Bill Text: TX SB277 | 2015-2016 | 84th Legislature | Enrolled

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Bill Title: Relating to certain health-related and other task forces and advisory committees.

Sponsorship: Partisan Bill (Republican 2)

Status: (Passed) 2015-06-18 - See remarks for effective date [SB277 Detail]

Download: Texas-2015-SB277-Enrolled.html

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S.B. No. 277

AN ACT
relating to certain health-related and other task forces and
advisory committees.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
ARTICLE 1. CHANGES TO ENTITIES EFFECTIVE SEPTEMBER 1, 2015
SECTION 1.01. (a) The Interagency Task Force on Electronic
Benefits Transfers is abolished.
(b) Section 531.045, Government Code, as amended by S.B.
219, Acts of the 84th Legislature, Regular Session, 2015, is
repealed.
SECTION 1.02. (a) The Medicaid and Public Assistance Fraud
Oversight Task Force is abolished.
(b) Section 22.028(c), Human Resources Code, as amended by
S.B. 219, Acts of the 84th Legislature, Regular Session, 2015, is
amended to read as follows:
(c) No later than the first day of each month, the
commission shall send the comptroller a report listing the accounts
on which enforcement actions or other steps were taken by the
commission in response to the records received from the EBT
operator under this section, and the action taken by the
commission. The comptroller shall promptly review the report and,
as appropriate, may solicit the advice of the office of the
inspector general [Medicaid and Public Assistance Fraud Oversight
Task Force] regarding the results of the commission's enforcement
actions.
(c) Section 531.107, Government Code, as amended by S.B.
219, Acts of the 84th Legislature, Regular Session, 2015, is
repealed.
SECTION 1.03. (a) The Advisory Committee on Inpatient
Mental Health Services is abolished.
(b) Section 571.027, Health and Safety Code, as amended by
S.B. 219, Acts of the 84th Legislature, Regular Session, 2015, is
repealed.
SECTION 1.04. (a) The Interagency Inspection Task Force is
abolished.
(b) Section 42.0442(c), Human Resources Code, is amended to
read as follows:
(c) [The interagency task force shall establish an
inspection checklist based on the inspection protocol developed
under Subsection (b).] Each state agency that inspects a facility
listed in Subsection (a) shall use an [the] inspection checklist
established by the department in performing an inspection. A state
agency shall make a copy of the completed inspection checklist
available to the facility at the facility's request to assist the
facility in maintaining records.
(c) Section 42.0442(b), Human Resources Code, as amended by
S.B. 219, Acts of the 84th Legislature, Regular Session, 2015, is
repealed.
SECTION 1.05. (a) The local authority network advisory
committee is abolished.
(b) Section 533.0359(a), Health and Safety Code, is amended
to read as follows:
(a) In developing rules governing local mental health
authorities under Sections 533.035, [533.0351,] 533.03521,
533.0357, and 533.0358, the executive commissioner shall use
rulemaking procedures under Subchapter B, Chapter 2001, Government
Code.
(c) Section 533.0351, Health and Safety Code, as amended by
S.B. 219, Acts of the 84th Legislature, Regular Session, 2015, is
repealed.
SECTION 1.06. (a) The Worksite Wellness Advisory Board is
abolished.
(b) Section 664.052, Government Code, is amended to read as
follows:
Sec. 664.052. RULES. The executive commissioner shall
adopt rules for the administration of this subchapter[, including
rules prescribing the frequency and location of board meetings].
(c) Section 664.058, Government Code, is amended to read as
follows:
Sec. 664.058. DONATIONS. The department [board] may
receive in-kind and monetary gifts, grants, and donations from
public and private donors to be used for the purposes of this
subchapter.
(d) Section 664.061(a), Government Code, is amended to read
as follows:
(a) A state agency may:
(1) allow each employee 30 minutes during normal
working hours for exercise three times each week;
(2) allow all employees to attend on-site wellness
seminars when offered;
(3) provide eight hours of additional leave time each
year to an employee who:
(A) receives a physical examination; and
(B) completes either an online health risk
assessment tool provided by the department [board] or a similar
health risk assessment conducted in person by a worksite wellness
coordinator;
(4) provide financial incentives, notwithstanding
Section 2113.201, for participation in a wellness program developed
under Section 664.053(e) after the agency establishes a written
policy with objective criteria for providing the incentives;
(5) offer on-site clinic or pharmacy services in
accordance with Subtitles B and J, Title 3, Occupations Code,
including the requirements regarding delegation of certain medical
acts under Chapter 157, Occupations Code; and
(6) adopt additional wellness policies, as determined
by the agency.
(e) Sections 664.051(1), 664.054, 664.055, 664.056,
664.057, 664.059, and 664.060(c) and (f), Government Code, are
repealed.
SECTION 1.07. (a) The Sickle Cell Advisory Committee is
abolished.
(b) Section 33.052, Health and Safety Code, is amended to
read as follows:
Sec. 33.052. DUTIES OF DEPARTMENT. The department shall[:
[(1)] identify efforts related to the expansion and
coordination of education, treatment, and continuity of care
programs for individuals with sickle cell trait and sickle cell
disease[;
[(2) assist the advisory committee created under
Section 33.053; and
[(3) provide the advisory committee created under
Section 33.053 with staff support necessary for the advisory
committee to fulfill its duties].
(c) Section 33.053, Health and Safety Code, is repealed.
SECTION 1.08. (a) The Arthritis Advisory Committee is
abolished.
(b) Section 97.007, Health and Safety Code, is repealed.
SECTION 1.09. (a) The Advisory Panel on Health
Care-Associated Infections and Preventable Adverse Events is
abolished.
(b) Section 536.002(b), Government Code, is amended to read
as follows:
(b) The executive commissioner shall appoint the members of
the advisory committee. The committee must consist of physicians
and other health care providers, representatives of health care
facilities, representatives of managed care organizations, and
other stakeholders interested in health care services provided in
this state, including:
(1) at least one member who is a physician with
clinical practice experience in obstetrics and gynecology;
(2) at least one member who is a physician with
clinical practice experience in pediatrics;
(3) at least one member who is a physician with
clinical practice experience in internal medicine or family
medicine;
(4) at least one member who is a physician with
clinical practice experience in geriatric medicine;
(5) at least three members who are or who represent a
health care provider that primarily provides long-term services and
supports; and
(6) at least one member who is a consumer
representative[; and
[(7) at least one member who is a member of the
Advisory Panel on Health Care-Associated Infections and
Preventable Adverse Events who meets the qualifications prescribed
by Section 98.052(a)(4), Health and Safety Code].
(c) The heading to Subchapter C, Chapter 98, Health and
Safety Code, is amended to read as follows:
SUBCHAPTER C. DUTIES OF DEPARTMENT [AND ADVISORY PANEL]; REPORTING
SYSTEM
(d) Section 98.1045(b), Health and Safety Code, is amended
to read as follows:
(b) The executive commissioner may exclude an adverse event
described by Subsection (a)(2) from the reporting requirement of
Subsection (a) if the executive commissioner[, in consultation with
the advisory panel,] determines that the adverse event is not an
appropriate indicator of a preventable adverse event.
