Bill Text: TX SB72 | 2011-2012 | 82nd Legislature | Engrossed
Bill Title: Relating to streamlining of and utilization management in Medicaid long-term care waiver programs.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Engrossed - Dead) 2011-05-18 - No action taken in committee [SB72 Detail]
Download: Texas-2011-SB72-Engrossed.html
By: Nelson | S.B. No. 72 |
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relating to streamlining of and utilization management in Medicaid | ||
long-term care waiver programs. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 161.077, Human Resources Code, as added | ||
by Chapter 759 (S.B. 705), Acts of the 81st Legislature, Regular | ||
Session, 2009, is redesignated as Section 161.081, Human Resources | ||
Code, and amended to read as follows: | ||
Sec. 161.081 [ |
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PROGRAMS: STREAMLINING AND UNIFORMITY. (a) In this section, | ||
"Section 1915(c) waiver program" has the meaning assigned by | ||
Section 531.001, Government Code. | ||
(b) The department, in consultation with the commission, | ||
shall streamline the administration of and delivery of services | ||
through Section 1915(c) waiver programs. In implementing this | ||
subsection, the department, subject to Subsection (c), may consider | ||
implementing the following streamlining initiatives: | ||
(1) reducing the number of forms used in administering | ||
the programs; | ||
(2) revising program provider manuals and training | ||
curricula; | ||
(3) consolidating service authorization systems; | ||
(4) eliminating any physician signature requirements | ||
the department considers unnecessary; | ||
(5) standardizing individual service plan processes | ||
across the programs; [ |
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(6) if feasible: | ||
(A) concurrently conducting program | ||
certification and billing audit and review processes and other | ||
related audit and review processes; | ||
(B) streamlining other billing and auditing | ||
requirements; | ||
(C) eliminating duplicative responsibilities | ||
with respect to the coordination and oversight of individual care | ||
plans for persons receiving waiver services; and | ||
(D) streamlining cost reports and other cost | ||
reporting processes; and | ||
(7) any other initiatives that will increase | ||
efficiencies in the programs. | ||
(c) The department shall ensure that actions taken under | ||
Subsection (b) [ |
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of the commission under Section 531.0218, Government Code. | ||
(d) The department and the commission shall jointly explore | ||
the development of uniform licensing and contracting standards that | ||
would: | ||
(1) apply to all contracts for the delivery of Section | ||
1915(c) waiver program services; | ||
(2) promote competition among providers of those | ||
program services; and | ||
(3) integrate with other department and commission | ||
efforts to streamline and unify the administration and delivery of | ||
the program services, including those required by this section or | ||
Section 531.0218, Government Code. | ||
SECTION 2. Subchapter D, Chapter 161, Human Resources Code, | ||
is amended by adding Section 161.082 to read as follows: | ||
Sec. 161.082. LONG-TERM CARE MEDICAID WAIVER PROGRAMS: | ||
UTILIZATION REVIEW. (a) In this section, "Section 1915(c) waiver | ||
program" has the meaning assigned by Section 531.001, Government | ||
Code. | ||
(b) The department shall perform utilization review of | ||
services in all Section 1915(c) waiver programs. The utilization | ||
review must include reviewing program recipients' levels of care | ||
and any plans of care for those recipients that exceed service level | ||
thresholds established in the applicable waiver program | ||
guidelines. | ||
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, 2011. |