Texas 2025 89th Regular

Texas House Bill HB4666 House Committee Report / Bill

Filed 04/28/2025

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                    89R20065 AB-F
 By: Manuel H.B. No. 4666
 Substitute the following for H.B. No. 4666:
 By:  Hull C.S.H.B. No. 4666




 A BILL TO BE ENTITLED
 AN ACT
 relating to certain reports required to be prepared or submitted by
 or in collaboration with the Health and Human Services Commission.
 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 SECTION 1.  The heading to Section 523.0154, Government
 Code, is amended to read as follows:
 Sec. 523.0154.  DATA ANALYSIS UNIT; ANNUAL REPORTS
 [QUARTERLY UPDATE].
 SECTION 2.  Section 523.0154(d), Government Code, is amended
 to read as follows:
 (d)  Not later than December 1 of each year [the 30th day
 following the end of each calendar quarter], the data analysis unit
 shall provide:
 (1)  a report [an update] on the unit's activities and
 findings to the governor, the lieutenant governor, the Legislative
 Budget Board, the speaker of the house of representatives, the
 chair of the Senate Finance Committee, the chair of the House
 Appropriations Committee, and the chairs of the standing committees
 of the senate and house of representatives having jurisdiction over
 Medicaid; and
 (2)  a report of any anomalies identified by the unit
 under Subsection (a)(3) to the commission's office of the inspector
 general.
 SECTION 3.  The heading to Section 532.0453, Government
 Code, is amended to read as follows:
 Sec. 532.0453.  CONTINUED IMPLEMENTATION OF CERTAIN
 INTERVENTIONS AND BEST PRACTICES BY PROVIDERS; BIENNIAL
 [SEMIANNUAL] REPORT.
 SECTION 4.  Section 532.0453(b), Government Code, is amended
 to read as follows:
 (b)  Each even-numbered year, the [The] commission shall
 [semiannually] prepare and submit to the legislature a report that
 contains a summary of the commission's efforts under this section
 and Section 532.0451(b).
 SECTION 5.  Section 542.0054, Government Code, is amended to
 read as follows:
 Sec. 542.0054.  BIENNIAL [ANNUAL] REPORT ON IMPLEMENTATION.
 (a)  Not later than September 30 of each even-numbered year, the
 commission, in collaboration with the advisory committee, shall
 prepare and submit to the legislature a report that includes:
 (1)  an assessment of the implementation of the system
 required by this chapter, including appropriate information
 regarding the provision of acute care services and long-term
 services and supports to individuals with an intellectual or
 developmental disability under Medicaid;
 (2)  recommendations regarding implementation of and
 improvements to the system redesign, including recommendations
 regarding appropriate statutory changes to facilitate the
 implementation; and
 (3)  an assessment of the effect of the system on:
 (A)  access to long-term services and supports;
 (B)  the quality of acute care services and
 long-term services and supports;
 (C)  meaningful outcomes for Medicaid recipients
 using person-centered planning, individualized budgeting, and
 self-determination, including an individual's inclusion in the
 community;
 (D)  the integration of service coordination of
 acute care services and long-term services and supports;
 (E)  the efficiency and use of funding;
 (F)  the placement of individuals in housing that
 is the least restrictive setting appropriate to an individual's
 needs;
 (G)  employment assistance and customized,
 integrated, competitive employment options; and
 (H)  the number and types of fair hearing and
 appeals processes in accordance with federal law.
 (b)  This section expires on the second anniversary of the
 date the commission completes implementation of the transition
 required under Section 542.0201.
 SECTION 6.  Sections 542.0119(a) and (b), Government Code,
 are amended to read as follows:
 (a)  The commission, in collaboration with the advisory
 committee and pilot program work group, shall review and evaluate
 the progress and outcomes of the pilot program and submit, as part
 of the [annual] report required under Section 542.0054, a report on
 the pilot program's status that includes recommendations for
 improving the pilot program.
 (b)  Not later than September 1, 2026, the commission, in
 collaboration with the advisory committee and pilot program work
 group, shall prepare and submit to the legislature a written report
 that evaluates the pilot program based on a comprehensive
 analysis.  The analysis must:
 (1)  assess the effect of the pilot program on:
 (A)  access to and quality of long-term services
 and supports;
 (B)  informed choice and meaningful outcomes