(e) Section 98.105, Health and Safety Code, is amended to
read as follows:
Sec. 98.105. REPORTING SYSTEM MODIFICATIONS. The [Based on
the recommendations of the advisory panel, the] executive
commissioner by rule may modify in accordance with this chapter the
list of procedures that are reportable under Section 98.103. The
modifications must be based on changes in reporting guidelines and
in definitions established by the federal Centers for Disease
Control and Prevention.
(f) Section 98.106(c), Health and Safety Code, is amended to
read as follows:
(c) The [In consultation with the advisory panel, the]
department shall publish the departmental summary in a format that
is easy to read.
(g) Section 98.108(a), Health and Safety Code, is amended to
read as follows:
(a) The [In consultation with the advisory panel, the]
executive commissioner by rule shall establish the frequency of
reporting by health care facilities required under Sections 98.103
and 98.1045.
(h) The following provisions are repealed:
(1) Sections 98.001(1) and 98.002, Health and Safety
Code; and
(2) Subchapter B, Chapter 98, Health and Safety Code.
SECTION 1.10. (a) The Youth Camp Training Advisory
Committee is abolished.
(b) Section 141.0095(d), Health and Safety Code, as amended
by S.B. 219, Acts of the 84th Legislature, Regular Session, 2015, is
amended to read as follows:
(d) In accordance with this section [and the criteria and
guidelines developed by the training advisory committee
established under Section 141.0096], the executive commissioner by
rule shall establish criteria and guidelines for training and
examination programs on sexual abuse and child molestation. The
department may approve training and examination programs offered by
trainers under contract with youth camps or by online training
organizations or may approve programs offered in another format
authorized by the department.
(c) Section 141.0096, Health and Safety Code, as amended by
S.B. 219, Acts of the 84th Legislature, Regular Session, 2015, is
repealed.
SECTION 1.11. (a) The Drug Demand Reduction Advisory
Committee is abolished.
(b) Subchapter F, Chapter 461A, Health and Safety Code, as
added by S.B. No. 219, Acts of the 84th Legislature, Regular
Session, 2015, is repealed.
(c) Section 7.030, Education Code, is repealed.
SECTION 1.12. (a) The Texas Medical Child Abuse Resources
and Education System (MEDCARES) Advisory Committee is abolished.
(b) Section 1001.155, Health and Safety Code, as added by
Chapter 1238 (S.B. 2080), Acts of the 81st Legislature, Regular
Session, 2009, is reenacted and amended to read as follows:
Sec. 1001.155. REQUIRED REPORT. Not later than December 1
of each even-numbered year, the department[, with the assistance of
the advisory committee established under this subchapter,] shall
submit a report to the governor and the legislature regarding the
grant activities of the program and grant recipients, including the
results and outcomes of grants provided under this subchapter.
(c) Section 1001.153, Health and Safety Code, as added by
Chapter 1238 (S.B. 2080), Acts of the 81st Legislature, Regular
Session, 2009, is repealed.
SECTION 1.13. Section 40.030, Human Resources Code, is
amended to read as follows:
Sec. 40.030. ADVISORY COMMITTEES. (a) The executive
commissioner or the executive commissioner's designee may appoint
advisory committees in accordance with Chapter 2110, Government
Code.
(b) The executive commissioner shall adopt rules, in
compliance with Chapter 2110, Government Code, regarding the
purpose, structure, and use of advisory committees by the
department. The rules may include provisions governing:
(1) an advisory committee's size and quorum
requirements;
(2) qualifications for membership of an advisory
committee, including:
(A) requirements relating to experience and
geographic representation; and
(B) requirements for the department to include as
members of advisory committees youth who have aged out of foster
care and parents who have successfully completed family service
plans and whose children were returned to the parents, as
applicable;
(3) appointment procedures for an advisory committee;
(4) terms for advisory committee members; and
(5) compliance with Chapter 551, Government Code.
SECTION 1.14. (a) The Texas Institute of Health Care Quality
and Efficiency is abolished.
(b) Section 98.1046(a), Health and Safety Code, is amended
to read as follows:
(a) The [In consultation with the Texas Institute of Health
Care Quality and Efficiency under Chapter 1002, the] department,
using data submitted under Chapter 108, shall publicly report for
hospitals in this state risk-adjusted outcome rates for those
potentially preventable complications and potentially preventable
readmissions that the department[, in consultation with the
institute,] has determined to be the most effective measures of
quality and efficiency.
(c) Section 98.1047(a), Health and Safety Code, is amended
to read as follows:
(a) The [In consultation with the Texas Institute of Health
Care Quality and Efficiency under Chapter 1002, the] department
shall study which adverse health conditions commonly occur in
long-term care facilities and, of those health conditions, which
are potentially preventable.
(d) Section 98.1065, Health and Safety Code, is amended to
read as follows:
Sec. 98.1065. STUDY OF INCENTIVES AND RECOGNITION FOR
HEALTH CARE QUALITY. The department[, in consultation with the
Texas Institute of Health Care Quality and Efficiency under Chapter
1002,] shall conduct a study on developing a recognition program to
recognize exemplary health care facilities for superior quality of
health care and make recommendations based on that study.
(e) The following provisions are repealed:
(1) Chapter 1002, Health and Safety Code, as amended
by S.B. No. 219, Acts of the 84th Legislature, Regular Session,
2015; and
(2) Section 848.001(7), Insurance Code.
SECTION 1.15. (a) The stakeholder workgroup established
in connection with the jail-based restoration of competency pilot
program is abolished.
(b) Article 46B.073(e), Code of Criminal Procedure, is
amended to read as follows:
(e) Notwithstanding Subsections (b), (c), and (d) and
notwithstanding the contents of the applicable order of commitment,
in a county in which the department operates a jail-based
restoration of competency pilot program under Article 46B.090, a
defendant for whom an order is issued under this article committing
the defendant to a mental health facility or residential care
facility shall be provided competency restoration services at the
jail under the pilot program if the service provider at the jail
determines the defendant will immediately begin to receive
services. If the service provider at the jail determines the
defendant will not immediately begin to receive competency
restoration services, the defendant shall be transferred to the
appropriate mental health facility or residential care facility as
provided by the court order. This subsection expires September 1,
2019 [2017].
(c) Subsections (c) and (o), Article 46B.090, Code of
Criminal Procedure, are amended to read as follows:
(c) Not later than November 1, 2013, the commissioner of the
department[, in consultation with a stakeholder workgroup
established by the department as provided by Subsection (d),] shall
adopt rules as necessary to implement the pilot program. In
adopting rules under this article, the commissioner shall specify
the types of information the department must collect during the
operation of the pilot program for use in evaluating the outcome of
the pilot program.
(o) This article expires September 1, 2019 [2017].
(d) Subsections (d) and (e), Article 46B.090, Code of
Criminal Procedure, are repealed.
