Texas 2019 - 86th Regular

Texas House Bill HB1295 Compare Versions

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

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1	1	86R4305 KFF-D
2	2	By: Davis of Harris H.B. No. 1295
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to early childhood intervention and rehabilitative and
8	8	habilitative services.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subchapter A, Chapter 533, Government Code, is
11	11	amended by adding Section 533.00521 to read as follows:
12	12	Sec. 533.00521. STAR HEALTH PROGRAM: EARLY CHILDHOOD
13	13	INTERVENTION SERVICES. (a) A managed care organization that
14	14	contracts with the commission to provide health care services to
15	15	recipients under the STAR Health program may not require prior
16	16	authorization for the provision of early childhood intervention
17	17	program services under Chapter 73, Human Resources Code, to a child
18	18	eligible for the program, including services specified in the
19	19	child's individualized family service plan issued by the commission
20	20	under the program.
21	21	(b) A contract between a managed care organization and the
22	22	commission for the organization to provide health care services to
23	23	recipients under the STAR Health program must contain a requirement
24	24	that the organization:
25	25	(1) proactively review and monitor recipient access
26	26	and utilization of early childhood intervention services under
27	27	Chapter 73, Human Resources Code; and
28	28	(2) demonstrate to the commission that the
29	29	organization is in compliance with Subsection (a), including a
30	30	requirement that the organization submit quarterly reports to the
31	31	commission that verify that the organization did not include a
32	32	prior authorization request for early childhood intervention
33	33	services under Chapter 73, Human Resources Code, as part of a
34	34	medical necessity determination.
35	35	SECTION 2. Section 73.001, Human Resources Code, is amended
36	36	by adding Subdivision (5) to read as follows:
37	37	(5) "Medicaid" means the medical assistance program
38	38	established under Chapter 32, Human Resources Code.
39	39	SECTION 3. Section 73.0051(l), Human Resources Code, is
40	40	redesignated as Section 73.0052, Human Resources Code, and amended
41	41	to read as follows:
42	42	Sec. 73.0052. SYSTEM OF PAYMENTS. (a) Subject to the
43	43	requirements of this section, the [(l) The] executive
44	44	commissioner by rule may establish a system of payments by families
45	45	of children receiving services under this chapter, including a
46	46	schedule of sliding fees, in a manner consistent with 34 C.F.R.
47	47	Sections 303.13(a)(3), 303.520, and 303.521.
48	48	(b) In adopting a system of payments under this section and
49	49	to the extent permitted by federal law, the executive commissioner
50	50	shall require that if a child has private health benefits coverage,
51	51	the health benefits plan provider that provides the coverage is the
52	52	primary payor of services provided under this chapter, except as
53	53	provided by Subsection (c).
54	54	(c) If the child covered by private health benefits coverage
55	55	described by Subsection (b) would be required to pay any amount
56	56	out-of-pocket for a service provided under this chapter, including
57	57	any deductible, copayment, coinsurance, or other cost-sharing
58	58	payment, the executive commissioner shall ensure the claim for
59	59	services is paid using money from the following sources in the
60	60	following order:
61	61	(1) federal funds received under Part C, Individuals
62	62	with Disabilities Education Act (IDEA) (20 U.S.C. Section 1431 et
63	63	seq.);
64	64	(2) Medicaid, if applicable; and
65	65	(3) to the extent money is appropriated for that
66	66	purpose, general revenue.
67	67	SECTION 4. Chapter 73, Human Resources Code, is amended by
68	68	adding Sections 73.00521 and 73.00522 to read as follows:
69	69	Sec. 73.00521. DELIVERY OF SERVICES. (a) Notwithstanding
70	70	any other law and except as provided by Subsection (b), the
71	71	commission shall provide services under this chapter to each
72	72	eligible child through the STAR Kids managed care program
73	73	established under Section 533.00253, Government Code, regardless
74	74	of the child's Medicaid eligibility.
75	75	(b) Notwithstanding any other law, the commission shall
76	76	provide through the STAR Health program services under this chapter
77	77	to each eligible child who is in the conservatorship of the
78	78	Department of Family and Protective Services.
