89R15290 LRM-F
By: Thompson H.B. No. 4760
A BILL TO BE ENTITLED
AN ACT
relating to Medicaid reimbursement for the costs of cognitive
assessment and care planning services provided to certain patients.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter D, Chapter 532, Government Code, as
effective April 1, 2025, is amended by adding Section 532.0158 to
read as follows:
Sec. 532.0158. REIMBURSEMENT SYSTEM FOR COGNITIVE CARE
PLANNING. (a) The executive commissioner by rule shall develop and
the commission shall implement a system to provide Medicaid
reimbursement to a health care provider, including a physician, for
the assessment of and care planning services provided to patients
with a cognitive impairment, including dementia or Alzheimer's
disease.
(b) To be eligible for reimbursement under this section, the
health care provider's care planning services must include:
(1) assessment of the patient's cognition, function,
and safety;
(2) an evaluation of the patient's neuropsychiatric
and behavioral symptoms;
(3) a review of the patient's medications;
(4) a needs assessment for the patient's caregiver;
(5) a comprehensive clinical visit for the patient;
and
(6) a complete written care plan for the patient.
(c) The executive commissioner shall prepare and seek a
waiver to the state Medicaid plan under Section 1115 of the Social
Security Act (42 U.S.C. Section 1315) or other applicable federal
law to obtain any federal money available for implementing the
system to assist eligible individuals in obtaining care planning
services.
SECTION 2. (a) As soon as practicable after the effective
date of this Act, the executive commissioner of the Health and Human
Services Commission shall adopt the rules necessary to implement
Section 532.0158, Government Code, as added by this Act.
(b) As soon as practicable after the effective date of this
Act, the executive commissioner of the Health and Human Services
Commission shall apply for and actively pursue from the federal
Centers for Medicare and Medicaid Services or another appropriate
federal agency the waiver required by Section 532.0158, Government
Code, as added by this Act. The commission may delay implementing
Section 532.0158, Government Code, until the waiver applied for
under this section is granted.
SECTION 3. This Act takes effect September 1, 2025.