ARTICLE 2. CHANGES TO ENTITIES EFFECTIVE JANUARY 1, 2016
SECTION 2.01. Section 262.353(d), Family Code, is amended
to read as follows:
(d) Not later than September 30, 2014, the department and
the Department of State Health Services shall file a report with the
legislature [and the Council on Children and Families] on the
results of the study required by Subsection (a). The report must
include:
(1) each option to prevent relinquishment of parental
custody that was considered during the study;
(2) each option recommended for implementation, if
any;
(3) each option that is implemented using existing
resources;
(4) any policy or statutory change needed to implement
a recommended option;
(5) the fiscal impact of implementing each option, if
any;
(6) the estimated number of children and families that
may be affected by the implementation of each option; and
(7) any other significant information relating to the
study.
SECTION 2.02. (a) Section 531.012, Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
Sec. 531.012. ADVISORY COMMITTEES. (a) The executive
commissioner shall establish and maintain [may appoint] advisory
committees to consider issues and solicit public input across all
major areas of the health and human services system, including
relating to the following issues:
(1) Medicaid and other social services programs;
(2) managed care under Medicaid and the child health
plan program;
(3) health care quality initiatives;
(4) aging;
(5) persons with disabilities, including persons with
autism;
(6) rehabilitation, including for persons with brain
injuries;
(7) children;
(8) public health;
(9) behavioral health;
(10) regulatory matters;
(11) protective services; and
(12) prevention efforts.
(b) Chapter 2110 applies to an advisory committee
established under this section.
(c) The executive commissioner shall adopt rules:
(1) in compliance with Chapter 2110 to govern an
advisory committee's purpose, tasks, reporting requirements, and
date of abolition; and
(2) related to an advisory committee's:
(A) size and quorum requirements;
(B) membership, including:
(i) qualifications to be a member,
including any experience requirements;
(ii) required geographic representation;
(iii) appointment procedures; and
(iv) terms of members; and
(C) duty to comply with the requirements for open
meetings under Chapter 551.
(d) An advisory committee established under this section
shall:
(1) report any recommendations to the executive
commissioner; and
(2) submit a written report to the legislature of any
policy recommendations made to the executive commissioner under
Subdivision (1) [as needed].
(b) Not later than March 1, 2016, the executive commissioner
of the Health and Human Services Commission shall adopt rules under
Section 531.012, Government Code, as amended by this article. This
subsection takes effect September 1, 2015.
SECTION 2.03. Subchapter A, Chapter 531, Government Code,
is amended by adding Section 531.0121 to read as follows:
Sec. 531.0121. PUBLIC ACCESS TO ADVISORY COMMITTEE
MEETINGS. (a) This section applies to an advisory committee
established under Section 531.012.
(b) The commission shall create a master calendar that
includes all advisory committee meetings across the health and
human services system.
(c) The commission shall make available on the commission's
Internet website:
(1) the master calendar;
(2) all meeting materials for an advisory committee
meeting; and
(3) streaming live video of each advisory committee
meeting.
(d) The commission shall provide Internet access in each
room used for a meeting that appears on the master calendar.
SECTION 2.04. Section 531.0216(b), Government Code, is
amended to read as follows:
(b) In developing the system, the executive commissioner by
rule shall:
(1) review programs and pilot projects in other states
to determine the most effective method for reimbursement;
(2) establish billing codes and a fee schedule for
services;
(3) provide for an approval process before a provider
can receive reimbursement for services;
(4) consult with the Department of State Health
Services [and the telemedicine and telehealth advisory committee]
to establish procedures to:
(A) identify clinical evidence supporting
delivery of health care services using a telecommunications system;
and
(B) annually review health care services,
considering new clinical findings, to determine whether
reimbursement for particular services should be denied or
authorized;
(5) establish a separate provider identifier for
telemedicine medical services providers, telehealth services
providers, and home telemonitoring services providers; and
(6) establish a separate modifier for telemedicine
medical services, telehealth services, and home telemonitoring
services eligible for reimbursement.
SECTION 2.05. Section 531.02441(j), Government Code, is
amended to read as follows:
(j) The task force is abolished and this [This] section
expires September 1, 2017.
SECTION 2.06. Section 531.051(c), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(c) In adopting rules for the consumer direction models, the
executive commissioner shall:
(1) [with assistance from the work group established
under Section 531.052,] determine which services are appropriate
and suitable for delivery through consumer direction;
(2) ensure that each consumer direction model is
designed to comply with applicable federal and state laws;
(3) maintain procedures to ensure that a potential
consumer or the consumer's legally authorized representative has
adequate and appropriate information, including the
responsibilities of a consumer or representative under each service
delivery option, to make an informed choice among the types of
consumer direction models;
(4) require each consumer or the consumer's legally
authorized representative to sign a statement acknowledging
receipt of the information required by Subdivision (3);
(5) maintain procedures to monitor delivery of
services through consumer direction to ensure:
(A) adherence to existing applicable program
standards;
(B) appropriate use of funds; and
(C) consumer satisfaction with the delivery of
services;
(6) ensure that authorized program services that are
not being delivered to a consumer through consumer direction are
provided by a provider agency chosen by the consumer or the
consumer's legally authorized representative; and
(7) [work in conjunction with the work group
established under Section 531.052 to] set a timetable to complete
the implementation of the consumer direction models.
SECTION 2.07. Section 531.067, Government Code, as amended
by S.B. 219, Acts of the 84th Legislature, Regular Session, 2015, is
amended to read as follows:
Sec. 531.067. PROGRAM TO IMPROVE AND MONITOR CERTAIN
OUTCOMES OF RECIPIENTS UNDER CHILD HEALTH PLAN PROGRAM AND MEDICAID
[PUBLIC ASSISTANCE HEALTH BENEFIT REVIEW AND DESIGN COMMITTEE].
The [(a) The commission shall appoint a Public Assistance Health
Benefit Review and Design Committee. The committee consists of
nine representatives of health care providers participating in
Medicaid or the child health plan program, or both. The committee
membership must include at least three representatives from each
program.
[(b) The executive commissioner shall designate one member
to serve as presiding officer for a term of two years.
[(c) The committee shall meet at the call of the presiding
officer.
[(d) The committee shall review and provide recommendations
to the commission regarding health benefits and coverages provided
under Medicaid, the child health plan program, and any other
income-based health care program administered by the commission or
a health and human services agency. In performing its duties under
this subsection, the committee must:
[(1) review benefits provided under each of the
programs; and
[(2) review procedures for addressing high
utilization of benefits by recipients.
[(e) The commission shall provide administrative support
and resources as necessary for the committee to perform its duties
under this section.
[(f) Section 2110.008 does not apply to the committee.
[(g) In performing the duties under this section, the]
commission may design and implement a program to improve and
monitor clinical and functional outcomes of a recipient of services
under Medicaid or the state child health plan program. The program
may use financial, clinical, and other criteria based on pharmacy,
medical services, and other claims data related to Medicaid or the
child health plan program. [The commission must report to the
committee on the fiscal impact, including any savings associated
with the strategies utilized under this section.]
SECTION 2.08. (a) Section 531.0691, Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is redesignated as Section 531.0735, Government Code, to read
as follows:
Sec. 531.0735 [531.0691]. MEDICAID DRUG UTILIZATION REVIEW
PROGRAM: DRUG USE REVIEWS AND ANNUAL REPORT. (a) In this section:
(1) "Medicaid Drug Utilization Review Program" means
the program operated by the vendor drug program to improve the
quality of pharmaceutical care under Medicaid.