79	79	Sec. 73.00522. OMBUDSMAN FOR CERTAIN STAR KIDS MANAGED CARE
80	80	PROGRAM ENROLLEES. (a) In this section, "ombudsman" means the
81	81	individual designated as the ombudsman for children receiving early
82	82	childhood intervention services through the STAR Kids managed care
83	83	program under Section 73.00521(a).
84	84	(b) The executive commissioner shall designate an ombudsman
85	85	for children receiving early childhood intervention services
86	86	through the STAR Kids managed care program under Section
87	87	73.00521(a).
88	88	(c) The ombudsman's office is administratively attached to
89	89	the office of the ombudsman of the commission.
90	90	(d) The commission may use an alternate title for the
91	91	ombudsman in consumer-directed materials if the commission
92	92	determines that the alternate title would benefit consumers'
93	93	understanding of or access to ombudsman services.
94	94	(e) The ombudsman serves as a neutral party to assist
95	95	children who are eligible to receive or receiving early childhood
96	96	intervention services through the STAR Kids managed care program
97	97	under Section 73.00521(a) and their parents and guardians in
98	98	resolving issues related to applying for and receiving those
99	99	services.
100	100	(f) The ombudsman shall for children and the parents and
101	101	guardians of children eligible to receive or receiving early
102	102	childhood intervention services through the STAR Kids managed care
103	103	program under Section 73.00521(a):
104	104	(1) provide dispute and complaint resolution
105	105	services;
106	106	(2) perform consumer protection and advocacy
107	107	functions; and
108	108	(3) collect inquiry and complaint data.
109	109	(g) The executive commissioner by rule shall adopt and
110	110	ensure the use of procedures for the reporting, monitoring, and
111	111	resolution of disputes and complaints described by Subsection (f)
112	112	that are consistent with the procedures adopted and used under
113	113	Medicaid.
114	114	SECTION 5. Section 73.009(a), Human Resources Code, is
115	115	amended to read as follows:
116	116	(a) The commission [department] shall develop and the
117	117	executive commissioner shall establish policies concerning
118	118	services described by this section. A child under three years of
119	119	age and the child's parent, guardian, or other legally authorized
120	120	representative:
121	121	(1) [family] may be referred for services described by
122	122	this section if the child is:
123	123	(A) [(1)] identified as having a developmental
124	124	delay;
125	125	(B) [(2)] suspected of having a developmental
126	126	delay; or
127	127	(C) [(3)] considered at risk of developmental
128	128	delay; and
129	129	(2) shall be referred for services described by this
130	130	section if the child is:
131	131	(A) in the conservatorship of the Department of
132	132	Family and Protective Services; and
133	133	(B) at least one year of age unless an earlier
134	134	referral for services is made.
135	135	SECTION 6. Chapter 73, Human Resources Code, is amended by
136	136	adding Sections 73.0105, 73.0111, and 73.012 to read as follows:
137	137	Sec. 73.0105. COMBINED OR CONCURRENT APPOINTMENTS. The
138	138	commission shall ensure that:
139	139	(1) the parent, guardian, or other legally authorized
140	140	representative of siblings who are eligible for the same service
141	141	under this chapter is allowed to elect to have the siblings receive
142	142	the service from the same provider at the same appointment if the
143	143	provider agrees that the provision of services in this manner is
144	144	appropriate treatment for the needs of each child; or
145	145	(2) if the siblings' parent, guardian, or other
146	146	legally authorized representative does not make the election under
147	147	Subdivision (1) or the siblings are eligible for different services
148	148	under this chapter that are available from the same provider, the
149	149	parent, guardian, or legally authorized representative may
150	150	schedule the appointments for the services near in time to each
151	151	other.
152	152	Sec. 73.0111. PROVIDER OMBUDSMAN. (a) In this section,
153	153	"ombudsman" means the individual designated as the ombudsman for
154	154	providers of services authorized under this chapter.
155	155	(b) The executive commissioner shall designate an ombudsman
156	156	for providers of services authorized under this chapter.
