87R2838 BDP-D
By: Guerra H.B. No. 1629
A BILL TO BE ENTITLED
AN ACT
relating to improvements to the Texas Medicaid Provider Procedures
Manual designed to prevent fraud, waste, or abuse in the provision
of Medicaid dental services.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. DEFINITIONS. In this Act:
(1) "Commission" means the Health and Human Services
Commission.
(2) "Executive commissioner" means the executive
commissioner of the commission.
(3) "Medicaid" means the medical assistance program
established under Chapter 32, Human Resources Code.
(4) "Work group" means the work group established
under Section 2 of this Act.
SECTION 2. WORK GROUP ON IMPROVING TEXAS MEDICAID PROVIDER
PROCEDURES MANUAL PROVISIONS RELATING TO DENTAL SERVICES. (a) The
executive commissioner shall establish a work group for the purpose
of providing recommendations to improve the Texas Medicaid Provider
Procedures Manual in a manner that prevents the incidence of fraud,
waste, or abuse in the provision of Medicaid dental services.
(b) The executive commissioner shall appoint the members of
the work group, which must include:
(1) a representative of the commission;
(2) the dental director appointed under Section
531.02114, Government Code;
(3) a representative of the commission's office of
inspector general;
(4) at least one stakeholder to represent each of the
following interests:
(A) managed care organizations that contract
with the commission to provide Medicaid dental services;
(B) providers of Medicaid dental services; and
(C) dental academia; and
(5) additional stakeholders or other persons the
executive commissioner determines appropriate.
(c) The commission shall provide administrative support to
the work group.
(d) The executive commissioner shall appoint a member of the
work group to serve as the presiding officer.
(e) The work group shall meet at the call of the presiding
officer.
(f) The work group shall:
(1) review all provisions in the Texas Medicaid
Provider Procedures Manual related to the provision of dental
services;
(2) determine which provisions can be eliminated or
changed to prevent fraud, waste, or abuse in the provision of dental
services, including changes related to the use of dental procedure
codes by providers; and
(3) make recommendations to the executive
commissioner for improving the Texas Medicaid Provider Procedures
Manual to prevent fraud, waste, or abuse in the provision of dental
services under Medicaid.
SECTION 3. REPORT. Not later than December 31, 2022, the
work group shall submit a report on the work group's
recommendations to the executive commissioner.
SECTION 4. ACTION ON REPORT. On receiving the work group's
recommendations, the executive commissioner shall:
(1) consider immediately adopting the recommendations
of the work group that do not require legislative action; and
(2) if implementation of a recommendation requires
legislative action, submit to the legislature a copy of the report
described by Section 3 of this Act together with the executive
commissioner's recommendations for any legislative action.
SECTION 5. ABOLISHMENT OF WORK GROUP; EXPIRATION. On
January 1, 2023:
(1) the work group is abolished; and
(2) this Act expires.
SECTION 6. FEDERAL AUTHORIZATION. 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 7. EFFECTIVE DATE. This Act takes effect September
1, 2021.