(2) "Prospective drug use review" means the review of
a patient's drug therapy and prescription drug order or medication
order before dispensing or distributing a drug to the patient.
(3) "Retrospective drug use review" means the review
of prescription drug claims data to identify patterns of
prescribing.
(b) The commission shall provide for an increase in the
number and types of retrospective drug use reviews performed each
year under the Medicaid Drug Utilization Review Program, in
comparison to the number and types of reviews performed in the state
fiscal year ending August 31, 2009.
(c) In determining the number and types of drug use reviews
to be performed, the commission shall:
(1) allow for the repeat of retrospective drug use
reviews that address ongoing drug therapy problems and that, in
previous years, improved client outcomes and reduced Medicaid
spending;
(2) consider implementing disease-specific
retrospective drug use reviews that address ongoing drug therapy
problems in this state and that reduced Medicaid prescription drug
use expenditures in other states; and
(3) regularly examine Medicaid prescription drug
claims data to identify occurrences of potential drug therapy
problems that may be addressed by repeating successful
retrospective drug use reviews performed in this state and other
states.
(d) In addition to any other information required by federal
law, the commission shall include the following information in the
annual report regarding the Medicaid Drug Utilization Review
Program:
(1) a detailed description of the program's
activities; and
(2) estimates of cost savings anticipated to result
from the program's performance of prospective and retrospective
drug use reviews.
(e) The cost-saving estimates for prospective drug use
reviews under Subsection (d) must include savings attributed to
drug use reviews performed through the vendor drug program's
electronic claims processing system and clinical edits screened
through the prior authorization system implemented under Section
531.073.
(f) The commission shall post the annual report regarding
the Medicaid Drug Utilization Review Program on the commission's
website.
(b) Subchapter B, Chapter 531, Government Code, is amended
by adding Section 531.0736 to read as follows:
Sec. 531.0736. DRUG UTILIZATION REVIEW BOARD. (a) In this
section, "board" means the Drug Utilization Review Board.
(b) In addition to performing any other duties required by
federal law, the board shall:
(1) develop and submit to the commission
recommendations for preferred drug lists adopted by the commission
under Section 531.072;
(2) suggest to the commission restrictions or clinical
edits on prescription drugs;
(3) recommend to the commission educational
interventions for Medicaid providers;
(4) review drug utilization across Medicaid; and
(5) perform other duties that may be specified by law
and otherwise make recommendations to the commission.
(c) The executive commissioner shall determine the
composition of the board, which must:
(1) comply with applicable federal law, including 42
C.F.R. Section 456.716;
(2) include two representatives of managed care
organizations as nonvoting members, one of whom must be a physician
and one of whom must be a pharmacist;
(3) include at least 17 physicians and pharmacists
who:
(A) provide services across the entire
population of Medicaid recipients and represent different
specialties, including at least one of each of the following types
of physicians:
(i) a pediatrician;
(ii) a primary care physician;
(iii) an obstetrician and gynecologist;
(iv) a child and adolescent psychiatrist;
and
(v) an adult psychiatrist; and
(B) have experience in either developing or
practicing under a preferred drug list; and
(4) include a consumer advocate who represents
Medicaid recipients.
(c-1) The executive commissioner by rule shall develop and
implement a process by which a person may apply to become a member
of the board and shall post the application and information
regarding the application process on the commission's Internet
website.
(d) Members appointed under Subsection (c)(2) may attend
quarterly and other regularly scheduled meetings, but may not:
(1) attend executive sessions; or
(2) access confidential drug pricing information.
(e) Members of the board serve staggered four-year terms.
(f) The voting members of the board shall elect from among
the voting members a presiding officer. The presiding officer must
be a physician.
(g) The board shall hold a public meeting quarterly at the
call of the presiding officer and shall permit public comment
before voting on any changes in the preferred drug lists, the
adoption of or changes to drug use criteria, or the adoption of
prior authorization or drug utilization review proposals. The
board shall hold public meetings at other times at the call of the
presiding officer. Minutes of each meeting shall be made available
to the public not later than the 10th business day after the date
the minutes are approved. The board may meet in executive session
to discuss confidential information as described by Subsection (i).
(h) In developing its recommendations for the preferred
drug lists, the board shall consider the clinical efficacy, safety,
and cost-effectiveness of and any program benefit associated with a
product.
(i) The executive commissioner shall adopt rules governing
the operation of the board, including rules governing the
procedures used by the board for providing notice of a meeting and
rules prohibiting the board from discussing confidential
information described by Section 531.071 in a public meeting. The
board shall comply with the rules adopted under this subsection and
Subsection (j).
(j) In addition to the rules under Subsection (i), the
executive commissioner by rule shall require the board or the
board's designee to present a summary of any clinical efficacy and
safety information or analyses regarding a drug under consideration
for a preferred drug list that is provided to the board by a private
entity that has contracted with the commission to provide the
information. The board or the board's designee shall provide the
summary in electronic form before the public meeting at which
consideration of the drug occurs. Confidential information
described by Section 531.071 must be omitted from the summary. The
summary must be posted on the commission's Internet website.
(k) To the extent feasible, the board shall review all drug
classes included in the preferred drug lists adopted under Section
531.072 at least once every 12 months and may recommend inclusions
to and exclusions from the lists to ensure that the lists provide
for a range of clinically effective, safe, cost-effective, and
medically appropriate drug therapies for the diverse segments of
the Medicaid population, children receiving health benefits
coverage under the child health plan program, and any other
affected individuals.
(l) The commission shall provide administrative support and
resources as necessary for the board to perform its duties.
(m) Chapter 2110 does not apply to the board.
(n) The commission or the commission's agent shall publicly
disclose, immediately after the board's deliberations conclude,
each specific drug recommended for or against preferred drug list
status for each drug class included in the preferred drug list for
the Medicaid vendor drug program. The disclosure must be posted on
the commission's Internet website not later than the 10th business
day after the date of conclusion of board deliberations that result
in recommendations made to the executive commissioner regarding the
placement of drugs on the preferred drug list. The public
disclosure must include:
(1) the general basis for the recommendation for each
drug class; and
(2) for each recommendation, whether a supplemental
rebate agreement or a program benefit agreement was reached under
Section 531.070.
(c) Section 531.0692, Government Code, is redesignated as
Section 531.0737, Government Code, and amended to read as follows:
Sec. 531.0737 [531.0692]. [MEDICAID] DRUG UTILIZATION
REVIEW BOARD: CONFLICTS OF INTEREST. (a) A voting member of the
[board of the Medicaid] Drug Utilization Review Board [Program] may
not have a contractual relationship, ownership interest, or other
conflict of interest with a pharmaceutical manufacturer or labeler
or with an entity engaged by the commission to assist in the
development of the preferred drug lists or in the administration of
the Medicaid Drug Utilization Review Program.
(b) The executive commissioner may implement this section
by adopting rules that identify prohibited relationships and
conflicts or requiring the board to develop a conflict-of-interest
policy that applies to the board.