157	157	(c) The ombudsman's office is administratively attached to
158	158	the office of the ombudsman of the commission.
159	159	(d) The commission may use an alternate title for the
160	160	ombudsman in provider-directed materials if the commission
161	161	determines that the alternate title would benefit providers'
162	162	understanding of or access to ombudsman services.
163	163	(e) The ombudsman serves as a neutral party to assist
164	164	providers of services authorized under this chapter in resolving
165	165	issues related to providing early childhood intervention services
166	166	under this chapter, including through the STAR Kids managed care
167	167	program.
168	168	(f) The ombudsman shall:
169	169	(1) provide dispute and complaint resolution
170	170	services;
171	171	(2) perform provider protection and advocacy
172	172	functions; and
173	173	(3) collect inquiry and complaint data.
174	174	(g) The executive commissioner by rule shall adopt and
175	175	ensure the use of procedures for the reporting, monitoring, and
176	176	resolution of disputes and complaints described by Subsection (f)
177	177	that are consistent with the procedures adopted and used under
178	178	Medicaid.
179	179	Sec. 73.012. REIMBURSEMENT METHODOLOGY FOR CASE MANAGEMENT
180	180	SERVICES. (a) The executive commissioner shall:
181	181	(1) apply for and actively pursue from the federal
182	182	Centers for Medicare and Medicaid Services or other appropriate
183	183	federal agency any waiver or other authorization necessary to
184	184	provide reimbursement under Medicaid for case management services
185	185	provided under this chapter; and
186	186	(2) pending authorization under Subdivision (1),
187	187	request clear direction and guidance from the federal Centers for
188	188	Medicare and Medicaid Services on the reimbursement methodology
189	189	that may be used for the provision of case management services under
190	190	this chapter, including direction on allowable and unallowable
191	191	costs.
192	192	(b) If appropriate and based on the guidance received under
193	193	Subsection (a), the executive commissioner shall amend rules
194	194	governing reimbursement for the provision of case management
195	195	services under this chapter to ensure providers are reimbursed for
196	196	all allowable costs.
197	197	(c) This section expires September 1, 2021.
198	198	SECTION 7. Subtitle B, Title 3, Human Resources Code, is
199	199	amended by adding Chapter 74 to read as follows:
200	200	CHAPTER 74. TELE-CONNECTIVE PILOT PROGRAM
201	201	Sec. 74.0001. DEFINITIONS. In this chapter:
202	202	(1) "Commission" means the Health and Human Services
203	203	Commission.
204	204	(2) "Developmental delay" has the meaning assigned by
205	205	Section 73.001.
206	206	(3) "Eligible child" means a child who is eligible for
207	207	early childhood intervention services under Chapter 73.
208	208	(4) "Executive commissioner" means the executive
209	209	commissioner of the Health and Human Services Commission.
210	210	(5) "Tele-connective pilot program" means the program
211	211	developed and implemented under Section 74.0002.
212	212	(6) "Telehealth service" and "telemedicine medical
213	213	service" have the meanings assigned by Section 111.001, Occupations
214	214	Code.
215	215	Sec. 74.0002. TELE-CONNECTIVE PILOT PROGRAM. The
216	216	commission shall develop and implement a pilot program to provide
217	217	early childhood intervention services under Chapter 73 to eligible
218	218	children through the provision of telehealth and telemedicine
219	219	medical services delivered using access points established in
220	220	school districts selected to participate in the program.
221	221	Sec. 74.0003. SCHOOL DISTRICT SELECTION. The commission in
222	222	cooperation with the Texas Education Agency shall select the school
223	223	districts in which to implement the tele-connective pilot program.
224	224	In determining the school districts in which to implement the
225	225	program, the commission and the Texas Education Agency:
226	226	(1) shall consider each school district in which there
227	227	is:
228	228	(A) a low or inadequate number of service
229	229	providers authorized under Chapter 73; or
230	230	(B) a significant risk of losing service
231	231	providers authorized under Chapter 73; and
232	232	(2) may implement the program only in school districts
233	233	in which the implementation is reasonable and feasible.
