Bill Text: TX HB4530 | 2019-2020 | 86th Legislature | Introduced


Bill Title: Relating to a review of Medicaid dental services provided to children.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2019-03-26 - Referred to Human Services [HB4530 Detail]

Download: Texas-2019-HB4530-Introduced.html
  86R13607 MM-D
 
  By: Lucio III H.B. No. 4530
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to a review of Medicaid dental services provided to
  children.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  (a) In this section:
               (1)  "Abuse" and "fraud" have the meanings assigned by
  Section 531.1011, Government Code.
               (2)  "Commission" means the Health and Human Services
  Commission.
               (3)  "Office of inspector general" means the
  commission's office of inspector general.
         (b)  The office of inspector general shall conduct a thorough
  review of the provision of Texas Health Steps therapeutic dental
  benefits to children to determine whether fraud, waste, or abuse is
  probably occurring with respect to the provision of those benefits.  
  The office shall conduct the review in conjunction with other
  appropriate divisions of the commission and collaborate with and
  seek input from stakeholders in the dental industry in this state.
         (c)  In determining whether fraud, waste, or abuse is
  probably occurring in the provision of Texas Health Steps
  therapeutic dental benefits to children, the office of inspector
  general and the commission shall:
               (1)  review a randomly selected representative sample
  of those services in a quantity sufficient to allow for the
  extrapolation of results; and
               (2)  use the American Academy of Pediatric Dentistry
  clinical guidelines and appropriate pediatric dentist peer review
  to:
                     (A)  determine dental necessity for provided
  services; and
                     (B)  assess other factors relevant to determining
  whether fraud, waste, or abuse is probably occurring.
         (d)  Not later than November 1, 2020, the office of inspector
  general and the commission shall submit a joint report on the
  results of the review to the standing committees of the senate and
  house of representatives having primary jurisdiction over
  Medicaid.  The report must include:
               (1)  a description of any policy changes implemented
  through commission rules as a result of the review; and
               (2)  recommendations for statutory changes, including
  any proposed legislation, to address any fraud, waste, and abuse
  identified as probably occurring in the provision of Texas Health
  Steps therapeutic dental benefits to children.
         SECTION 2.  This Act takes effect September 1, 2019.
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