| 1 | 1 | | 87R2838 BDP-D |
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| 2 | 2 | | By: Hinojosa S.B. No. 951 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to improvements to the Texas Medicaid Provider Procedures |
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| 8 | 8 | | Manual designed to prevent fraud, waste, or abuse in the provision |
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| 9 | 9 | | of Medicaid dental services. |
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| 10 | 10 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 11 | 11 | | SECTION 1. DEFINITIONS. In this Act: |
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| 12 | 12 | | (1) "Commission" means the Health and Human Services |
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| 13 | 13 | | Commission. |
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| 14 | 14 | | (2) "Executive commissioner" means the executive |
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| 15 | 15 | | commissioner of the commission. |
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| 16 | 16 | | (3) "Medicaid" means the medical assistance program |
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| 17 | 17 | | established under Chapter 32, Human Resources Code. |
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| 18 | 18 | | (4) "Work group" means the work group established |
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| 19 | 19 | | under Section 2 of this Act. |
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| 20 | 20 | | SECTION 2. WORK GROUP ON IMPROVING TEXAS MEDICAID PROVIDER |
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| 21 | 21 | | PROCEDURES MANUAL PROVISIONS RELATING TO DENTAL SERVICES. (a) The |
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| 22 | 22 | | executive commissioner shall establish a work group for the purpose |
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| 23 | 23 | | of providing recommendations to improve the Texas Medicaid Provider |
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| 24 | 24 | | Procedures Manual in a manner that prevents the incidence of fraud, |
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| 25 | 25 | | waste, or abuse in the provision of Medicaid dental services. |
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| 26 | 26 | | (b) The executive commissioner shall appoint the members of |
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| 27 | 27 | | the work group, which must include: |
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| 28 | 28 | | (1) a representative of the commission; |
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| 29 | 29 | | (2) the dental director appointed under Section |
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| 30 | 30 | | 531.02114, Government Code; |
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| 31 | 31 | | (3) a representative of the commission's office of |
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| 32 | 32 | | inspector general; |
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| 33 | 33 | | (4) at least one stakeholder to represent each of the |
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| 34 | 34 | | following interests: |
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| 35 | 35 | | (A) managed care organizations that contract |
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| 36 | 36 | | with the commission to provide Medicaid dental services; |
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| 37 | 37 | | (B) providers of Medicaid dental services; and |
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| 38 | 38 | | (C) dental academia; and |
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| 39 | 39 | | (5) additional stakeholders or other persons the |
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| 40 | 40 | | executive commissioner determines appropriate. |
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| 41 | 41 | | (c) The commission shall provide administrative support to |
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| 42 | 42 | | the work group. |
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| 43 | 43 | | (d) The executive commissioner shall appoint a member of the |
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| 44 | 44 | | work group to serve as the presiding officer. |
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| 45 | 45 | | (e) The work group shall meet at the call of the presiding |
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| 46 | 46 | | officer. |
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| 47 | 47 | | (f) The work group shall: |
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| 48 | 48 | | (1) review all provisions in the Texas Medicaid |
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| 49 | 49 | | Provider Procedures Manual related to the provision of dental |
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| 50 | 50 | | services; |
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| 51 | 51 | | (2) determine which provisions can be eliminated or |
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| 52 | 52 | | changed to prevent fraud, waste, or abuse in the provision of dental |
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| 53 | 53 | | services, including changes related to the use of dental procedure |
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| 54 | 54 | | codes by providers; and |
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| 55 | 55 | | (3) make recommendations to the executive |
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| 56 | 56 | | commissioner for improving the Texas Medicaid Provider Procedures |
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| 57 | 57 | | Manual to prevent fraud, waste, or abuse in the provision of dental |
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| 58 | 58 | | services under Medicaid. |
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| 59 | 59 | | SECTION 3. REPORT. Not later than December 31, 2022, the |
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| 60 | 60 | | work group shall submit a report on the work group's |
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| 61 | 61 | | recommendations to the executive commissioner. |
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| 62 | 62 | | SECTION 4. ACTION ON REPORT. On receiving the work group's |
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| 63 | 63 | | recommendations, the executive commissioner shall: |
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| 64 | 64 | | (1) consider immediately adopting the recommendations |
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| 65 | 65 | | of the work group that do not require legislative action; and |
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| 66 | 66 | | (2) if implementation of a recommendation requires |
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| 67 | 67 | | legislative action, submit to the legislature a copy of the report |
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| 68 | 68 | | described by Section 3 of this Act together with the executive |
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| 69 | 69 | | commissioner's recommendations for any legislative action. |
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| 70 | 70 | | SECTION 5. ABOLISHMENT OF WORK GROUP; EXPIRATION. On |
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| 71 | 71 | | January 1, 2023: |
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| 72 | 72 | | (1) the work group is abolished; and |
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| 73 | 73 | | (2) this Act expires. |
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| 74 | 74 | | SECTION 6. FEDERAL AUTHORIZATION. If before implementing |
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| 75 | 75 | | any provision of this Act a state agency determines that a waiver or |
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| 76 | 76 | | authorization from a federal agency is necessary for implementation |
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| 77 | 77 | | of that provision, the agency affected by the provision shall |
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| 78 | 78 | | request the waiver or authorization and may delay implementing that |
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| 79 | 79 | | provision until the waiver or authorization is granted. |
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| 80 | 80 | | SECTION 7. EFFECTIVE DATE. This Act takes effect September |
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| 81 | 81 | | 1, 2021. |
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