234	234	Sec. 74.0004. PROVIDER PARTICIPATION. (a) The commission
235	235	shall ensure that providers of services under Chapter 73 other than
236	236	school districts are allowed to participate as providers in the
237	237	tele-connective pilot program and provide services outside the
238	238	school-based setting.
239	239	(b) The commission shall collaborate with the Texas
240	240	Education Agency to establish school-based provider access points
241	241	for the program.
242	242	Sec. 74.0005. ADEQUATE NETWORK OF ACCESS POINTS. The
243	243	commission and the Texas Education Agency shall ensure that an
244	244	adequate number of school-based and non-school-based
245	245	tele-connective pilot program access points are established in a
246	246	school district participating in the program.
247	247	Sec. 74.0006. AUTOMATIC AND VOLUNTARY PARTICIPATION OF
248	248	CERTAIN ELIGIBLE CHILDREN. (a) Subject to Subsection (b) and
249	249	notwithstanding Section 73.0051(j), the commission shall
250	250	automatically enroll an eligible child in the tele-connective pilot
251	251	program if the child has a developmental delay of at least 30
252	252	percent but less than 70 percent in only one area. An eligible
253	253	child may not be enrolled in the tele-connective pilot program and
254	254	may receive services in an in-person setting if the child has a
255	255	developmental delay:
256	256	(1) in any degree in at least two areas; or
257	257	(2) of at least 70 percent in one area.
258	258	(b) The parent, guardian, or other legally authorized
259	259	representative of an eligible child may, at any time, elect to opt
260	260	the child out of the tele-connective pilot program.
261	261	Sec. 74.0007. SCHOOL DISTRICT EMPLOYEE TRAINING. The Texas
262	262	Education Agency shall develop a training course on the
263	263	tele-connective pilot program to be given to appropriate school
264	264	district employees.
265	265	Sec. 74.0008. INITIAL SCREENING AND EVALUATION. (a) An
266	266	initial screening or evaluation under the tele-connective pilot
267	267	program must:
268	268	(1) be an in-person consultation; and
269	269	(2) have the parent, guardian, or other legally
270	270	authorized representative of the eligible child present.
271	271	(b) The parent, guardian, or other legally authorized
272	272	representative of an eligible child must be given the opportunity
273	273	to opt the child out of the tele-connective pilot program at the
274	274	time of the child's initial screening or evaluation.
275	275	(c) Notwithstanding any other law, after a child is enrolled
276	276	in the tele-connective pilot program, health care services,
277	277	including any initial treatment or prescription, that are delivered
278	278	or issued by a physician or by a health care provider acting under
279	279	the delegation or supervision of the physician or under the health
280	280	care provider's license may be provided using telecommunications or
281	281	other information technology.
282	282	Sec. 74.0009. PROVIDER REIMBURSEMENT. The executive
283	283	commissioner in adopting rules governing the tele-connective pilot
284	284	program shall ensure that provider reimbursement for a telehealth
285	285	or telemedicine medical service is made at a rate that is comparable
286	286	to the rate paid under private health benefit plans.
287	287	Sec. 74.0010. CONFIDENTIALITY OF INFORMATION. The
288	288	commission shall ensure that the tele-connective pilot program
289	289	complies with federal and state law regarding confidentiality of
290	290	medical information, including the Health Insurance Portability
291	291	and Accountability Act of 1996 (42 U.S.C. Section 1320d et seq.) and
292	292	the Family Educational Rights and Privacy Act of 1974 (20 U.S.C.
293	293	Section 1232g).
294	294	Sec. 74.0011. ACCESS POINT EVALUATION. Not later than
295	295	September 1, 2020, the commission shall conduct an evaluation of
296	296	the tele-connective pilot program to ensure that an adequate number
297	297	of access points have been established in each school district
298	298	participating in the program. This section expires January 1,
299	299	2021.
