Texas 2021 - 87th Regular

Texas Senate Bill SB1858 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	87R8204 KKR-D
2	2	By: Powell S.B. No. 1858
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to a study and pilot program to evaluate the provision of
8	8	prenatal and well child care in a group clinical setting and
9	9	authority to take related action.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. Subchapter B, Chapter 531, Government Code, is
12	12	amended by adding Section 531.02493 to read as follows:
13	13	Sec. 531.02493. CURRICULUM-BASED GROUP WELL CHILD CARE
14	14	PILOT PROGRAM. (a) The commission shall develop and, not later
15	15	than March 1, 2022, implement a pilot program to increase the rate
16	16	at which recipients attend well child health care visits,
17	17	developmental screenings, and immunizations by providing those
18	18	services through a curriculum-based group well child care model in
19	19	a clinical setting.
20	20	(b) The commission shall operate the pilot program in one or
21	21	more geographic areas of this state.
22	22	(c) In implementing the pilot program, the commission
23	23	shall:
24	24	(1) require a Medicaid managed care organization to
25	25	provide enhanced reimbursement in an amount determined by the
26	26	commission to a health care provider for providing curriculum-based
27	27	group well child care to recipients; and
28	28	(2) evaluate whether the enhanced reimbursement
29	29	increases the rate of children receiving well child visits,
30	30	developmental screenings, and immunizations.
31	31	(d) The commission shall operate the pilot program for two
32	32	years.
33	33	(e) Not later than September 1, 2024, the commission shall
34	34	submit to the governor, the lieutenant governor, the speaker of the
35	35	house of representatives, and each standing committee of the
36	36	legislature having primary jurisdiction over health and human
37	37	services a written report that:
38	38	(1) summarizes the results of the pilot program; and
39	39	(2) recommends whether the pilot program should
40	40	continue, be expanded, or terminate or if the commission should
41	41	permanently implement enhanced reimbursement to health care
42	42	providers for providing curriculum-based group well child care in a
43	43	clinical setting.
44	44	(f) The executive commissioner may adopt rules as necessary
45	45	to implement this section.
46	46	(g) This section expires September 1, 2025.
47	47	SECTION 2. (a) In this section:
48	48	(1) "Commission" means the Health and Human Services
49	49	Commission.
50	50	(2) "Medicaid" means the medical assistance program
51	51	established under Chapter 32, Human Resources Code.
52	52	(3) "Medicaid managed care organization" means a
53	53	managed care organization as defined by Section 533.001, Government
54	54	Code, that contracts with the commission under Chapter 533,
55	55	Government Code, to provide health care services to Medicaid
56	56	recipients.
57	57	(b) The commission shall conduct a study regarding the
58	58	provision of curriculum-based prenatal care and curriculum-based
59	59	well child care offered in a group clinical setting. The study
60	60	must:
61	61	(1) evaluate the health benefits and potential cost
62	62	savings to Medicaid that would result from implementing
63	63	curriculum-based group prenatal care models, including
64	64	implementation of those models using virtual modalities similar to
65	65	those used during the COVID-19 pandemic;
66	66	(2) evaluate the use of procedure codes under Medicaid
67	67	for curriculum-based group prenatal care in a clinical setting;
68	68	(3) reassess the provider types authorized to provide
69	69	prenatal benefits in a group clinical setting under Medicaid by
70	70	identifying provider types that deliver curriculum-based group
71	71	prenatal care, including federally qualified health centers,
72	72	hospitals, rural health clinics, and individual health care
73	73	providers; and
74	74	(4) explore options for promoting curriculum-based
75	75	group well child care models under Medicaid, including by:
76	76	(A) assessing the need for establishing a
77	77	procedure code under Medicaid for the provision of curriculum-based
78	78	group well child care in a clinical setting; and
79	79	(B) promoting value-based payment arrangements
80	80	between providers and Medicaid managed care organizations.
81	81	(c) Not later than September 1, 2022, the commission shall:
82	82	(1) prepare and submit a report on the findings of the
83	83	study conducted under Subsection (b) of this section to the
84	84	standing committees of the senate and house of representatives
85	85	having jurisdiction over Medicaid; and
86	86	(2) based on the assessment under Subsection (b)(3) of
87	87	this section, update the health care provider types that may
88	88	provide prenatal benefits in a group clinical setting under
89	89	Medicaid.
90	90	(d) This section expires September 1, 2023.
91	91	SECTION 3. If before implementing any provision of this Act
92	92	a state agency determines that a waiver or authorization from a
93	93	federal agency is necessary for implementation of that provision,
94	94	the agency affected by the provision shall request the waiver or
95	95	authorization and may delay implementing that provision until the
96	96	waiver or authorization is granted.
97	97	SECTION 4. This Act takes effect September 1, 2021.