(d) Sections 531.072(c) and (e), Government Code, are
amended to read as follows:
(c) In making a decision regarding the placement of a drug
on each of the preferred drug lists, the commission shall consider:
(1) the recommendations of the Drug Utilization Review
Board [Pharmaceutical and Therapeutics Committee established]
under Section 531.0736 [531.074];
(2) the clinical efficacy of the drug;
(3) the price of competing drugs after deducting any
federal and state rebate amounts; and
(4) program benefit offerings solely or in conjunction
with rebates and other pricing information.
(e) In this subsection, "labeler" and "manufacturer" have
the meanings assigned by Section 531.070. The commission shall
ensure that:
(1) a manufacturer or labeler may submit written
evidence supporting the inclusion of a drug on the preferred drug
lists before a supplemental agreement is reached with the
commission; and
(2) any drug that has been approved or has had any of
its particular uses approved by the United States Food and Drug
Administration under a priority review classification will be
reviewed by the Drug Utilization Review Board [Pharmaceutical and
Therapeutics Committee] at the next regularly scheduled meeting of
the board [committee]. On receiving notice from a manufacturer or
labeler of the availability of a new product, the commission, to the
extent possible, shall schedule a review for the product at the next
regularly scheduled meeting of the board [committee].
(e) Section 531.073(b), Government Code, is amended to read
as follows:
(b) The commission shall establish procedures for the prior
authorization requirement under the Medicaid vendor drug program to
ensure that the requirements of 42 U.S.C. Section 1396r-8(d)(5) and
its subsequent amendments are met. Specifically, the procedures
must ensure that:
(1) a prior authorization requirement is not imposed
for a drug before the drug has been considered at a meeting of the
Drug Utilization Review Board [Pharmaceutical and Therapeutics
Committee established] under Section 531.0736 [531.074];
(2) there will be a response to a request for prior
authorization by telephone or other telecommunications device
within 24 hours after receipt of a request for prior authorization;
and
(3) a 72-hour supply of the drug prescribed will be
provided in an emergency or if the commission does not provide a
response within the time required by Subdivision (2).
(f) Section 531.0741, Government Code, is amended to read as
follows:
Sec. 531.0741. PUBLICATION OF INFORMATION REGARDING
COMMISSION DECISIONS ON PREFERRED DRUG LIST PLACEMENT. The
commission shall publish on the commission's Internet website any
decisions on preferred drug list placement, including:
(1) a list of drugs reviewed and the commission's
decision for or against placement on a preferred drug list of each
drug reviewed;
(2) for each recommendation, whether a supplemental
rebate agreement or a program benefit agreement was reached under
Section 531.070; and
(3) the rationale for any departure from a
recommendation of the Drug Utilization Review Board
[pharmaceutical and therapeutics committee established] under
Section 531.0736 [531.074].
(g) Section 531.074, Government Code, as amended by S.B.
219, Acts of the 84th Legislature, Regular Session, 2015, is
repealed.
(h) The term of a member serving on the Medicaid Drug
Utilization Review Board on January 1, 2016, expires on February
29, 2016. Not later than March 1, 2016, the executive commissioner
of the Health and Human Services Commission shall appoint the
initial members to the Drug Utilization Review Board in accordance
with Section 531.0736, Government Code, as added by this article,
for terms beginning March 1, 2016. In making the initial
appointments and notwithstanding Section 531.0736(e), Government
Code, as added by this article, the executive commissioner shall
designate as close to one-half as possible of the members to serve
for terms expiring March 1, 2018, and the remaining members to serve
for terms expiring March 1, 2020.
(i) Not later than February 1, 2016, and before making
initial appointments to the Drug Utilization Review Board as
provided by Subsection (h) of this section, the executive
commissioner of the Health and Human Services Commission shall
adopt and implement the application process required under Section
531.0736(c-1), Government Code, as added by this article.
(j) Not later than May 1, 2016, and except as provided by
Subsection (i) of this section, the executive commissioner of the
Health and Human Services Commission shall adopt or amend rules as
necessary to reflect the changes in law made to the Drug Utilization
Review Board under Section 531.0736, Government Code, as added by
this article, including rules that reflect the changes to the
board's functions and composition.
SECTION 2.09. The heading to Subchapter D, Chapter 531,
Government Code, is amended to read as follows:
SUBCHAPTER D. PLAN TO SUPPORT GUARDIANSHIPS [GUARDIANSHIP ADVISORY
BOARD]
SECTION 2.10. Section 531.124, Government Code, is amended
to read as follows:
Sec. 531.124. COMMISSION DUTIES. The [(a) With the advice
of the advisory board, the] commission shall develop and, subject
to appropriations, implement a plan to:
(1) ensure that each incapacitated individual in this
state who needs a guardianship or another less restrictive type of
assistance to make decisions concerning the incapacitated
individual's own welfare and financial affairs receives that
assistance; and
(2) foster the establishment and growth of local
volunteer guardianship programs.
[(b) The advisory board shall biennially review and comment
on the minimum standards adopted under Section 111.041 and the plan
implemented under Subsection (a) and shall include its conclusions
in the report submitted under Section 531.1235.]
SECTION 2.11. Section 531.907(a), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(a) Based on [the recommendations of the advisory committee
established under Section 531.904 and] feedback provided by
interested parties, the commission in stage two of implementing the
health information exchange system may expand the system by:
(1) providing an electronic health record for each
child enrolled in the child health plan program;
(2) including state laboratory results information in
an electronic health record, including the results of newborn
screenings and tests conducted under the Texas Health Steps
program, based on the system developed for the health passport
under Section 266.006, Family Code;
(3) improving data-gathering capabilities for an
electronic health record so that the record may include basic
health and clinical information in addition to available claims
information, as determined by the executive commissioner;
(4) using evidence-based technology tools to create a
unique health profile to alert health care providers regarding the
need for additional care, education, counseling, or health
management activities for specific patients; and
(5) continuing to enhance the electronic health record
created for each Medicaid recipient as technology becomes available
and interoperability capabilities improve.
SECTION 2.12. Section 531.909, Government Code, is amended
to read as follows:
Sec. 531.909. INCENTIVES. The commission [and the advisory
committee established under Section 531.904] shall develop
strategies to encourage health care providers to use the health
information exchange system, including incentives, education, and
outreach tools to increase usage.
SECTION 2.13. Section 533.00251(c), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(c) Subject to Section 533.0025 and notwithstanding any
other law, the commission[, in consultation with the advisory
committee,] shall provide benefits under Medicaid to recipients who
reside in nursing facilities through the STAR + PLUS Medicaid
managed care program. In implementing this subsection, the
commission shall ensure:
(1) that the commission is responsible for setting the
minimum reimbursement rate paid to a nursing facility under the
managed care program, including the staff rate enhancement paid to
a nursing facility that qualifies for the enhancement;
(2) that a nursing facility is paid not later than the
10th day after the date the facility submits a clean claim;
(3) the appropriate utilization of services
consistent with criteria established by the commission;
(4) a reduction in the incidence of potentially
preventable events and unnecessary institutionalizations;
(5) that a managed care organization providing
services under the managed care program provides discharge
planning, transitional care, and other education programs to
physicians and hospitals regarding all available long-term care
settings;
(6) that a managed care organization providing
services under the managed care program:
(A) assists in collecting applied income from
recipients; and
(B) provides payment incentives to nursing
facility providers that reward reductions in preventable acute care
costs and encourage transformative efforts in the delivery of
nursing facility services, including efforts to promote a
resident-centered care culture through facility design and
services provided;
(7) the establishment of a portal that is in
compliance with state and federal regulations, including standard
coding requirements, through which nursing facility providers
participating in the STAR + PLUS Medicaid managed care program may
submit claims to any participating managed care organization;
(8) that rules and procedures relating to the
certification and decertification of nursing facility beds under
Medicaid are not affected; and
(9) that a managed care organization providing
services under the managed care program, to the greatest extent
possible, offers nursing facility providers access to:
(A) acute care professionals; and
(B) telemedicine, when feasible and in
accordance with state law, including rules adopted by the Texas
Medical Board.