300	300	Sec. 74.0012. REPORT. Not later than January 1, 2021, the
301	301	commission shall submit an initial report to the governor, the
302	302	lieutenant governor, the speaker of the house of representatives,
303	303	and the presiding officers of the standing committees of the senate
304	304	and house of representatives having primary jurisdiction over the
305	305	early childhood intervention program authorized by Chapter 73. The
306	306	report must evaluate the operation of the tele-connective pilot
307	307	program and make recommendations regarding the continuation or
308	308	expansion of the program.
309	309	Sec. 74.0013. FUNDING. The commission shall actively seek
310	310	and apply for any available federal money to support the
311	311	tele-connective pilot program, including federal money made
312	312	available by the:
313	313	(1) Federal Communications Commission, including
314	314	money available under the federal Rural Health Care Program;
315	315	(2) United States Health Resources and Services
316	316	Administration's Office for the Advancement of Telehealth; and
317	317	(3) United States Department of Agriculture,
318	318	including the Distance Learning and Telemedicine Grant Program
319	319	established under 7 C.F.R. Part 1734.
320	320	Sec. 74.0014. EXPIRATION. This chapter expires September
321	321	1, 2023.
322	322	SECTION 8. The heading to Subchapter E, Chapter 1367,
323	323	Insurance Code, is amended to read as follows:
324	324	SUBCHAPTER E. EARLY CHILDHOOD INTERVENTION SERVICES AND
325	325	DEVELOPMENTAL DELAYS
326	326	SECTION 9. Section 1367.201, Insurance Code, is amended to
327	327	read as follows:
328	328	Sec. 1367.201. DEFINITION. In this subchapter,
329	329	rehabilitative and habilitative therapies and related services
330	330	include:
331	331	(1) occupational therapy evaluations and services;
332	332	(2) physical therapy evaluations and services;
333	333	(3) speech therapy evaluations and services; [and]
334	334	(4) dietary or nutritional evaluations;
335	335	(5) specialized skills training by a person certified
336	336	as an early intervention specialist;
337	337	(6) applied behavior analysis treatment by a board
338	338	certified behavior analyst or licensed psychologist; and
339	339	(7) case management provided by a person certified as
340	340	an early intervention specialist.
341	341	SECTION 10. Section 1367.202, Insurance Code, is amended to
342	342	read as follows:
343	343	Sec. 1367.202. APPLICABILITY OF SUBCHAPTER. (a) This
344	344	subchapter applies only to a health benefit plan that:
345	345	(1) provides benefits for medical or surgical expenses
346	346	incurred as a result of a health condition, accident, or sickness,
347	347	including an individual, group, blanket, or franchise insurance
348	348	policy or insurance agreement, a group hospital service contract,
349	349	or an individual or group evidence of coverage that is offered by:
350	350	(A) an insurance company;
351	351	(B) a group hospital service corporation
352	352	operating under Chapter 842;
353	353	(C) a fraternal benefit society operating under
354	354	Chapter 885;
355	355	(D) a stipulated premium company operating under
356	356	Chapter 884;
357	357	(E) a health maintenance organization operating
358	358	under Chapter 843; or
359	359	(F) a multiple employer welfare arrangement
360	360	subject to regulation under Chapter 846;
361	361	(2) is offered by an approved nonprofit health
362	362	corporation that holds a certificate of authority under Chapter
363	363	844; or
364	364	(3) provides health and accident coverage through a
365	365	risk pool created under Chapter 172, Local Government Code,
366	366	notwithstanding Section 172.014, Local Government Code, or any
367	367	other law.
368	368	(b) Notwithstanding any other law, this subchapter also
369	369	applies to a standard health benefit plan provided under Chapter
370	370	1507.
371	371	(c) Notwithstanding any provision in Chapter 1575 or 1579 or
372	372	any other law, this subchapter applies to:
373	373	(1) a basic plan under Chapter 1575; and
374	374	(2) a primary care coverage plan under Chapter 1579.
