Texas 2021 - 87th Regular

Texas House Bill HB3368 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	~~87R17013~~ KKR-F
	1	+	87R9056 KKR-F
2	2		By: Minjarez H.B. No. 3368
3		-	Substitute the following for H.B. No. 3368:
4		-	By: Klick C.S.H.B. No. 3368
5	3
6	4
7	5		A BILL TO BE ENTITLED
8	6		AN ACT
9	7		relating to the program of all-inclusive care for the elderly.
10	8		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	9		SECTION 1. Section 32.053, Human Resources Code, is amended
12	10		by amending Subsections (b) and (e) and adding Subsections (b-1)
13	11		and (e-1) to read as follows:
14	12		(b) The executive commissioner shall adopt rules as
15	13		necessary to implement this section. In adopting rules, the
16	14		executive commissioner shall:
17	15		(1) use the Bienvivir Senior Health Services of El
18	16		Paso initiative as a model for the program;
19	17		(2) ensure that a person is not required to hold a
20	18		certificate of authority as a health maintenance organization under
21	19		Chapter 843, Insurance Code, to provide services under the PACE
22	20		program;
23	21		(3) ensure that participation in the PACE program is
24	22		available as an alternative to enrollment in a Medicaid managed
25	23		care plan under Chapter 533, Government Code, for eligible
26	24		recipients, including recipients eligible for assistance under
27	25		both the medical assistance and Medicare programs;
28	26		(4) ensure that the commission's enrollment broker
29		-	complies with the requirement under Subsection (b-1) to notify
30		-	recipients about the PACE program and refer those recipients, as
31		-	appropriate, to corresponding program sites;
	27	+	complies with Subsection (b-1);
32	28		(5) ensure that qualified eligible recipients who
33	29		choose to participate in the PACE program are allowed to enroll in
34	30		the program [managed care organizations that contract under Chapter
35	31		533, Government Code, consider the availability of the PACE program
36	32		when considering whether to refer a recipient to a nursing facility
37	33		or other long-term care facility];
38	34		(6) [and
39	35		[(5)] establish protocols for the referral of eligible
40	36		persons to the PACE program; and
41		-	(7) ensure that the PACE enrollment census in existing
42		-	and future corresponding PACE program sites is allowed to grow
43		-	naturally based on need as determined by the enrollment census.
	37	+	(7) ensure that the PACE enrollment census is allowed
	38	+	to grow based on need as determined by the enrollment census.
44	39		(b-1) The commission's enrollment broker shall:
45		-	(1) at the time a Medicaid recipient, including a
46		-	recipient enrolled in a managed care plan under Chapter 533,
47		-	Government Code, is determined eligible for nursing facility care,
48		-	if the recipient resides in a PACE program service area:
49		-	(A) notify the recipient that the recipient may:
50		-	(i) request an eligibility assessment to
	40	+	(1) identify all individuals enrolling in Medicaid who
	41	+	are eligible for nursing facility care and reside in a PACE program
	42	+	service area and advise those individuals that they may:
	43	+	(A) request an eligibility assessment to
51	44		participate in the PACE program; and
52		-	(ii) choose to enroll in the PACE program as
53		-	an alternative to enrolling in a managed care plan under Chapter
54		-	533, Government Code; and
55		-	(B) provide with the notification required by
56		-	Paragraph (A) educational materials described by Subsection (e-1);
57		-	and
58		-	(2) on a monthly basis and by electronic means, refer
59		-	each recipient described by Subdivision (1) to the PACE program
60		-	site in the corresponding service area.
	45	+	(B) choose to enroll in the PACE program as an
	46	+	alternative to enrolling in a managed care plan under Chapter 533,
	47	+	Government Code; and
	48	+	(2) on a monthly basis, refer each recipient described
	49	+	by Subdivision (1) that the broker advised to the PACE program site
	50	+	in the corresponding service area.
61	51		(e) The commission [Department of Aging and Disability
62	52		Services] and area agencies on aging shall develop and implement a
63	53		coordinated plan to promote PACE program sites operating under this
64	54		section. The executive commissioner shall adopt policies and
65	55		procedures, including operating guidelines, to ensure that
66	56		caseworkers and any other appropriate department staff discuss the
67	57		benefits of participating in the PACE program with long-term care
68	58		clients.
69	59		(e-1) The commission shall develop educational materials
70		-	about the PACE program, including:
71		-	(1) the benefits of receiving acute care services and
72		-	long-term care services through the program;
73		-	(2) contact information for each program service area
74		-	site; and
75		-	(3) a statement that reads as follows: "YOU ARE
76		-	ELIGIBLE TO RECEIVE MEDICAL SERVICES IN OUR HOME THROUGH THE PACE
77		-	PROGRAM IN YOUR COMMUNITY. PLEASE CONTACT THE TELEPHONE NUMBER
78		-	BELOW: (telephone number)".
	60	+	that describe the PACE program, including the services provided
	61	+	under the program, and the benefits of receiving acute care
	62	+	services and long-term care services through the program.
79	63		SECTION 2. If before implementing any provision of this Act
80	64		a state agency determines that a waiver or authorization from a
81	65		federal agency is necessary for implementation of that provision,
82	66		the agency affected by the provision shall request the waiver or
83	67		authorization and may delay implementing that provision until the
84	68		waiver or authorization is granted.
85	69		SECTION 3. This Act takes effect September 1, 2021.