SECTION 2.14. Section 533.00253, Government Code, is
amended by amending Subsection (b), as amended by S.B. 219, Acts of
the 84th Legislature, Regular Session, 2015, and Subsection (f) to
read as follows:
(b) Subject to Section 533.0025, the commission shall, in
consultation with the [advisory committee and the] Children's
Policy Council established under Section 22.035, Human Resources
Code, establish a mandatory STAR Kids capitated managed care
program tailored to provide Medicaid benefits to children with
disabilities. The managed care program developed under this
section must:
(1) provide Medicaid benefits that are customized to
meet the health care needs of recipients under the program through a
defined system of care;
(2) better coordinate care of recipients under the
program;
(3) improve the health outcomes of recipients;
(4) improve recipients' access to health care
services;
(5) achieve cost containment and cost efficiency;
(6) reduce the administrative complexity of
delivering Medicaid benefits;
(7) reduce the incidence of unnecessary
institutionalizations and potentially preventable events by
ensuring the availability of appropriate services and care
management;
(8) require a health home; and
(9) coordinate and collaborate with long-term care
service providers and long-term care management providers, if
recipients are receiving long-term services and supports outside of
the managed care organization.
(f) The commission shall seek ongoing input from the
Children's Policy Council regarding the establishment and
implementation of the STAR Kids managed care program. This
subsection expires on the date the Children's Policy Council is
abolished under Section 22.035(n), Human Resources Code.
SECTION 2.15. Section 533.00254(f), Government Code, is
amended to read as follows:
(f) On the first anniversary of the date the commission
completes implementation of the STAR Kids Medicaid managed care
program under Section 533.00253 [September 1, 2016]:
(1) the advisory committee is abolished; and
(2) this section expires.
SECTION 2.16. Section 533.00256(a), Government Code, is
amended to read as follows:
(a) In consultation with [the Medicaid and CHIP
Quality-Based Payment Advisory Committee established under Section
536.002 and other] appropriate stakeholders with an interest in the
provision of acute care services and long-term services and
supports under the Medicaid managed care program, the commission
shall:
(1) establish a clinical improvement program to
identify goals designed to improve quality of care and care
management and to reduce potentially preventable events, as defined
by Section 536.001; and
(2) require managed care organizations to develop and
implement collaborative program improvement strategies to address
the goals.
SECTION 2.17. Section 534.053(g), Government Code, is
amended to read as follows:
(g) On the one-year anniversary of the date the commission
completes implementation of the transition required under Section
534.202 [January 1, 2024]:
(1) the advisory committee is abolished; and
(2) this section expires.
SECTION 2.18. Section 535.053, Government Code, is amended
by amending Subsection (a) and adding Subsection (a-1) to read as
follows:
(a) The interagency coordinating group for faith- and
community-based initiatives is composed of each faith- and
community-based liaison designated under Section 535.051 and a
liaison from the State Commission on National and Community
Service. [The commission shall provide administrative support to
the interagency coordinating group.]
(a-1) Service on the interagency coordinating group is an
additional duty of the office or position held by each person
designated as a liaison under Section 535.051(b). The state
agencies described by Section 535.051(b) shall provide
administrative support for the interagency coordinating group as
coordinated by the presiding officer.
SECTION 2.19. Sections 535.055(a) and (b), Government Code,
are amended to read as follows:
(a) The Texas Nonprofit Council is established to help
direct the interagency coordinating group in carrying out the
group's duties under this section. The state agencies of the
interagency coordinating group described by Section 535.051(b)
[commission] shall provide administrative support to the council as
coordinated by the presiding officer of the interagency
coordinating group.
(b) The governor [executive commissioner], in consultation
with the presiding officer of the interagency coordinating group,
shall appoint as members of the council two representatives from
each of the following groups and entities to represent each group's
and entity's appropriate sector:
(1) statewide nonprofit organizations;
(2) local governments;
(3) faith-based groups, at least one of which must be a
statewide interfaith group;
(4) community-based groups;
(5) consultants to nonprofit corporations; and
(6) statewide associations of nonprofit
organizations.
SECTION 2.20. Section 535.104(a), Government Code, is
amended to read as follows:
(a) The commission shall:
(1) contract with the State Commission on National and
Community Service to administer funds appropriated from the account
in a manner that:
(A) consolidates the capacity of and strengthens
national service and community and faith- and community-based
initiatives; and
(B) leverages public and private funds to benefit
this state;
(2) develop a competitive process to be used in
awarding grants from account funds that is consistent with state
law and includes objective selection criteria;
(3) oversee the delivery of training and other
assistance activities under this subchapter;
(4) develop criteria limiting awards of grants under
Section 535.105(1)(A) to small and medium-sized faith- and
community-based organizations that provide charitable services to
persons in this state;
(5) establish general state priorities for the
account;
(6) establish and monitor performance and outcome
measures for persons to whom grants are awarded under this
subchapter; and
(7) establish policies and procedures to ensure that
any money appropriated from the account to the commission that is
allocated to build the capacity of a faith-based organization or
for a faith-based initiative[, including money allocated for the
establishment of the advisory committee under Section 535.108,] is
not used to advance a sectarian purpose or to engage in any form of
proselytization.
SECTION 2.21. Section 536.001(20), Government Code, is
amended to read as follows:
(20) "Potentially preventable readmission" means a
return hospitalization of a person within a period specified by the
commission that may have resulted from deficiencies in the care or
treatment provided to the person during a previous hospital stay or
from deficiencies in post-hospital discharge follow-up. The term
does not include a hospital readmission necessitated by the
occurrence of unrelated events after the discharge. The term
includes the readmission of a person to a hospital for:
(A) the same condition or procedure for which the
person was previously admitted;
(B) an infection or other complication resulting
from care previously provided;
(C) a condition or procedure that indicates that
a surgical intervention performed during a previous admission was
unsuccessful in achieving the anticipated outcome; or
(D) another condition or procedure of a similar
nature, as determined by the executive commissioner [after
consulting with the advisory committee].
