines based on the nationally recognized standards of
care,
[(7) Require licensed Medicaid enrolled therapists to
document and support decisions for continued therapy based on
professional assessment of a client's progress relative to their
individual treatment plan and in concert with the client's primary
care physician and the individual and/or family,
[(8) Ensure appropriate duration of services by
aligning authorization periods with national standards,
[(9) Streamline prior authorization processes, and
[(10) Implement policies that ensure services are
provided in the most cost-efficient and medically appropriate
setting, and implementation of other medical or billing policy
changes].
SECTION 5. DEPARTMENT OF FAMILY AND PROTECTIVE SERVICES:
ADDITIONAL APPROPRIATIONS. In addition to amounts previously
appropriated for the state fiscal biennium ending August 31, 2017,
the following amounts are appropriated from the general revenue
fund to the Department of Family and Protective Services for the
state fiscal year ending August 31, 2017, for the following
purposes as listed in Chapter 1281 (H.B. 1), Acts of the 84th
Legislature, Regular Session, 2015 (the General Appropriations
Act):
(1) $12,740,200 for Strategy B.1.3., TWC Contracted
Day Care;
(2) $31,993,283 for Strategy B.1.9., Foster Care
Payments; and
(3) $1,576,783 for Strategy B.1.10., Adoption/PCA
Payments.
SECTION 6. DEPARTMENT OF FAMILY AND PROTECTIVE SERVICES:
CERTAIN TRANSFERS. Notwithstanding the limitations of Rider 32,
page II-43, Chapter 1281 (H.B. 1), Acts of the 84th Legislature,
Regular Session, 2015 (the General Appropriations Act), to the bill
pattern of the appropriations to the Department of Family and
Protective Services, the department shall transfer $435,475 from
Strategy B.1.11., Relative Caregiver Payments, to Strategy B.1.9.,
Foster Care Payments, as listed in Chapter 1281 (H.B. 1), Acts of
the 84th Legislature, Regular Session, 2015 (the General
Appropriations Act).
SECTION 7. DEPARTMENT OF FAMILY AND PROTECTIVE SERVICES:
ADDITIONAL APPROPRIATIONS FOR AGENCY CRITICAL NEEDS. In addition
to amounts previously appropriated for the state fiscal biennium
ending August 31, 2017, the Department of Family and Protective
Services is appropriated for the state fiscal year ending August
31, 2017, the following amounts from the general revenue fund for
the following strategies as listed in Chapter 1281 (H.B. 1), Acts of
the 84th Legislature, Regular Session, 2015 (the General
Appropriations Act), to address critical needs of the agency with
respect to those strategies:
(1) $75,521,204 for Strategy B.1.1., CPS Direct
Delivery Staff;
(2) $613,174 for Strategy B.1.2., CPS Program Support;
(3) $21,000,000 for Strategy B.1.9., Foster Care
Payments;
(4) $138,854 for Strategy D.1.1., APS Direct Delivery
Staff;
(5) $6,703 for Strategy D.1.2., APS Program Support;
(6) $376,259 for Strategy F.1.1., Central
Administration;
(7) $33,546 for Strategy F.1.2., Other Support
Services;
(8) $3,067,626 for Strategy F.1.4., IT Program
Support; and
(9) $940,108 for Strategy G.1.1., Agency-Wide
Automated Systems.
SECTION 8. DEPARTMENT OF FAMILY AND PROTECTIVE SERVICES:
CERTAIN TRANSFERS. (a) Notwithstanding any transfer limitation
specified in Chapter 1281 (H.B. 1), Acts of the 84th Legislature,
Regular Session, 2015 (the General Appropriations Act), the
Department of Family and Protective Services shall transfer to the
Health and Human Services Commission the following amounts:
(1) $29,247,213 of general revenue funds; and
(2) $72,450,261 of Temporary Assistance for Needy
Families (TANF) program federal funds.
(b) The Health and Human Services Commission may spend
Temporary Assistance for Needy Families (TANF) program federal
funds transferred under Subsection (a)(2) of this section during
the state fiscal year ending August 31, 2017, only with the prior
written approval of the Legislative Budget Board in accordance with
Section 69, Article XVI, Texas Constitution.
SECTION 9. TEXAS A&M FOREST SERVICE: APPROPRIATION FOR
GENERAL COSTS CAUSED BY VARIOUS EMERGENCY WEATHER-RELATED
RESPONSES. In addition to amounts previously appropriated for the
state fiscal biennium ending August 31, 2017, $5,100,000 is
appropriated from the general revenue fund to the Texas A&M Forest
Service for the state fiscal year ending August 31, 2017, for the
purpose of paying for, or reimbursing payments made for, costs
incurred by the forest service associated with responding to
various weather-related emergencies.
SECTION 10. DEPARTMENT OF CRIMINAL JUSTICE: CORRECTIONAL
MANAGED HEALTH CARE SHORTFALL. In addition to amounts previously
appropriated for the state fiscal biennium ending August 31, 2017,
$80,000,000 is appropriated from the general revenue fund to the
Department of Criminal Justice for the state fiscal year ending
August 31, 2017, for correctional managed health care under
Strategy C.1.9., Hospital and Clinical Care, as listed in Chapter
1281 (H.B. 1), Acts of the 84th Legislature, Regular Session, 2015
(the General Appropriations Act).
SECTION 11. JUVENILE JUSTICE DEPARTMENT: OPERATIONAL
SHORTFALL. In addition to amounts previously appropriated for the
state fiscal biennium ending August 31, 2017, $4,469,257 is
appropriated from the general revenue fund to the Juvenile Justice
Department for the state fiscal year ending August 31, 2017, for an
operational shortfall.
SECTION 12. ANIMAL HEALTH COMMISSION: CATTLE FEVER TICKS.
In addition to amounts previously appropriated for the state fiscal
biennium ending August 31, 2017, $649,987 is appropriated from the
general revenue fund to the Animal Health Commission for the state
fiscal year ending August 31, 2017, for preparedness for, response
to, and mitigation of cattle fever ticks under Strategy A.1.1.,
Field Operations, as listed in Chapter 1281 (H.B. 1), Acts of the
84th Legislature, Regular Session, 2015 (the General
Appropriations Act).
SECTION 13. EFFECTIVE DATE. This Act takes effect
immediately.