88R20236 SCP-F
By: Oliverson, Rose, Raymond, Manuel H.B. No. 2983
Substitute the following for H.B. No. 2983:
By: Klick C.S.H.B. No. 2983
A BILL TO BE ENTITLED
AN ACT
relating to a pilot project to provide medical nutrition assistance
to certain Medicaid recipients in this state.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter B, Chapter 32, Human Resources Code,
is amended by adding Section 32.077 to read as follows:
Sec. 32.077. HEALTHY FOOD IS GOOD MEDICINE PILOT PROJECT
FOR PREGNANT AND POSTPARTUM MEDICAID RECIPIENTS. (a) In this
section:
(1) "Community-based organization" means an
organization that:
(A) is exempt from the payment of federal income
taxes under Section 501(a), Internal Revenue Code of 1986, by being
listed as an exempt entity under Section 501(c)(3) of that code;
(B) provides medical nutrition assistance;
(C) has an established agreement with a medical
provider to implement medical nutrition assistance under this
section; and
(D) employs:
(i) at least one registered dietitian
nutritionist;
(ii) culinary personnel; and
(iii) support personnel capable of
providing patient referrals to a medical provider, sourcing
ingredients, and packaging and delivering meals to medical
nutrition assistance recipients.
(2) "Healthy food prescription program" means a
program under which a medical provider prescribes healthy food to a
high-risk patient to decrease the incidence of one or more
diet-related chronic illnesses by increasing the patient's access
to healthy food, including fresh fruits and vegetables, through the
use of vouchers or by other means.
(3) "Medical nutrition assistance" means:
(A) the provision of medically tailored meals to
individuals who have a chronic disease, including diabetes,
congestive heart failure, chronic pulmonary disease, kidney
disease, or other chronic disease, that is impacted by the
individual's diet and limits at least one activity of the
individual's daily living to support treatment and management of
the disease; and
(B) the provision of healthy food prescription
programs to individuals who experience food insecurity and have at
least one chronic health condition directly impacted by the
nutritional quality of food to support treatment and management of
the condition.
(4) "Medical provider" means:
(A) a federally qualified health center as
defined by 42 U.S.C. Section 1396d(l)(2)(B); or
(B) a participating provider, as defined by
Section 32.101.
(5) "Medically tailored meal" means food prepared as
prescribed by a dietician or other qualified health care
professional to address an individual's chronic disease or health
condition and any associated symptoms.
(6) "Pilot project" means the pilot project required
under Subsection (b).
(b) The executive commissioner shall seek a waiver under
Section 1115 of the federal Social Security Act (42 U.S.C. 1315) to
the state Medicaid plan to develop and implement a five-year pilot
project to demonstrate the cost effectiveness and improved health
care outcomes of Medicaid recipients in this state during pregnancy
and the postpartum period who are provided medical nutrition
assistance through medical providers and community-based
organizations in not more than six Medicaid service delivery areas.
(c) The pilot project must be established in service
delivery areas located in:
(1) a municipality with a population greater than
670,000; or
(2) a county:
(A) with a population greater than 65,000;
(B) that is located on an international border;
and
(C) in which at least one World Birding Center
site is located.
(d) The commission shall collaborate and contract with
managed care organizations, the state Medicaid managed care
advisory committee, community-based organizations, and medical
providers in administering the pilot project.
(e) In implementing the pilot project, the executive
commissioner by rule shall establish eligibility criteria for
Medicaid recipients to participate in the pilot project. The
criteria must require that a recipient be pregnant or recently, as
determined by commission rule, postpartum and:
(1) have a diet-related or pregnancy-related health
condition; or
(2) be likely to experience improved maternal and
infant health outcomes as a result of increased access to healthy
foods.
(f) The commission shall, to the extent allowed by a waiver
obtained under Subsection (b), establish a payment methodology,
including payment rates, for:
(1) a medical provider who through medical personnel,
including dieticians, nutritionists, social workers, and community
health workers, provides the following services:
(A) assessments and screening of recipients to
determine eligibility for participation in the pilot project;
(B) development of individual care plans and
health outcome tracking for pilot project participants; and
(C) care management services, including
nutrition and health education and assisting participants in
adhering to individual case plans; and
(2) community-based organizations that provide the
following services:
(A) referral of recipients to a medical provider
for assessment and screening for eligibility for participation in
the pilot project;
(B) ingredient sourcing and meal preparation for
pilot project participants;
(C) meal delivery to pilot project participants;
and
(D) community outreach, including education on
disease management, nutrition and health, and access to community
nutrition services.
(g) The commission shall submit reports to the legislature
on the results of a pilot project implemented under this section as
follows:
(1) an initial report to be submitted not later than
the first anniversary of the date the pilot project is implemented
under this section;
(2) a second report to be submitted not later than 30
months following the date the pilot project is implemented; and
(3) a final report to be submitted not later than three
months after the pilot project concludes.
(h) A report submitted to the legislature under Subsection
(g) must include:
(1) the number of participants in the pilot project;
(2) de-identified and aggregated data on any relevant
medical outcomes for the participants and the infants born to
participants during the time the participants participated in the
pilot project, including:
(A) the results of participants' hemoglobin A1c
tests;
(B) the incidence of pregnancy-related
conditions, including gestational diabetes and preeclampsia;
(C) changes in participants' body mass index;
(D) changes in participants' blood pressure;
(E) the birth weight of the infants; and
(F) participant or infant hospital admissions
and emergency room visits;
(3) any cost savings or increased expenditures
incurred as a result of the pilot project; and
(4) a commission recommendation on whether to
terminate, continue, or expand the pilot project.
(i) This section expires September 1, 2029.
SECTION 2. As soon as practicable after the effective date
of this Act, the executive commissioner of the Health and Human
Services Commission shall apply for and actively pursue a waiver
under Section 1115 of the federal Social Security Act (42 U.S.C.
Section 1315) to the state Medicaid plan from the federal Centers
for Medicare and Medicaid Services or any other federal agency to
implement Section 32.077, Human Resources Code, as added by this
Act. The commission may delay implementing Section 32.077, Human
Resources Code, as added by this Act, until the waiver applied for
under this section is granted.
SECTION 3. This Act takes effect September 1, 2023.