 using person-centered planning, flexible consumer-directed
 services, individualized budgeting, and self-determination,
 including a pilot program participant's inclusion in the community;
 (C)  the integration of service coordination of
 acute care services and long-term services and supports;
 (D)  employment assistance and customized,
 integrated, competitive employment options;
 (E)  the number, types, and dispositions of fair
 hearings and appeals in accordance with federal and state law;
 (F)  increasing the use and flexibility of the
 consumer direction model;
 (G)  increasing the use of alternatives to
 guardianship, including supported decision-making agreements as
 defined by Section 1357.002, Estates Code;
 (H)  achieving the best and most cost-effective
 funding use based on a pilot program participant's needs and
 preferences; and
 (I)  attendant recruitment and retention;
 (2)  analyze the experiences and outcomes of the
 following systems changes:
 (A)  the comprehensive assessment instrument
 described by Section 533A.0335, Health and Safety Code;
 (B)  the 21st Century Cures Act (Pub. L.
 No. 114-255);
 (C)  implementation of the federal rule adopted by
 the Centers for Medicare and Medicaid Services and published at 79
 Fed. Reg. 2948 (January 16, 2014) related to the provision of
 long-term services and supports through a home and community-based
 services (HCS) waiver program under Section 1915(c), 1915(i), or
 1915(k) of the Social Security Act (42 U.S.C. Section 1396n(c),
 (i), or (k));
 (D)  the provision of basic attendant and
 habilitation services under Section 542.0152; and
 (E)  the benefits of providing STAR+PLUS Medicaid
 managed care services to individuals based on functional needs;
 (3)  include feedback on the pilot program based on the
 personal experiences of:
 (A)  individuals with an intellectual or
 developmental disability and individuals with similar functional
 needs who were pilot program participants;
 (B)  families of and other persons actively
 involved in the lives of individuals described by Paragraph (A);
 and
 (C)  comprehensive long-term services and
 supports providers who delivered services under the pilot program;
 (4)  be incorporated in the [annual] report required
 under Section 542.0054; and
 (5)  include recommendations on:
 (A)  a system of programs and services for the
 legislature's consideration;
 (B)  necessary statutory changes; and
 (C)  whether to implement the pilot program
 statewide under the STAR+PLUS Medicaid managed care program for
 eligible individuals.
 SECTION 7.  Section 542.0151(b), Government Code, is amended
 to read as follows:
 (b)  The commission, in collaboration with the advisory
 committee, shall analyze the outcomes of providing acute care
 Medicaid benefits to individuals with an intellectual or
 developmental disability under a model described by Subsection
 (a).  The analysis must:
 (1)  include an assessment of the effects of the
 delivery model on:
 (A)  access to and quality of acute care services;
 and
 (B)  the number and types of fair hearing and
 appeals processes in accordance with federal law;
 (2)  be incorporated into the [annual] report to the
 legislature required under Section 542.0054; and
 (3)  include recommendations for delivery model
 improvements and implementation for the legislature's
 consideration, including recommendations for needed statutory
 changes.
 SECTION 8.  Section 543A.0003(a), Government Code, is
 amended to read as follows:
 (a)  The commission shall include aggregate, nonidentifying
 data collected using the quality-based outcome measure described by
 Section 543A.0002(b) in the [annual] report required by Section
 543A.0008.  The commission may include the data in any other report
 required by this chapter.
 SECTION 9.  The heading of Section 543A.0008, Government
 Code, is amended to read as follows:
 Sec. 543A.0008.  BIENNIAL [ANNUAL] REPORT.
 SECTION 10.  Section 543A.0008(a), Government Code, is
 amended to read as follows:
 (a)  The commission shall submit to the legislature and make
 available to the public in each even-numbered year a [an annual]
 report on:
 (1)  the quality-based outcome and process measures
 developed under Sections [Section] 543A.0002 and 543A.0003,
 including measures based on each potentially preventable event; and
 (2)  the progress of implementing quality-based
 payment systems under Section 543A.0004 and other payment
 initiatives under this chapter.
 SECTION 11.  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 12.  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, 2025.