HB4760 - Relating to Medicaid reimbursement for the costs of cognitive assessment and care planning services provided to certain patients.

  89R15290 LRM-F     By: Thompson H.B. No. 4760       A BILL TO BE ENTITLED   AN ACT   relating to Medicaid reimbursement for the costs of cognitive   assessment and care planning services provided to certain patients.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Subchapter D, Chapter 532, Government Code, as   effective April 1, 2025, is amended by adding Section 532.0158 to   read as follows:           Sec.   532.0158.     REIMBURSEMENT SYSTEM FOR COGNITIVE CARE   PLANNING. (a) The executive commissioner by rule shall develop and   the commission shall implement a system to provide Medicaid   reimbursement to a health care provider, including a physician, for   the assessment of and care planning services provided to patients   with a cognitive impairment, including dementia or Alzheimer's   disease.           (b)     To be eligible for reimbursement under this section, the   health care provider's care planning services must include:                 (1)     assessment of the patient's cognition, function,   and safety;                 (2)     an evaluation of the patient's neuropsychiatric   and behavioral symptoms;                 (3)  a review of the patient's medications;                 (4)  a needs assessment for the patient's caregiver;                 (5)     a comprehensive clinical visit for the patient;   and                 (6)  a complete written care plan for the patient.           (c)     The executive commissioner shall prepare and seek a   waiver to the state Medicaid plan under Section 1115 of the Social   Security Act (42 U.S.C. Section 1315) or other applicable federal   law to obtain any federal money available for implementing the   system to assist eligible individuals in obtaining care planning   services.          SECTION 2.  (a) As soon as practicable after the effective   date of this Act, the executive commissioner of the Health and Human   Services Commission shall adopt the rules necessary to implement   Section 532.0158, Government Code, as added by this Act.          (b)  As soon as practicable after the effective date of this   Act, the executive commissioner of the Health and Human Services   Commission shall apply for and actively pursue from the federal   Centers for Medicare and Medicaid Services or another appropriate   federal agency the waiver required by Section 532.0158, Government   Code, as added by this Act. The commission may delay implementing   Section 532.0158, Government Code, until the waiver applied for   under this section is granted.          SECTION 3.  This Act takes effect September 1, 2025.