Texas 2021 - 87th Regular

Texas Senate Bill SB1149 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	87R26527 KKR-D
2		-	By: Kolkhorst, et al. S.B. No. 1149
3		-	(Noble, Hinojosa, Minjarez, Frank, Shaheen)
4		-	Substitute the following for S.B. No. 1149: No.
	1	+	By: Kolkhorst, Gutierrez S.B. No. 1149
	2	+	Zaffirini
5	3
6	4
7	5		A BILL TO BE ENTITLED
8	6		AN ACT
9	7		relating to the transition of case management for children and
10	8		pregnant women program services and Healthy Texas Women program
11	9		services to a managed care program.
12	10		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
13	11		SECTION 1. Subchapter A, Chapter 533, Government Code, is
14	12		amended by adding Section 533.002555 to read as follows:
15	13		Sec. 533.002555. TRANSITION OF CASE MANAGEMENT FOR CHILDREN
16	14		AND PREGNANT WOMEN PROGRAM RECIPIENTS TO MANAGED CARE PROGRAM. (a)
17	15		In this section, "children and pregnant women program" means the
18	16		benefits program provided under Medicaid and administered by the
19	17		Department of State Health Services that provides case management
20	18		services to children who have a health condition or health risk and
21	19		pregnant women who have a high-risk condition.
22	20		(b) The commission shall transition to a Medicaid managed
23	21		care model for case management services provided to recipients
24	22		under the children and pregnant women program. In transitioning
25	23		services under this section, the commission shall ensure a
26	24		recipient is provided case management services through the managed
27	25		care plan in which the recipient is enrolled.
28	26		(c) In implementing this section, the commission shall
29	27		ensure:
30	28		(1) a seamless transition in case management for
31	29		recipients receiving benefits under the children and pregnant women
32	30		program; and
33	31		(2) case management services provided under the
34	32		program are not interrupted.
35	33		SECTION 2. Subchapter F, Chapter 32, Health and Safety
36	34		Code, is amended by amending Section 32.152 and adding Sections
37	35		32.156 and 32.157 to read as follows:
38	36		Sec. 32.152. [ASSESSING] PROVISION OF HEALTHY TEXAS WOMEN
39		-	PROGRAM SERVICES THROUGH MANAGED CARE. (a) The commission shall
	37	+	PROGRAM SERVICES THROUGH MANAGED CARE. [(a)] The commission shall
40	38		contract [assess:
41	39		[(1) the feasibility and cost-effectiveness of
42	40		contracting] with Medicaid managed care organizations to provide
43	41		Healthy Texas Women program services [through managed care in one
44	42		or more health care service regions in this state if the Healthy
45	43		Texas Women Section 1115 Demonstration Waiver is approved; and
46	44		[(2) the potential impact of that delivery model on
47	45		women receiving services under the program].
48		-	(b) In implementing this section, the commission shall:
49		-	(1) consult with the state Medicaid managed care
50		-	advisory committee before contracting with Medicaid managed care
51		-	organizations to provide Healthy Texas Women program services under
52		-	this section;
53		-	(2) identify barriers that prevent women from
54		-	obtaining Healthy Texas Women program services and seek
55		-	opportunities to mitigate those barriers; and
56		-	(3) designate Healthy Texas Women program service
57		-	providers as significant traditional providers until at least the
58		-	third anniversary of the date the commission initially contracts
59		-	with Medicaid managed care organizations to provide program
60		-	services. [This section expires September 1, 2021.]
	46	+	[(b) This section expires September 1, 2021.]
61	47		Sec. 32.156. INFORMATION ABOUT AVAILABILITY OF SUBSIDIZED
62	48		HEALTH INSURANCE COVERAGE. (a) The commission and each managed
63	49		care organization participating in the Healthy Texas Women program
64	50		shall provide a written notice containing information about
65	51		eligibility requirements for and enrollment in a health benefit
66	52		plan for which an enrollee receives a premium subsidy under the
67	53		Patient Protection and Affordable Care Act (Pub. L. No. 111-148),
68	54		based on family income, to a woman who:
69	55		(1) is enrolled in the Healthy Texas Women program;
70	56		and
71	57		(2) has a household income that is more than 100
72	58		percent but not more than 200 percent of the federal poverty level.
73	59		(b) The commission, in consultation with the Texas
74	60		Department of Insurance, shall develop the form and content of the
75	61		notice required under this section. The notice must include:
76	62		(1) the latest information written in clear and easily
77	63		understood language on available options for obtaining a subsidized
78	64		health benefit plan described by Subsection (a); and
79	65		(2) resources for receiving assistance applying for
80	66		and enrolling in that health benefit plan.
81	67		Sec. 32.157. ASSESSING AUTOMATIC ENROLLMENT OF CERTAIN
82	68		WOMEN IN MANAGED CARE. (a) Not later than January 1, 2023, the
83	69		commission shall assess the feasibility, cost-effectiveness, and
84	70		benefits of automatically enrolling in managed care the women who
85	71		become pregnant while receiving services through the Healthy Texas
86	72		Women program. The assessment must examine whether automatically
87	73		enrolling those women leads to the delivery of prenatal care and
88	74		services earlier in the women's pregnancies.
89	75		(b) This section expires September 1, 2023.
90	76		SECTION 3. As soon as practicable after the effective date
91	77		of this Act, the executive commissioner of the Health and Human
92	78		Services Commission shall adopt rules necessary to implement the
93	79		changes in law made by this Act.
94	80		SECTION 4. If before implementing any provision of this Act
95	81		a state agency determines that a waiver or authorization from a
96	82		federal agency is necessary for implementation of that provision,
97	83		the agency affected by the provision shall request the waiver or
98	84		authorization and may delay implementing that provision until the
99	85		waiver or authorization is granted.
100	86		SECTION 5. The Health and Human Services Commission is
101	87		required to implement a provision of this Act only if the
102	88		legislature appropriates money specifically for that purpose. If
103	89		the legislature does not appropriate money specifically for that
104	90		purpose, the Health and Human Services Commission may, but is not
105	91		required to, implement a provision of this Act using other
106	92		appropriations available for that purpose.
107	93		SECTION 6. This Act takes effect September 1, 2021.