SECTION 2.22. Section 536.003(a), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(a) The commission[, in consultation with the advisory
committee,] shall develop quality-based outcome and process
measures that promote the provision of efficient, quality health
care and that can be used in the child health plan program and
Medicaid to implement quality-based payments for acute care
services and long-term services and supports across all delivery
models and payment systems, including fee-for-service and managed
care payment systems. Subject to Subsection (a-1), the commission,
in developing outcome and process measures under this section, must
include measures that are based on potentially preventable events
and that advance quality improvement and innovation. The
commission may change measures developed:
(1) to promote continuous system reform, improved
quality, and reduced costs; and
(2) to account for managed care organizations added to
a service area.
SECTION 2.23. Section 536.004(a), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(a) Using quality-based outcome and process measures
developed under Section 536.003 and subject to this section, the
commission, after consulting with [the advisory committee and
other] appropriate stakeholders with an interest in the provision
of acute care and long-term services and supports under the child
health plan program and Medicaid, shall develop quality-based
payment systems, and require managed care organizations to develop
quality-based payment systems, for compensating a physician or
other health care provider participating in the child health plan
program or Medicaid that:
(1) align payment incentives with high-quality,
cost-effective health care;
(2) reward the use of evidence-based best practices;
(3) promote the coordination of health care;
(4) encourage appropriate physician and other health
care provider collaboration;
(5) promote effective health care delivery models; and
(6) take into account the specific needs of the child
health plan program enrollee and Medicaid recipient populations.
SECTION 2.24. Section 536.006(a), Government Code, is
amended to read as follows:
(a) The commission [and the advisory committee] shall:
(1) ensure transparency in the development and
establishment of:
(A) quality-based payment and reimbursement
systems under Section 536.004 and Subchapters B, C, and D,
including the development of outcome and process measures under
Section 536.003; and
(B) quality-based payment initiatives under
Subchapter E, including the development of quality of care and
cost-efficiency benchmarks under Section 536.204(a) and efficiency
performance standards under Section 536.204(b);
(2) develop guidelines establishing procedures for
providing notice and information to, and receiving input from,
managed care organizations, health care providers, including
physicians and experts in the various medical specialty fields, and
other stakeholders, as appropriate, for purposes of developing and
establishing the quality-based payment and reimbursement systems
and initiatives described under Subdivision (1);
(3) in developing and establishing the quality-based
payment and reimbursement systems and initiatives described under
Subdivision (1), consider that as the performance of a managed care
organization or physician or other health care provider improves
with respect to an outcome or process measure, quality of care and
cost-efficiency benchmark, or efficiency performance standard, as
applicable, there will be a diminishing rate of improved
performance over time; and
(4) develop web-based capability to provide managed
care organizations and health care providers with data on their
clinical and utilization performance, including comparisons to
peer organizations and providers located in this state and in the
provider's respective region.
SECTION 2.25. Section 536.052(b), Government Code, is
amended to read as follows:
(b) The commission[, after consulting with the advisory
committee,] shall develop quality of care and cost-efficiency
benchmarks, including benchmarks based on a managed care
organization's performance with respect to reducing potentially
preventable events and containing the growth rate of health care
costs.
SECTION 2.26. Section 536.102(a), Government Code, is
amended to read as follows:
(a) Subject to this subchapter, the commission[, after
consulting with the advisory committee,] may develop and implement
quality-based payment systems for health homes designed to improve
quality of care and reduce the provision of unnecessary medical
services. A quality-based payment system developed under this
section must:
(1) base payments made to a participating enrollee's
health home on quality and efficiency measures that may include
measurable wellness and prevention criteria and use of
evidence-based best practices, sharing a portion of any realized
cost savings achieved by the health home, and ensuring quality of
care outcomes, including a reduction in potentially preventable
events; and
(2) allow for the examination of measurable wellness
and prevention criteria, use of evidence-based best practices, and
quality of care outcomes based on the type of primary or specialty
care provider practice.
SECTION 2.27. Section 536.152(a), Government Code, is
amended to read as follows:
(a) Subject to Subsection (b), using the data collected
under Section 536.151 and the diagnosis-related groups (DRG)
methodology implemented under Section 536.005, if applicable, the
commission[, after consulting with the advisory committee,] shall
to the extent feasible adjust child health plan and Medicaid
reimbursements to hospitals, including payments made under the
disproportionate share hospitals and upper payment limit
supplemental payment programs, based on the hospital's performance
with respect to exceeding, or failing to achieve, outcome and
process measures developed under Section 536.003 that address the
rates of potentially preventable readmissions and potentially
preventable complications.
SECTION 2.28. Section 536.202(a), Government Code, is
amended to read as follows:
(a) The commission shall[, after consulting with the
advisory committee,] establish payment initiatives to test the
effectiveness of quality-based payment systems, alternative
payment methodologies, and high-quality, cost-effective health
care delivery models that provide incentives to physicians and
other health care providers to develop health care interventions
for child health plan program enrollees or Medicaid recipients, or
both, that will:
(1) improve the quality of health care provided to the
enrollees or recipients;
(2) reduce potentially preventable events;
(3) promote prevention and wellness;
(4) increase the use of evidence-based best practices;
(5) increase appropriate physician and other health
care provider collaboration;
(6) contain costs; and
(7) improve integration of acute care services and
long-term services and supports, including discharge planning from
acute care services to community-based long-term services and
supports.
SECTION 2.29. Section 536.204(a), Government Code, is
amended to read as follows:
(a) The executive commissioner shall[:
[(1) consult with the advisory committee to] develop
quality of care and cost-efficiency benchmarks and measurable goals
that a payment initiative must meet to ensure high-quality and
cost-effective health care services and healthy outcomes[; and
[(2) approve benchmarks and goals developed as
provided by Subdivision (1)].
SECTION 2.30. Section 536.251(a), Government Code, is
amended to read as follows:
(a) Subject to this subchapter, the commission, after
consulting with [the advisory committee and other] appropriate
stakeholders representing nursing facility providers with an
interest in the provision of long-term services and supports, may
develop and implement quality-based payment systems for Medicaid
long-term services and supports providers designed to improve
quality of care and reduce the provision of unnecessary services. A
quality-based payment system developed under this section must base
payments to providers on quality and efficiency measures that may
include measurable wellness and prevention criteria and use of
evidence-based best practices, sharing a portion of any realized
cost savings achieved by the provider, and ensuring quality of care
outcomes, including a reduction in potentially preventable events.
SECTION 2.31. Section 538.052(a), Government Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(a) Subject to Subsection (b), the commission shall solicit
and accept suggestions for clinical initiatives, in either written
or electronic form, from:
(1) a member of the state legislature;
(2) the executive commissioner;
(3) the commissioner of aging and disability services;
(4) the commissioner of state health services;
(5) the commissioner of the Department of Family and
Protective Services;
(6) the commissioner of assistive and rehabilitative
services;
(7) the medical care advisory committee established
under Section 32.022, Human Resources Code; and
(8) the physician payment advisory committee created
under Section 32.022(d), Human Resources Code[; and
[(9) the Electronic Health Information Exchange
System Advisory Committee established under Section 531.904].
SECTION 2.32. Section 22.035, Human Resources Code, is
amended by adding Subsection (n) to read as follows:
(n) The work group is abolished and this section expires
September 1, 2017.
