Texas 2023 - 88th Regular

Texas House Bill HB2983 Compare Versions

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1	1	By: Oliverson, Rose, Raymond, Manuel, H.B. No. 2983
2	2	Thierry, et al.
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to a pilot project to provide medical nutrition assistance
8	8	to certain Medicaid recipients in this state.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subchapter B, Chapter 32, Human Resources Code,
11	11	is amended by adding Section 32.077 to read as follows:
12	12	Sec. 32.077. HEALTHY FOOD IS GOOD MEDICINE PILOT PROJECT
13	13	FOR PREGNANT AND POSTPARTUM MEDICAID RECIPIENTS. (a) In this
14	14	section:
15	15	(1) "Community-based organization" means an
16	16	organization that:
17	17	(A) is exempt from the payment of federal income
18	18	taxes under Section 501(a), Internal Revenue Code of 1986, by being
19	19	listed as an exempt entity under Section 501(c)(3) of that code;
20	20	(B) provides medical nutrition assistance;
21	21	(C) has an established agreement with a medical
22	22	provider to implement medical nutrition assistance under this
23	23	section; and
24	24	(D) employs:
25	25	(i) at least one registered dietitian
26	26	nutritionist;
27	27	(ii) culinary personnel; and
28	28	(iii) support personnel capable of
29	29	providing patient referrals to a medical provider, sourcing
30	30	ingredients, and packaging and delivering meals to medical
31	31	nutrition assistance recipients.
32	32	(2) "Healthy food prescription program" means a
33	33	program under which a medical provider prescribes healthy food to a
34	34	high-risk patient to decrease the incidence of one or more
35	35	diet-related chronic illnesses by increasing the patient's access
36	36	to healthy food, including fresh fruits and vegetables, through the
37	37	use of vouchers or by other means.
38	38	(3) "Medical nutrition assistance" means:
39	39	(A) the provision of medically tailored meals to
40	40	individuals who have a chronic disease, including diabetes,
41	41	congestive heart failure, chronic pulmonary disease, kidney
42	42	disease, or other chronic disease, that is impacted by the
43	43	individual's diet and limits at least one activity of the
44	44	individual's daily living to support treatment and management of
45	45	the disease; and
46	46	(B) the provision of healthy food prescription
47	47	programs to individuals who experience food insecurity and have at
48	48	least one chronic health condition directly impacted by the
49	49	nutritional quality of food to support treatment and management of
50	50	the condition.
51	51	(4) "Medical provider" means:
52	52	(A) a federally qualified health center as
53	53	defined by 42 U.S.C. Section 1396d(l)(2)(B); or
54	54	(B) a participating provider, as defined by
55	55	Section 32.101.
56	56	(5) "Medically tailored meal" means food prepared as
57	57	prescribed by a registered dietitian nutritionist or other
58	58	qualified health care professional to address an individual's
59	59	chronic disease or health condition and any associated symptoms.
60	60	(6) "Pilot project" means the pilot project required
61	61	under Subsection (b).
62	62	(b) The executive commissioner shall seek a waiver under
63	63	Section 1115 of the federal Social Security Act (42 U.S.C. 1315) to
64	64	the state Medicaid plan to develop and implement a five-year pilot
65	65	project to demonstrate the cost effectiveness and improved health
66	66	care outcomes of Medicaid recipients in this state during pregnancy
67	67	and the postpartum period who are provided medical nutrition
68	68	assistance through medical providers and community-based
69	69	organizations in not more than six Medicaid service delivery areas.
70	70	(c) The pilot project must be established in service
71	71	delivery areas located in:
72	72	(1) a municipality with a population greater than
73	73	670,000; or
74	74	(2) a county:
75	75	(A) with a population greater than 65,000;
76	76	(B) that is located on an international border;
77	77	and
78	78	(C) in which at least one World Birding Center
79	79	site is located.
