88R14929 SCP-F
By: Guerra H.B. No. 5024
A BILL TO BE ENTITLED
AN ACT
relating to establishing the Medicaid home health efficiency
technologies pilot program.
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. MEDICAID HOME HEALTH EFFICIENCY TECHNOLOGIES
PILOT PROGRAM. (a) In this section:
(1) "Efficiency technology" includes:
(A) location-aware AI-assisted home health
scheduling software;
(B) telemedicine medical services software;
(C) logistics or route-optimization software;
and
(D) additional categories of technology that the
commission determines may significantly improve the efficiency and
capacity of home health services providers.
(2) "Home and community support services agency" and
"home health service" have the meanings assigned by Section
142.001, Health and Safety Code.
(3) "Home health provider" means a home and community
support services agency that provides home health services to
recipients under Medicaid.
(4) "Pilot program" means the Medicaid home health
efficiency technologies pilot program established under this
section.
(b) The executive commissioner by rule shall develop and
implement a pilot program to increase access to and the capacity of
home health services under Medicaid. Under the program, the
commission shall incentivize home and community support services
agencies to adopt efficiency technologies by reimbursing those
providers for purchases of efficiency technologies.
(c) The pilot program shall operate for 20 months in the
following phases:
(1) an initial planning phase, not to exceed four
months, for designing the program;
(2) a 12-month operational phase that begins
immediately after the conclusion of the planning phase, during
which the commission shall:
(A) reimburse home health providers for the
purchase of efficiency technologies; and
(B) monitor reimbursements in a manner that
ensures there is sufficient data to evaluate the program's success;
and
(3) a wind-up phase, not to exceed four months, that
begins immediately after the conclusion of the operational phase,
during which the commission shall analyze data collected during the
operational phase and prepare and submit a report to the
legislature.
(d) The commission shall provide up to $9,500 as
reimbursement for the one-time purchase of an efficiency technology
to the first 250 home health providers who:
(1) apply during the operational phase described by
Subsection (c)(2); and
(2) meet eligibility requirements.
(e) To be eligible for reimbursement under Subsection (d), a
home health services provider must:
(1) be in good standing with the commission; and
(2) submit an application in the form and manner
prescribed by the commission that includes:
(A) proof that the provider purchased an
efficiency technology after the commencement date of the pilot
program, including a copy of the paid invoice or receipt showing the
seller's name and address, the efficiency technology purchased, the
date of purchase, and the amount paid by the provider; and
(B) a statement from the provider that the
provider:
(i) has not purchased or used the same
efficiency technology from the same seller within the preceding 12
months; and
(ii) agrees to provide any data required by
the commission that is not accessible through Medicaid claims data.
(f) The commission may contract with a private entity to
assist the commission in implementing the pilot program, monitoring
reimbursements, collecting data during the operational phase, and
analyzing that data during the wind-up phase to evaluate and
measure the success of the program.
(g) The commission shall prepare and submit to the
legislature at least one report during the operational phase of the
pilot program that describes the program's progress and includes
any other information the commission determines appropriate.
(h) Not later than the 60th day after the date the pilot
program ceases operation, the commission shall prepare and submit
to the legislature a report on the program that contains:
(1) an objective evaluation of the program's effect
on:
(A) quality measures and outcomes for Medicaid
recipients;
(B) patient capacity, denial rates, and
timeliness of care after a home health provider receives a request
or referral for the provision of services by the provider; and
(C) home health providers' efficiency in
providing services, including:
(i) staff utilization and efficiency; and
(ii) cost of and miles driven for each home
visit to a Medicaid recipient by the provider;
(2) a comparison of the effectiveness and relative
benefit for each category of efficiency technology used during the
program;
(3) a cost benefit analysis of the program; and
(4) recommendations on the feasibility of
continuation and expansion of the program to all Medicaid
recipients and home health providers.
(i) The commission shall make the report prepared under
Subsection (g) available on the commission's publicly accessible
Internet website.
(j) This section expires September 1, 2025.
SECTION 2. As soon as practicable after the effective date
of this Act, the executive commissioner of the Health and Human
Services Commission shall adopt rules necessary to implement
Section 32.077, Human Resources Code, as added by this Act.
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 immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2023.