Texas 2019 - 86th Regular

Texas House Bill HB2368 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	~~86R24656~~ MM-F
	1	+	86R12293 MM-F
2	2		By: Miller H.B. No. 2368
3		-	Substitute the following for H.B. No. 2368:
4		-	By: Frank C.S.H.B. No. 2368
5	3
6	4
7	5		A BILL TO BE ENTITLED
8	6		AN ACT
9	7		relating to access to and the provision of behavioral and mental
10	8		health care services and trauma-informed care in the Medicaid
11	9		managed care program.
12	10		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
13	11		SECTION 1. Sections 533.0051(a) and (d), Government Code,
14	12		are amended to read as follows:
15	13		(a) The commission shall establish outcome-based
16	14		performance measures and incentives to include in each contract
17	15		between a health maintenance organization and the commission for
18	16		the provision of health care services, including behavioral and
19	17		mental health care services, to recipients that is procured and
20	18		managed under a value-based purchasing model. The performance
21	19		measures and incentives must:
22	20		(1) be designed to facilitate and increase recipients'
23	21		access to appropriate health care services, including behavioral
24	22		and mental health care services; [and]
25	23		(2) to the extent possible, align with other state and
26	24		regional quality care improvement initiatives; and
27	25		(3) for contracts for the provision of behavioral and
28	26		mental health care services to recipients under the STAR Health
29	27		program, be designed to facilitate and increase recipients' access
30	28		to trauma-informed care.
31	29		(d) Subject to Subsection (f), the commission shall assess
32	30		the feasibility and cost-effectiveness of including provisions in a
33	31		contract described by Subsection (a) that require the health
34	32		maintenance organization to provide to the providers in the
35	33		organization's provider network pay-for-performance opportunities
36	34		that support quality improvements in the care of recipients.
37	35		Pay-for-performance opportunities may include incentives for
38	36		providers to provide care after normal business hours and to
39	37		participate in the early and periodic screening, diagnosis, and
40	38		treatment program and other activities that improve recipients'
41	39		access to care, including trauma-informed care and behavioral and
42	40		mental health care services. If the commission determines that the
43	41		provisions are feasible and may be cost-effective, the commission
44	42		shall develop and implement a pilot program in at least one health
45	43		care service region under which the commission will include the
46	44		provisions in contracts with health maintenance organizations
47	45		offering managed care plans in the region.
48	46		SECTION 2. Section 533.0052, Government Code, is amended by
49		-	amending Subsection (a) and adding Subsections (c), (d), ~~and~~ (e) to
50		-	read as follows:
	47	+	amending Subsection (a) and adding Subsections (c), (d), (e), (f),
	48	+	and (g) to read as follows:
51	49		(a) A contract between a managed care organization and the
52	50		commission for the organization to provide health care services,
53	51		including behavioral and mental health care services, to recipients
54	52		under the STAR Health program must include a requirement that
55	53		[trauma-informed care training be offered to] each contracted
56	54		physician or provider who diagnoses or provides treatment for a
57	55		behavioral or mental health condition or prescribes psychotropic
58	56		medication receive training regarding the impact of trauma on
59	57		children and trauma-informed care.
60	58		(c) The commission shall determine the appropriate
61	59		information to include in the training required by Subsection (a).
62	60		The training must include information regarding:
63	61		(1) the effects of trauma, toxic stress, and adverse
64	62		childhood experiences on a child's:
65	63		(A) brain development; and
66		-	(B) cognitive, ~~emotional, psychological,~~
67		-	~~physical, and behavioral~~ functioning;
	64	+	(B) emotional, cognitive, and social
	65	+	functioning;
68	66		(2) trauma screening and accessing a child's trauma
69	67		history;
70		-	(3) the management of traumatic memories and
71		-	trauma-related symptoms;
	68	+	(3) the management of traumatic memories;
72	69		(4) the overlap between symptoms of trauma and
73	70		symptoms of mental health disorders, including
74	71		attention-deficit/hyperactivity disorder, bipolar disorder, and
75	72		oppositional defiant disorder;
76	73		(5) the potential risks of using psychotropic
77	74		medication for children who have experienced trauma;
78		-	(6) the availability of research-supported or
79		-	evidence-based, trauma-informed, non-pharmacological
80		-	interventions;
	75	+	(6) the availability of research-supported,
	76	+	trauma-informed, non-pharmacological interventions; and
81	77		(7) appropriate coding and billing procedures for
82		-	reimbursement of trauma-informed care, treatments, and services;
83		-	and
84		-	(8) the impact of trauma on children with an
85		-	intellectual or developmental disability.
