Texas 2021 - 87th Regular

Texas Senate Bill SB1136 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	S.B. No. 1136
	1	+	By: Kolkhorst S.B. No. 1136
	2	+	(Frank)
2	3
3	4
	5	+	A BILL TO BE ENTITLED
4	6		AN ACT
5	7		relating to implementation of certain health care provider
6	8		initiatives and measures designed to reduce costs and improve
7	9		recipient health outcomes under Medicaid.
8	10		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	11		SECTION 1. Section 531.085, Government Code, is amended to
10	12		read as follows:
11	13		Sec. 531.085. HOSPITAL EMERGENCY ROOM USE REDUCTION
12	14		INITIATIVES. (a) The commission shall develop and implement a
13	15		comprehensive plan to reduce the use of hospital emergency room
14	16		services by recipients under Medicaid. The plan may include:
15	17		(1) a pilot program designed to facilitate program
16	18		participants in accessing an appropriate level of health care,
17	19		which may include as components:
18	20		(A) providing program participants access to
19	21		bilingual health services providers; and
20	22		(B) giving program participants information on
21	23		how to access primary care physicians, advanced practice registered
22	24		nurses, and local health clinics;
23	25		(2) a pilot program under which health care providers,
24	26		other than hospitals, are given financial incentives for treating
25	27		recipients outside of normal business hours to divert those
26	28		recipients from hospital emergency rooms;
27	29		(3) payment of a nominal referral fee to hospital
28	30		emergency rooms that perform an initial medical evaluation of a
29	31		recipient and subsequently refer the recipient, if medically
30	32		stable, to an appropriate level of health care, such as care
31	33		provided by a primary care physician, advanced practice registered
32	34		nurse, or local clinic;
33	35		(4) a program under which the commission or a managed
34	36		care organization that enters into a contract with the commission
35	37		under Chapter 533 contacts, by telephone or mail, a recipient who
36	38		accesses a hospital emergency room three times during a six-month
37	39		period and provides the recipient with information on ways the
38	40		recipient may secure a medical home to avoid unnecessary treatment
39	41		at hospital emergency rooms;
40	42		(5) a health care literacy program under which the
41	43		commission develops partnerships with other state agencies and
42	44		private entities to:
43	45		(A) assist the commission in developing
44	46		materials that:
45	47		(i) contain basic health care information
46	48		for parents of young children who are recipients under Medicaid and
47	49		who are participating in public or private child-care or
48	50		prekindergarten programs, including federal Head Start programs;
49	51		and
50	52		(ii) are written in a language
51	53		understandable to those parents and specifically tailored to be
52	54		applicable to the needs of those parents;
53	55		(B) distribute the materials developed under
54	56		Paragraph (A) to those parents; and
55	57		(C) otherwise teach those parents about the
56	58		health care needs of their children and ways to address those needs;
57	59		and
58	60		(6) other initiatives developed and implemented in
59	61		other states that have shown success in reducing the incidence of
60	62		unnecessary treatment in hospital emergency rooms.
61	63		(b) The commission shall coordinate with hospitals and
62	64		other providers that receive supplemental payments under the
63	65		uncompensated care payment program operated under the Texas Health
64	66		Care Transformation and Quality Improvement Program waiver issued
65	67		under Section 1115 of the federal Social Security Act (42 U.S.C.
66	68		Section 1315) to identify and implement initiatives based on best
67	69		practices and models that are designed to reduce Medicaid
68	70		recipients' use of hospital emergency room services as a primary
69	71		means of receiving health care benefits, including initiatives
70	72		designed to improve recipients' access to and use of primary care
71	73		providers.
72	74		SECTION 2. Subchapter B, Chapter 531, Government Code, is
73	75		amended by adding Section 531.0862 to read as follows:
74	76		Sec. 531.0862. CONTINUED IMPLEMENTATION OF CERTAIN
75	77		INTERVENTIONS AND BEST PRACTICES BY PROVIDERS; BIANNUAL REPORT.
76	78		(a) The commission shall encourage Medicaid providers to continue
77	79		implementing effective interventions and best practices associated
78	80		with improvements in the health outcomes of Medicaid recipients
79	81		that were developed and achieved under the Delivery System Reform
80	82		Incentive Payment (DSRIP) program previously operated under the
81	83		Texas Health Care Transformation and Quality Improvement Program
82	84		waiver issued under Section 1115 of the federal Social Security Act
83	85		(42 U.S.C. Section 1315), through:
84	86		(1) existing provider incentive programs and the
85	87		creation of new provider incentive programs;
86	88		(2) the terms included in contracts with Medicaid
87	89		managed care organizations;
88	90		(3) implementation of alternative payment models; or
89	91		(4) adoption of other cost-effective measures.
90	92		(b) The commission shall biannually prepare and submit a
91	93		report to the legislature that contains a summary of the
92	94		commission's efforts under this section and Section 531.085(b).
93	95		SECTION 3. If before implementing any provision of this Act
94	96		a state agency determines that a waiver or authorization from a
95	97		federal agency is necessary for implementation of that provision,
96	98		the agency affected by the provision shall request the waiver or
97	99		authorization and may delay implementing that provision until the
98	100		waiver or authorization is granted.
99	101		SECTION 4. This Act takes effect September 1, 2021.
100		-	______________________________ ______________________________
101		-	President of the Senate Speaker of the House
102		-	I hereby certify that S.B. No. 1136 passed the Senate on
103		-	April 29, 2021, by the following vote: Yeas 31, Nays 0.
104		-	______________________________
105		-	Secretary of the Senate
106		-	I hereby certify that S.B. No. 1136 passed the House on
107		-	May 23, 2021, by the following vote: Yeas 144, Nays 1, two
108		-	present not voting.
109		-	______________________________
110		-	Chief Clerk of the House
111		-	Approved:
112		-	______________________________
113		-	Date
114		-	______________________________
115		-	Governor