87R8204 KKR-D
By: Powell S.B. No. 1858
A BILL TO BE ENTITLED
AN ACT
relating to a study and pilot program to evaluate the provision of
prenatal and well child care in a group clinical setting and
authority to take related action.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter B, Chapter 531, Government Code, is
amended by adding Section 531.02493 to read as follows:
Sec. 531.02493. CURRICULUM-BASED GROUP WELL CHILD CARE
PILOT PROGRAM. (a) The commission shall develop and, not later
than March 1, 2022, implement a pilot program to increase the rate
at which recipients attend well child health care visits,
developmental screenings, and immunizations by providing those
services through a curriculum-based group well child care model in
a clinical setting.
(b) The commission shall operate the pilot program in one or
more geographic areas of this state.
(c) In implementing the pilot program, the commission
shall:
(1) require a Medicaid managed care organization to
provide enhanced reimbursement in an amount determined by the
commission to a health care provider for providing curriculum-based
group well child care to recipients; and
(2) evaluate whether the enhanced reimbursement
increases the rate of children receiving well child visits,
developmental screenings, and immunizations.
(d) The commission shall operate the pilot program for two
years.
(e) Not later than September 1, 2024, the commission shall
submit to the governor, the lieutenant governor, the speaker of the
house of representatives, and each standing committee of the
legislature having primary jurisdiction over health and human
services a written report that:
(1) summarizes the results of the pilot program; and
(2) recommends whether the pilot program should
continue, be expanded, or terminate or if the commission should
permanently implement enhanced reimbursement to health care
providers for providing curriculum-based group well child care in a
clinical setting.
(f) The executive commissioner may adopt rules as necessary
to implement this section.
(g) This section expires September 1, 2025.
SECTION 2. (a) In this section:
(1) "Commission" means the Health and Human Services
Commission.
(2) "Medicaid" means the medical assistance program
established under Chapter 32, Human Resources Code.
(3) "Medicaid managed care organization" means a
managed care organization as defined by Section 533.001, Government
Code, that contracts with the commission under Chapter 533,
Government Code, to provide health care services to Medicaid
recipients.
(b) The commission shall conduct a study regarding the
provision of curriculum-based prenatal care and curriculum-based
well child care offered in a group clinical setting. The study
must:
(1) evaluate the health benefits and potential cost
savings to Medicaid that would result from implementing
curriculum-based group prenatal care models, including
implementation of those models using virtual modalities similar to
those used during the COVID-19 pandemic;
(2) evaluate the use of procedure codes under Medicaid
for curriculum-based group prenatal care in a clinical setting;
(3) reassess the provider types authorized to provide
prenatal benefits in a group clinical setting under Medicaid by
identifying provider types that deliver curriculum-based group
prenatal care, including federally qualified health centers,
hospitals, rural health clinics, and individual health care
providers; and
(4) explore options for promoting curriculum-based
group well child care models under Medicaid, including by:
(A) assessing the need for establishing a
procedure code under Medicaid for the provision of curriculum-based
group well child care in a clinical setting; and
(B) promoting value-based payment arrangements
between providers and Medicaid managed care organizations.
(c) Not later than September 1, 2022, the commission shall:
(1) prepare and submit a report on the findings of the
study conducted under Subsection (b) of this section to the
standing committees of the senate and house of representatives
having jurisdiction over Medicaid; and
(2) based on the assessment under Subsection (b)(3) of
this section, update the health care provider types that may
provide prenatal benefits in a group clinical setting under
Medicaid.
(d) This section expires September 1, 2023.
SECTION 3. 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 4. This Act takes effect September 1, 2021.