Bill Text: TX SB1858 | 2021-2022 | 87th Legislature | Introduced
Bill Title: Relating to a study and pilot program to evaluate the provision of prenatal and well child care in a group clinical setting and authority to take related action.
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2021-03-26 - Referred to Health & Human Services [SB1858 Detail]
Download: Texas-2021-SB1858-Introduced.html
| 87R8204 KKR-D | ||
| By: Powell | S.B. No. 1858 | |
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| relating to a study and pilot program to evaluate the provision of | ||
| prenatal and well child care in a group clinical setting and | ||
| authority to take related action. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Subchapter B, Chapter 531, Government Code, is | ||
| amended by adding Section 531.02493 to read as follows: | ||
| Sec. 531.02493. CURRICULUM-BASED GROUP WELL CHILD CARE | ||
| PILOT PROGRAM. (a) The commission shall develop and, not later | ||
| than March 1, 2022, implement a pilot program to increase the rate | ||
| at which recipients attend well child health care visits, | ||
| developmental screenings, and immunizations by providing those | ||
| services through a curriculum-based group well child care model in | ||
| a clinical setting. | ||
| (b) The commission shall operate the pilot program in one or | ||
| more geographic areas of this state. | ||
| (c) In implementing the pilot program, the commission | ||
| shall: | ||
| (1) require a Medicaid managed care organization to | ||
| provide enhanced reimbursement in an amount determined by the | ||
| commission to a health care provider for providing curriculum-based | ||
| group well child care to recipients; and | ||
| (2) evaluate whether the enhanced reimbursement | ||
| increases the rate of children receiving well child visits, | ||
| developmental screenings, and immunizations. | ||
| (d) The commission shall operate the pilot program for two | ||
| years. | ||
| (e) Not later than September 1, 2024, the commission shall | ||
| submit to the governor, the lieutenant governor, the speaker of the | ||
| house of representatives, and each standing committee of the | ||
| legislature having primary jurisdiction over health and human | ||
| services a written report that: | ||
| (1) summarizes the results of the pilot program; and | ||
| (2) recommends whether the pilot program should | ||
| continue, be expanded, or terminate or if the commission should | ||
| permanently implement enhanced reimbursement to health care | ||
| providers for providing curriculum-based group well child care in a | ||
| clinical setting. | ||
| (f) The executive commissioner may adopt rules as necessary | ||
| to implement this section. | ||
| (g) This section expires September 1, 2025. | ||
| SECTION 2. (a) In this section: | ||
| (1) "Commission" means the Health and Human Services | ||
| Commission. | ||
| (2) "Medicaid" means the medical assistance program | ||
| established under Chapter 32, Human Resources Code. | ||
| (3) "Medicaid managed care organization" means a | ||
| managed care organization as defined by Section 533.001, Government | ||
| Code, that contracts with the commission under Chapter 533, | ||
| Government Code, to provide health care services to Medicaid | ||
| recipients. | ||
| (b) The commission shall conduct a study regarding the | ||
| provision of curriculum-based prenatal care and curriculum-based | ||
| well child care offered in a group clinical setting. The study | ||
| must: | ||
| (1) evaluate the health benefits and potential cost | ||
| savings to Medicaid that would result from implementing | ||
| curriculum-based group prenatal care models, including | ||
| implementation of those models using virtual modalities similar to | ||
| those used during the COVID-19 pandemic; | ||
| (2) evaluate the use of procedure codes under Medicaid | ||
| for curriculum-based group prenatal care in a clinical setting; | ||
| (3) reassess the provider types authorized to provide | ||
| prenatal benefits in a group clinical setting under Medicaid by | ||
| identifying provider types that deliver curriculum-based group | ||
| prenatal care, including federally qualified health centers, | ||
| hospitals, rural health clinics, and individual health care | ||
| providers; and | ||
| (4) explore options for promoting curriculum-based | ||
| group well child care models under Medicaid, including by: | ||
| (A) assessing the need for establishing a | ||
| procedure code under Medicaid for the provision of curriculum-based | ||
| group well child care in a clinical setting; and | ||
| (B) promoting value-based payment arrangements | ||
| between providers and Medicaid managed care organizations. | ||
| (c) Not later than September 1, 2022, the commission shall: | ||
| (1) prepare and submit a report on the findings of the | ||
| study conducted under Subsection (b) of this section to the | ||
| standing committees of the senate and house of representatives | ||
| having jurisdiction over Medicaid; and | ||
| (2) based on the assessment under Subsection (b)(3) of | ||
| this section, update the health care provider types that may | ||
| provide prenatal benefits in a group clinical setting under | ||
| Medicaid. | ||
| (d) This section expires September 1, 2023. | ||
| SECTION 3. 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 4. This Act takes effect September 1, 2021. | ||
