Texas 2025 - 89th Regular

Texas House Bill HB4459 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	89R6229 KKR-D
2	2	By: Bhojani H.B. No. 4459
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7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to the provision of certain services under the Medicaid
10	10	managed care program to recipients who are victims of family
11	11	violence.
12	12	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
13	13	SECTION 1. Chapter 540, Government Code, as effective April
14	14	1, 2025, is amended by adding Subchapter T to read as follows:
15	15	SUBCHAPTER T. FAMILY VIOLENCE SERVICES
16	16	Sec. 540.0951. DEFINITIONS. In this subchapter:
17	17	(1) "Family violence" has the meaning assigned by
18	18	Section 71.004, Family Code.
19	19	(2) "Family violence services provider" means a
20	20	licensed health care provider, licensed mental health or behavioral
21	21	health provider, or other provider designated by commission rule
22	22	who provides family violence services.
23	23	(3) "Family violence services" means services that
24	24	provide trauma-informed care to a recipient who is a survivor of
25	25	family violence, including health care services, mental and
26	26	behavioral health services, and other services designated by
27	27	commission rule as family violence services.
28	28	(4) "Service coordination" includes:
29	29	(A) contact between a recipient and a service
30	30	coordinator for a Medicaid managed care organization;
31	31	(B) coordination, including with providers, to
32	32	assist a recipient in accessing benefits provided by the
33	33	organization; and
34	34	(C) coordination, including with providers as
35	35	appropriate, to assist a recipient in accessing services provided
36	36	by other entities or service providers in the recipient's
37	37	community.
38	38	Sec. 540.0952. FAMILY VIOLENCE SERVICES; SERVICE
39	39	COORDINATION. (a) A contract between a Medicaid managed care
40	40	organization and the commission to provide health care services to
41	41	recipients must:
42	42	(1) require the contracting Medicaid managed care
43	43	organization to:
44	44	(A) ensure recipients who are survivors of family
45	45	violence have access to family violence services providers and
46	46	family violence services; and
47	47	(B) provide family violence services
48	48	coordination to those recipients; and
49	49	(2) include performance metrics designed to assist the
50	50	commission in evaluating the organization's coordination and
51	51	provision of those services, including metrics related to:
52	52	(A) the number of family violence screenings
53	53	conducted;
54	54	(B) the number and types of referrals for family
55	55	violence services; and
56	56	(C) the organization's engagement with family
57	57	violence services providers.
58	58	(b) In implementing family violence services coordination
59	59	for recipients, a Medicaid managed care organization must:
60	60	(1) establish partnerships with licensed family
61	61	violence services providers to develop service coordination
62	62	pathways for recipients who are survivors of family violence;
63	63	(2) develop protocols for integrating the provision of
64	64	trauma-informed family violence services with health care and
65	65	mental health services provided to recipients in a manner that
66	66	meets a recipient's specific needs;
67	67	(3) require health care and mental health providers
68	68	participating in the organization's provider network to conduct
69	69	screenings of recipients to identify signs that a recipient is a
70	70	survivor of family violence that:
71	71	(A) use evidence-based screening methods
72	72	sensitive to a recipient's needs; and
73	73	(B) are conducted by personnel with appropriate
74	74	training about trauma-informed care, family violence awareness,
75	75	and culturally competent support practices;
76	76	(4) develop a streamlined process for referring
77	77	recipients to domestic violence services providers that ensures
78	78	continuity of care and provides access to specialized services and
79	79	family violence resources, including emergency shelters and
80	80	organizations providing legal support; and
81	81	(5) ensure recipients have access to mental and
82	82	behavioral health services that specifically address trauma
83	83	experienced by survivors of domestic violence, including:
84	84	(A) counseling to address the immediate and
85	85	long-term mental health needs of a recipient; and
86	86	(B) group counseling or support groups.
87	87	Sec. 540.0953. SERVICE COORDINATOR TRAINING. A Medicaid
88	88	managed care organization must ensure that each individual who
89	89	provides family violence service coordination to recipients under
90	90	this subchapter receive training on trauma-informed care, family
91	91	violence awareness, and culturally competent support practices.
92	92	Sec. 540.0954. MEDICAID MANAGED CARE ORGANIZATION ANNUAL
93	93	REPORT. A Medicaid managed care organization shall annually submit
94	94	to the commission a written report detailing the organization's
95	95	efforts to comply with this subchapter during the preceding year.
96	96	The report must include data on:
97	97	(1) the number of family violence screenings conducted
98	98	by providers included in the organization's provider network;
99	99	(2) the number and type of recipient referrals for
100	100	family violence services made by providers; and
101	101	(3) the scope of family violence mental health and
102	102	behavioral health services provided to recipients.
103	103	Sec. 540.0955. ANNUAL AUDIT. (a) The commission shall
104	104	annually conduct a performance audit of a Medicaid managed care
105	105	organization to:
106	106	(1) ensure the organization is providing family
107	107	violence services coordination; and
108	108	(2) evaluate the organization's performance in
109	109	providing family violence services and service coordination to
110	110	recipients under this subchapter.
111	111	(b) In evaluating a Medicaid managed care organization's
112	112	performance under Subsection (a), the commission shall:
113	113	(1) use the metrics included in the organization's
114	114	contract with the commission; and
115	115	(2) assess the quality of care and service
116	116	coordination provided to recipients by the organization.
117	117	Sec. 540.0956. RULES. The executive commissioner shall
118	118	adopt rules necessary to implement this subchapter, including rules
119	119	designating:
120	120	(1) services that are considered family violence
121	121	services; and
122	122	(2) health care providers that may receive Medicaid
123	123	reimbursement for providing family violence services.
124	124	SECTION 2. Section 32.024, Human Resources Code, is amended
125	125	by adding Subsection (ss) to read as follows:
126	126	(ss) The commission shall ensure that medical assistance
127	127	reimbursement is provided to a family violence services provider
128	128	for providing family violence services to a recipient under
129	129	Subchapter T, Chapter 540, Government Code.
130	130	SECTION 3. (a) The Health and Human Services Commission
131	131	shall, in a contract between the commission and a managed care
132	132	organization under Chapter 540, Government Code, as effective April
133	133	1, 2025, that is entered into or renewed on or after the effective
134	134	date of this Act, require that the managed care organization comply
135	135	with Subchapter T, Chapter 540, Government Code, as added by this
136	136	Act.
137	137	(b) The Health and Human Services Commission shall seek to
138	138	amend contracts entered into with managed care organizations under
139	139	Chapter 533, Government Code, or under Chapter 540, Government
140	140	Code, as effective April 1, 2025, before the effective date of this
141	141	Act to require those managed care organizations to comply with
142	142	Subchapter T, Chapter 540, Government Code, as added by this Act.
143	143	To the extent of a conflict between Subchapter T, Chapter 540,
144	144	Government Code, as added by this Act, and a provision of a contract
145	145	with a managed care organization entered into before the effective
146	146	date of this Act, the contract provision prevails.
147	147	SECTION 4. If before implementing any provision of this Act
148	148	a state agency determines that a waiver or authorization from a
149	149	federal agency is necessary for implementation of that provision,
150	150	the agency affected by the provision shall request the waiver or
151	151	authorization and may delay implementing that provision until the
152	152	waiver or authorization is granted.
153	153	SECTION 5. This Act takes effect September 1, 2025.