375	375	SECTION 11. Section 1367.203, Insurance Code, is amended to
376	376	read as follows:
377	377	Sec. 1367.203. EXCEPTION. (a) This subchapter does not
378	378	apply to:
379	379	(1) a plan that provides coverage:
380	380	(A) only for a specified disease or for another
381	381	limited benefit;
382	382	(B) only for accidental death or dismemberment;
383	383	(C) for wages or payments in lieu of wages for a
384	384	period during which an employee is absent from work because of
385	385	sickness or injury;
386	386	(D) as a supplement to a liability insurance
387	387	policy;
388	388	(E) for credit insurance;
389	389	(F) only for dental or vision care; or
390	390	(G) only for indemnity for hospital confinement;
391	391	(2) a small employer health benefit plan written under
392	392	Chapter 1501;
393	393	(3) a Medicare supplemental policy as defined by
394	394	Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss);
395	395	(4) a workers' compensation insurance policy;
396	396	(5) medical payment insurance coverage provided under
397	397	a motor vehicle insurance policy; or
398	398	(6) a long-term care insurance policy, including a
399	399	nursing home fixed indemnity policy, unless the commissioner
400	400	determines that the policy provides benefit coverage so
401	401	comprehensive that the policy is a health benefit plan as described
402	402	by Section 1367.202.
403	403	(b) This subchapter does not apply to a qualified health
404	404	plan to the extent that a determination is made under 45 C.F.R.
405	405	Section 155.170 that:
406	406	(1) this subchapter requires the plan to offer
407	407	benefits in addition to the essential health benefits required
408	408	under 42 U.S.C. Section 18022(b); and
409	409	(2) this state is required to defray the cost of the
410	410	benefits mandated under this subchapter.
411	411	SECTION 12. Section 1367.204, Insurance Code, is amended to
412	412	read as follows:
413	413	Sec. 1367.204. PROVISION [OFFER] OF COVERAGE REQUIRED.
414	414	[(a)] A health benefit plan issuer must provide [offer] coverage
415	415	that complies with this subchapter.
416	416	[(b) The individual or group policy or contract holder may
417	417	reject coverage required to be offered under this section.]
418	418	SECTION 13. Section 1367.205, Insurance Code, is amended by
419	419	amending Subsections (a) and (b) and adding Subsection (d) to read
420	420	as follows:
421	421	(a) A health benefit plan required to provide [that
422	422	provides] coverage for rehabilitative and habilitative therapies
423	423	and related services under this subchapter may not prohibit or
424	424	restrict payment for covered services provided to a child and
425	425	determined to be necessary to and provided in accordance with an
426	426	individualized family service plan issued by the Health and Human
427	427	Services Commission [Interagency Council on Early Childhood
428	428	Intervention] under Chapter 73, Human Resources Code.
429	429	(b) Rehabilitative and habilitative therapies and related
430	430	services described by Subsection (a) must be covered in the amount,
431	431	duration, scope, and service setting established in the child's
432	432	individualized family service plan.
433	433	(d) A health benefit plan prior authorization requirement,
434	434	or another requirement that a service be authorized, otherwise
435	435	applicable to a covered rehabilitative or habilitative therapy
436	436	service or a related service is satisfied if the service is
437	437	specified in a child's individualized family service plan.
438	438	SECTION 14. Section 1367.206, Insurance Code, is amended to
439	439	read as follows:
440	440	Sec. 1367.206. PROHIBITED ACTIONS. Under the coverage
441	441	required to be provided [offered] under this subchapter, a health
442	442	benefit plan issuer may not:
443	443	(1) apply the cost of rehabilitative and habilitative
444	444	therapies and related services described by Section 1367.205(a) to
445	445	an annual or lifetime maximum plan benefit or similar provision
446	446	under the plan; or
447	447	(2) use the cost of rehabilitative or habilitative
448	448	therapies and related services described by Section 1367.205(a) as
449	449	the sole justification for:
450	450	(A) increasing plan premiums; or
451	451	(B) terminating the insured's or enrollee's
452	452	participation in the plan.
