86R13480 KLA-D
By: Muñoz, Jr. H.B. No. 2354
A BILL TO BE ENTITLED
AN ACT
relating to establishing caseload standards for certain care
coordinators under the Medicaid managed care program.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter A, Chapter 533, Government Code, is
amended by adding Section 533.00292 to read as follows:
Sec. 533.00292. CARE COORDINATOR CASELOAD STANDARDS. (a)
In this section:
(1) "Care coordination" means assisting recipients to
develop a plan of care, including a service plan, that meets the
recipient's needs and coordinating the provision of Medicaid
benefits in a manner that is consistent with the plan of care. The
term is synonymous with "case management," "service coordination,"
and "service management."
(2) "Care coordinator" means a person, including a
case manager, engaged by a managed care organization to provide
care coordination benefits.
(b) The executive commissioner by rule shall establish
caseload standards for care coordinators providing care
coordination under the STAR+PLUS home and community-based services
supports (HCBS) program.
(c) The executive commissioner by rule may, if the executive
commissioner determines it appropriate, establish caseload
standards for care coordinators providing care coordination under
Medicaid programs other than the STAR+PLUS home and community-based
services supports (HCBS) program.
(d) In determining whether to establish caseload standards
for a Medicaid program under Subsection (c), the executive
commissioner shall consider whether implementing the standards
would improve:
(1) contract compliance by managed care organizations
that contract with the commission under this chapter to provide
health care services to recipients;
(2) the quality and consistency of care coordination
provided under the program; and
(3) transparency regarding the availability of care
coordination benefits to recipients and interested stakeholders.
SECTION 2. If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
SECTION 3. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2019.