	78	+	reimbursement of trauma-informed care, treatments, and services.
86	79		(d) The commission shall make at least one opportunity to
87	80		receive the training required by Subsection (a) available at no
88		-	cost to each physician or provider described by Subsection (a) with
89		-	whom a contract is entered into or renewed.
90		-	(e) The commission may establish performance measures and
	81	+	cost to each contracted physician or provider described by
	82	+	Subsection (a).
	83	+	(e) A contracted physician or provider described by
	84	+	Subsection (a) who has received the training required by that
	85	+	subsection before September 1, 2019, may meet the training
	86	+	requirement by providing documentation to the commission of the
	87	+	relevant training. This subsection expires September 1, 2020.
	88	+	(f) Notwithstanding any other law, a contracted physician
	89	+	or provider described by Subsection (a) is not required to meet the
	90	+	training requirement of this section before September 1, 2020.
	91	+	This subsection expires September 1, 2021.
	92	+	(g) The commission may establish performance measures and
91	93		incentives described by Section 533.0051 to encourage improved
92	94		access to trauma-informed care and behavioral and mental health
93	95		care services for recipients under the STAR Health program and to
94	96		support contracted physicians or providers described by Subsection
95	97		(a) in receiving:
96	98		(1) training required by Subsection (a); and
97		-	(2) additional training in research-supported or
98		-	evidence-based, trauma-informed, non-pharmacological
99		-	interventions.
	99	+	(2) additional training in research-supported,
	100	+	trauma-informed, non-pharmacological interventions.
100	101		SECTION 3. Not later than January 1, 2020, the executive
101	102		commissioner of the Health and Human Services Commission shall
102	103		adopt rules necessary to implement Sections 533.0051 and 533.0052,
103	104		Government Code, as amended by this Act.
104	105		SECTION 4. (a) Sections 533.0051 and 533.0052, Government
105	106		Code, as amended by this Act, apply only to a contract between the
106	107		Health and Human Services Commission and a managed care
107	108		organization that is entered into or renewed on or after the
108	109		effective date of this Act.
109	110		(b) To the extent permitted by law or the terms of the
110	111		contract, the Health and Human Services Commission shall amend a
111	112		contract entered into before the effective date of this Act with a
112	113		managed care organization to comply with Sections 533.0051 and
113	114		533.0052, Government Code, as amended by this Act.
114		-	SECTION 5. (a) Notwithstanding Section 533.0052,
115		-	Government Code, as amended by this Act, a physician or provider is
116		-	not required to complete the training described by that section
117		-	before September 1, 2023.
118		-	(b) The implementation of the training described by Section
119		-	533.0052, Government Code, as amended by this Act, must align with
120		-	the transition of the Department of Family and Protective Services
121		-	to a trauma-informed system of care as required by H.B. No. 1536 or
122		-	similar legislation of the 86th Legislature, Regular Session, 2019,
123		-	if that bill or similar legislation is enacted and becomes law.
124		-	SECTION 6. If before implementing any provision of this Act
	115	+	SECTION 5. If before implementing any provision of this Act
125	116		a state agency determines that a waiver or authorization from a
126	117		federal agency is necessary for implementation of that provision,
127	118		the agency affected by the provision shall request the waiver or
128	119		authorization and may delay implementing that provision until the
129	120		waiver or authorization is granted.
130		-	SECTION 7. This Act takes effect September 1, 2019.
	121	+	SECTION 6. This Act takes effect September 1, 2019.