453	453	SECTION 15. Subchapter A, Chapter 302, Labor Code, is
454	454	amended by adding Section 302.0061 to read as follows:
455	455	Sec. 302.0061. WORKFORCE DEVELOPMENT GRANTS FOR PROVIDERS
456	456	UNDER EARLY CHILDHOOD INTERVENTION PROGRAM. (a) In this section,
457	457	"early childhood intervention program" means the program
458	458	established under Chapter 73, Human Resources Code, to provide
459	459	early childhood intervention services in accordance with Part C,
460	460	Individuals with Disabilities Education Act (IDEA)(20 U.S.C.
461	461	Section 1431 et seq.).
462	462	(b) The commission shall actively seek and apply for federal
463	463	funding to establish a program designed to provide workforce
464	464	development grants to providers participating in the early
465	465	childhood intervention program for purposes of improving the
466	466	provision of program services by offering providers appropriate
467	467	education and training.
468	468	SECTION 16. (a) The Health and Human Services Commission,
469	469	after consulting with the Texas Education Agency, other appropriate
470	470	state agencies, and the advisory committee established under
471	471	Section 73.004, Human Resources Code, shall conduct a financial
472	472	evaluation of the early childhood intervention services provided
473	473	under Chapter 73, Human Resources Code, and report on that
474	474	evaluation. The report must quantify the amount by which providing
475	475	early childhood intervention services in this state affects other
476	476	budget strategies.
477	477	(b) Not later than September 1, 2020, the Health and Human
478	478	Services Commission shall submit the report prepared under
479	479	Subsection (a) of this section to the governor, the lieutenant
480	480	governor, the speaker of the house of representatives, and the
481	481	presiding officers of the standing committees of the senate and
482	482	house of representatives having primary jurisdiction over the early
483	483	childhood intervention program authorized by Chapter 73, Human
484	484	Resources Code.
485	485	SECTION 17. Not later than December 1, 2019, the Health and
486	486	Human Services Commission shall issue guidance to health benefit
487	487	plan issuers clarifying that providers of early childhood
488	488	intervention services under Chapter 73, Human Resources Code, as
489	489	amended by this Act, must file claims using the national provider
490	490	identifier number and Texas provider identifier number.
491	491	SECTION 18. Section 533.00521(b), Government Code, as added
492	492	by this Act, applies to a contract entered into or renewed on or
493	493	after the effective date of this Act. A contract entered into or
494	494	renewed before that date is governed by the law in effect on the
495	495	date the contract was entered into or renewed, and that law is
496	496	continued in effect for that purpose.
497	497	SECTION 19. Subchapter E, Chapter 1367, Insurance Code, as
498	498	amended by this Act, applies only to a health benefit plan
499	499	delivered, issued for delivery, or renewed on or after January 1,
500	500	2020. A health benefit plan delivered, issued for delivery, or
501	501	renewed before January 1, 2020, is governed by the law as it existed
502	502	immediately before the effective date of this Act, and that law is
503	503	continued in effect for that purpose.
504	504	SECTION 20. (a) As soon as practicable after the effective
505	505	date of this Act, but not later than January 1, 2020, the Health and
506	506	Human Services Commission shall develop and implement the
507	507	tele-connective pilot program required by Chapter 74, Human
508	508	Resources Code, as added by this Act.
509	509	(b) Immediately after the effective date of this Act, the
510	510	Health and Human Services Commission shall apply for and actively
511	511	pursue from the federal Centers for Medicare and Medicaid Services
512	512	or other appropriate federal agency any waiver or other
513	513	authorization necessary to implement Section 73.00521, Human
514	514	Resources Code, as added by this Act. The commission may delay
515	515	implementing Section 73.00521, Human Resources Code, as added by
516	516	this Act, until the waiver or authorization is granted.
517	517	(c) If before implementing any provision of this Act other
518	518	than Sections 73.00521 and 73.012(a)(1), Human Resources Code, as
519	519	added by this Act, a state agency determines that a waiver or
520	520	authorization from a federal agency is necessary for implementation
521	521	of that provision, the agency affected by the provision shall
522	522	request the waiver or authorization and may delay implementing that
523	523	provision until the waiver or authorization is granted.
524	524	SECTION 21. This Act takes effect September 1, 2019.