80	80	(d) The commission shall collaborate and contract with
81	81	managed care organizations, the state Medicaid managed care
82	82	advisory committee, community-based organizations, and medical
83	83	providers in administering the pilot project.
84	84	(e) In implementing the pilot project, the executive
85	85	commissioner by rule shall establish eligibility criteria for
86	86	Medicaid recipients to participate in the pilot project. The
87	87	criteria must require that a recipient be pregnant or recently, as
88	88	determined by commission rule, postpartum and:
89	89	(1) have a diet-related or pregnancy-related health
90	90	condition; or
91	91	(2) be likely to experience improved maternal and
92	92	infant health outcomes as a result of increased access to healthy
93	93	foods.
94	94	(f) The commission shall, to the extent allowed by a waiver
95	95	obtained under Subsection (b), establish a payment methodology,
96	96	including payment rates, for:
97	97	(1) a medical provider who through medical personnel,
98	98	including registered dietitian nutritionists, social workers, and
99	99	community health workers, provides the following services:
100	100	(A) assessments and screening of recipients to
101	101	determine eligibility for participation in the pilot project;
102	102	(B) development of individual care plans and
103	103	health outcome tracking for pilot project participants; and
104	104	(C) care management services, including
105	105	nutrition and health education and assisting participants in
106	106	adhering to individual case plans; and
107	107	(2) community-based organizations that provide the
108	108	following services:
109	109	(A) referral of recipients to a medical provider
110	110	for assessment and screening for eligibility for participation in
111	111	the pilot project;
112	112	(B) ingredient sourcing and meal preparation for
113	113	pilot project participants;
114	114	(C) meal delivery to pilot project participants;
115	115	and
116	116	(D) community outreach, including education on
117	117	disease management, nutrition and health, and access to community
118	118	nutrition services.
119	119	(g) The commission shall submit reports to the legislature
120	120	on the results of a pilot project implemented under this section as
121	121	follows:
122	122	(1) an initial report to be submitted not later than
123	123	the first anniversary of the date the pilot project is implemented
124	124	under this section;
125	125	(2) a second report to be submitted not later than 30
126	126	months following the date the pilot project is implemented; and
127	127	(3) a final report to be submitted not later than three
128	128	months after the pilot project concludes.
129	129	(h) A report submitted to the legislature under Subsection
130	130	(g) must include:
131	131	(1) the number of participants in the pilot project;
132	132	(2) de-identified and aggregated data on any relevant
133	133	medical outcomes for the participants and the infants born to
134	134	participants during the time the participants participated in the
135	135	pilot project, including:
136	136	(A) the results of participants' hemoglobin A1c
137	137	tests;
138	138	(B) the incidence of pregnancy-related
139	139	conditions, including gestational diabetes and preeclampsia;
140	140	(C) changes in participants' body mass index;
141	141	(D) changes in participants' blood pressure;
142	142	(E) the birth weight of the infants; and
143	143	(F) participant or infant hospital admissions
144	144	and emergency room visits;
145	145	(3) any cost savings or increased expenditures
146	146	incurred as a result of the pilot project; and
147	147	(4) a commission recommendation on whether to
148	148	terminate, continue, or expand the pilot project.
149	149	(i) This section expires September 1, 2029.
150	150	SECTION 2. As soon as practicable after the effective date
151	151	of this Act, the executive commissioner of the Health and Human
152	152	Services Commission shall apply for and actively pursue a waiver
153	153	under Section 1115 of the federal Social Security Act (42 U.S.C.
154	154	Section 1315) to the state Medicaid plan from the federal Centers
155	155	for Medicare and Medicaid Services or any other federal agency to
156	156	implement Section 32.077, Human Resources Code, as added by this
157	157	Act. The commission may delay implementing Section 32.077, Human
158	158	Resources Code, as added by this Act, until the waiver applied for
159	159	under this section is granted.
160	160	SECTION 3. This Act takes effect September 1, 2023.