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

Texas House Bill 4530 (Prior Session Legislation)

Introduced

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

Sponsorship: Partisan Bill (Democrat 1)

Status: (Introduced - Dead) 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.