89R5364 SCF-F
By: Oliverson H.B. No. 2946
A BILL TO BE ENTITLED
AN ACT
relating to the provision of nutrition support services to Medicaid
recipients in lieu of other state Medicaid plan services and a
report on the health outcomes of providing those services.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 540.0272, Government Code, as effective
April 1, 2025, is amended to read as follows:
Sec. 540.0272. CERTAIN SERVICES PERMITTED IN LIEU OF STATE
MEDICAID PLAN SERVICES [OTHER MENTAL HEALTH OR SUBSTANCE USE
DISORDER SERVICES]; ANNUAL REPORT. (a) A contract to which this
subchapter applies must contain language permitting the
contracting Medicaid managed care organization to offer recipients
enrolled in the organization's managed care plan medically
appropriate, cost-effective, evidence-based mental health or
substance use services or, subject to Section 540.02721, nutrition
support services from a list of services approved by the commission
[state Medicaid managed care advisory committee] and included in
the contract as services the organization may provide recipients in
lieu of [mental health or substance use disorder] services
specified in the state Medicaid plan. A recipient is not required
to use a service from the list included in the contract in lieu of a
[another mental health or substance use disorder] service specified
in the state Medicaid plan.
(b) The commission shall:
(1) not later than November 1 of each year, prepare and
submit to the legislature a [an annual] report on the number of
times during the preceding year a service from the list included in
the contract is used; and
(2) consider the actual cost and use of any services
from the list included in the contract that are offered by a
Medicaid managed care organization when setting the capitation
rates for that organization under the contract.
SECTION 2. Subchapter F, Chapter 540, Government Code, as
effective April 1, 2025, is amended by adding Section 540.02721 to
read as follows:
Sec. 540.02721. NUTRITION SUPPORT SERVICES; BIENNIAL
REPORT. (a) In this section:
(1) "Community-based nutrition support organization"
means an organization that:
(A) provides nutrition support services;
(B) has an established agreement with a health
care provider to implement nutrition support services under this
section; and
(C) employs:
(i) at least one registered dietitian
nutritionist;
(ii) culinary personnel; and
(iii) support personnel capable of
providing patient referrals to a health care provider, sourcing
ingredients, and packaging and delivering meals to eligible
recipients.
(2) "Food prescription program" means a program under
which a health care provider prescribes nutritious food, including
fresh fruits and vegetables, to an individual who has or is at risk
of developing a diet-related chronic disease to, as appropriate,
treat the disease or reduce the individual's risk of developing the
disease by increasing the patient's access to and consumption of
healthy food.
(3) "Medically tailored meal" means food prepared as
prescribed by a dietician or other health care provider to treat an
individual's diet-related chronic disease or health condition and
any associated symptoms.
(b) In approving the list of nutrition support services that
are permitted in lieu of services specified in the state Medicaid
plan under Section 540.0272, the commission shall consider
including the following services:
(1) case management services related to food and
nutrition access;
(2) nutrition counseling and guidance that is specific
to an individual's needs or designed to improve health outcomes;
(3) the provision of medically tailored meals;
(4) food prescription programs; and
(5) any other nutrition support service the commission
determines to be appropriate, evidence-based, and cost-effective.
(c) In implementing Section 540.0272 as it relates to
nutrition support services and this section, the commission shall
ensure that:
(1) community-based nutrition support organizations
may provide nutrition support services to recipients under
Medicaid; and
(2) a recipient does not receive duplicate services
under Medicaid.
(d) The executive commissioner shall establish a separate
provider type for community-based nutrition support organizations
for purposes of enrollment and reimbursement as a provider under
Medicaid.
(e) Not later than November 1 of each even-numbered year,
the commission shall prepare and submit to the legislature a
biennial report on the health outcomes of providing nutrition
support services in lieu of services specified in the state
Medicaid plan. The report must include:
(1) the number of recipients receiving nutrition
support services during the preceding two-year period; and
(2) an assessment of those individuals' health
outcomes based on relevant National Committee for Quality Assurance
Healthcare Effectiveness Data and Information Set (HEDIS)
measures, including:
(A) hemoglobin A1c levels;
(B) blood pressure control;
(C) birth weight, if applicable;
(D) emergency room visits; and
(E) any other measure of the health outcomes the
commission determines relevant to evaluate the effectiveness of
nutrition support services.
SECTION 3. The changes in law made by this Act apply to a
contract entered into or renewed on or after the effective date of
this Act. A contract entered into or renewed before that date is
governed by the law in effect on the date the contract was entered
into or renewed, and that law is continued in effect for that
purpose.
SECTION 4. 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 5. This Act takes effect September 1, 2025.