SECTION 2.33. (a) Section 32.022(b), Human Resources
Code, as amended by S.B. 219, Acts of the 84th Legislature, Regular
Session, 2015, is amended to read as follows:
(b) The executive commissioner shall appoint the committee
in compliance with the requirements of the federal agency
administering medical assistance. The appointments shall:
(1) provide for a balanced representation of the
general public, providers, consumers, and other persons, state
agencies, or groups with knowledge of and interest in the
committee's field of work; and
(2) include one member who is the representative of a
managed care organization.
(b) Not later than January 1, 2016, the executive
commissioner of the Health and Human Services Commission shall
appoint an additional member to the medical care advisory committee
in accordance with Section 32.022(b)(2), Human Resources Code, as
added by this article.
SECTION 2.34. Section 32.0641(a), Human Resources Code, as
amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
2015, is amended to read as follows:
(a) To the extent permitted under and in a manner that is
consistent with Title XIX, Social Security Act (42 U.S.C. Section
1396 et seq.) and any other applicable law or regulation or under a
federal waiver or other authorization, the executive commissioner
shall adopt[, after consulting with the Medicaid and CHIP
Quality-Based Payment Advisory Committee established under Section
536.002, Government Code,] cost-sharing provisions that encourage
personal accountability and appropriate utilization of health care
services, including a cost-sharing provision applicable to a
recipient who chooses to receive a nonemergency medical service
through a hospital emergency room.
SECTION 2.35. Section 1352.004(b), Insurance Code, is
amended to read as follows:
(b) The commissioner by rule shall require a health benefit
plan issuer to provide adequate training to personnel responsible
for preauthorization of coverage or utilization review under the
plan. The purpose of the training is to prevent denial of coverage
in violation of Section 1352.003 and to avoid confusion of medical
benefits with mental health benefits. The commissioner[, in
consultation with the Texas Traumatic Brain Injury Advisory
Council,] shall prescribe by rule the basic requirements for the
training described by this subsection.
SECTION 2.36. Section 1352.005(b), Insurance Code, is
amended to read as follows:
(b) The commissioner[, in consultation with the Texas
Traumatic Brain Injury Advisory Council,] shall prescribe by rule
the specific contents and wording of the notice required under this
section.
SECTION 2.37. (a) Section 162.309, Family Code, as amended
by S.B. 219, Acts of the 84th Legislature, Regular Session, 2015, is
repealed.
(b) The following provisions of the Government Code,
including provisions amended by S.B. 219, Acts of the 84th
Legislature, Regular Session, 2015, are repealed:
(1) Section 531.0217(j);
(2) Section 531.02172;
(3) Section 531.02173(c);
(4) Section 531.052;
(5) Section 531.0571;
(6) Section 531.068;
(7) Sections 531.121(1), (5), and (6);
(8) Section 531.122;
(9) Section 531.123;
(10) Section 531.1235;
(11) Subchapters R and T, Chapter 531;
(12) Section 531.904;
(13) Section 533.00251(a)(1);
(14) Section 533.00252;
(15) Sections 533.00255(e) and (f);
(16) Section 533.00285;
(17) Subchapters B and C, Chapter 533;
(18) Section 535.055(f);
(19) Section 535.108;
(20) Section 536.001(1);
(21) the heading to Section 536.002;
(22) Sections 536.002(a) and (c);
(23) Section 536.002(b), as amended by Article 1 of
this Act; and
(24) Section 536.007(b).
(c) The following provisions of the Health and Safety Code,
including provisions amended by S.B. 219, Acts of the 84th
Legislature, Regular Session, 2015, are repealed:
(1) Subchapter C, Chapter 32;
(2) Section 62.151(e);
(3) Section 62.1571(c);
(4) Section 81.010;
(5) Section 92.011;
(6) Subchapter B, Chapter 92; and
(7) Chapter 115.
(d) Section 32.022(e), Human Resources Code, as amended by
S.B. 219, Acts of the 84th Legislature, Regular Session, 2015, and
Section 40.073, Human Resources Code, are repealed.
SECTION 2.38. On the effective date of this article, the
following advisory committees are abolished:
(1) the advisory committee on Medicaid and child
health plan program rate and expenditure disparities;
(2) the Advisory Committee on Qualifications for
Health Care Translators and Interpreters;
(3) the Behavioral Health Integration Advisory
Committee;
(4) the Consumer Direction Work Group;
(5) the Council on Children and Families;
(6) the Electronic Health Information Exchange System
Advisory Committee;
(7) the Guardianship Advisory Board;
(8) the hospital payment advisory committee;
(9) the Interagency Coordinating Council for HIV and
Hepatitis;
(10) the Medicaid and CHIP Quality-Based Payment
Advisory Committee;
(11) each Medicaid managed care advisory committee
appointed for a health care service region under Subchapter B,
Chapter 533, Government Code;
(12) the Public Assistance Health Benefit Review and
Design Committee;
(13) the renewing our communities account advisory
committee;
(14) the STAR + PLUS Nursing Facility Advisory
Committee;
(15) the STAR + PLUS Quality Council;
(16) the state Medicaid managed care advisory
committee;
(17) the task force on domestic violence;
(18) the Interagency Task Force for Children With
Special Needs;
(19) the telemedicine and telehealth advisory
committee;
(20) the board of directors of the Texas Institute of
Health Care Quality and Efficiency;
(21) the Texas Traumatic Brain Injury Advisory
Council; and
(22) the volunteer advocate program advisory
committee.
SECTION 2.39. (a) Not later than November 1, 2015, the
executive commissioner of the Health and Human Services Commission
shall publish in the Texas Register:
(1) a list of the new advisory committees established
or to be established as a result of this article, including the
advisory committees required under Section 531.012(a), Government
Code, as amended by this article; and
(2) a list that identifies the advisory committees
listed in Section 2.40 of this article:
(A) that will not be continued in any form; or
(B) whose functions will be assumed by a new
advisory committee established under Section 531.012(a),
Government Code, as amended by this article.
(b) The executive commissioner of the Health and Human
Services Commission shall ensure that an advisory committee
established under Section 531.012(a), Government Code, as amended
by this article, begins operations immediately on its establishment
to ensure ongoing public input and engagement.
(c) This section takes effect September 1, 2015.
SECTION 2.40. Except as otherwise provided by this article,
this article takes effect January 1, 2016.
ARTICLE 3. TRANSITION, FEDERAL AUTHORIZATION, AND GENERAL
EFFECTIVE DATE
SECTION 3.01. If an entity that is abolished by this Act has
property, records, or other assets, the Health and Human Services
Commission shall take custody of the entity's property, records, or
other assets.
SECTION 3.02. 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 3.03. Except as otherwise provided by this Act,
this Act takes effect September 1, 2015.
______________________________ ______________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 277 passed the Senate on
April 9, 2015, by the following vote: Yeas 31, Nays 0; and that
the Senate concurred in House amendments on May 29, 2015, by the
following vote: Yeas 30, Nays 1.
______________________________
Secretary of the Senate
I hereby certify that S.B. No. 277 passed the House, with
amendments, on May 26, 2015, by the following vote: Yeas 146,
Nays 0, two present not voting.
______________________________
Chief Clerk of the House
Approved:
______________________________
Date
______________________________
Governor