SB2192 - Relating to state fiscal matters.

  89R12506 CS-D     By: Huffman S.B. No. 2192       A BILL TO BE ENTITLED   AN ACT   relating to state fiscal matters.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:   ARTICLE 1. STATE FISCAL MATTERS RELATED TO HEALTH AND HUMAN   SERVICES AGENCIES AND STATE AGENCIES ADMINISTERING HEALTH AND HUMAN   SERVICES PROGRAMS          SECTION 1.01.  (a) This section applies to any state agency   that receives an appropriation under Article II of the General   Appropriations Act and to any program administered by any of those   agencies.          (b)  Notwithstanding any other statute of this state, each   state agency to which this section applies is authorized to reduce   or recover expenditures by:                (1)  consolidating any reports or publications the   agency is required to make and filing or delivering any of those   reports or publications exclusively by electronic means;                (2)  extending the effective period of any license,   permit, or registration the agency grants or administers;                (3)  entering into a contract with another governmental   entity or with a private vendor to carry out any of the agency's   duties;                (4)  adopting additional eligibility requirements   consistent with federal law for persons who receive benefits under   any law the agency administers to ensure that those benefits are   received by the most deserving persons consistent with the purposes   for which the benefits are provided, including under the following   laws:                      (A)  Chapter 62, Health and Safety Code (child   health plan program);                      (B)  Chapter 31, Human Resources Code (Temporary   Assistance for Needy Families program);                      (C)  Chapter 32, Human Resources Code (Medicaid   program);                      (D)  Chapter 33, Human Resources Code   (supplemental nutrition assistance and other nutritional   assistance programs);                      (E)  Chapter 540, Government Code, as effective   April 1, 2025 (Medicaid managed care); and                      (F)  Chapter 540A, Government Code, as effective   April 1, 2025 (Medicaid Managed Transportation Services);                (5)  providing that any communication between the   agency and another person and any document required to be delivered   to or by the agency, including any application, notice, billing   statement, receipt, or certificate, may be made or delivered by   e-mail or through the Internet; and                (6)  modifying and streamlining processes used in:                      (A)  the conduct of eligibility determinations   for programs listed in Subdivision (4) of this subsection by or   under the direction of the Health and Human Services Commission;                      (B)  the provision of child and adult protective   services by the Department of Family and Protective Services;                      (C)  the provision of community health services,   consumer protection services, and mental health services by the   Department of State Health Services; and                      (D)  the provision or administration of other   services provided or programs operated by the Health and Human   Services Commission or a health and human services agency, as   defined by Section 521.0001, Government Code, as effective April 1,   2025.          SECTION 1.02.  Subchapter O, Chapter 540, Government Code,   as effective April 1, 2025, is amended by adding Sections 540.0715,   540.0716, and 540.0717 to read as follows:           Sec.   540.0715.     CARE COORDINATION BENEFITS.   (a)   In this   section, "care coordination" means assisting recipients to develop   a plan of care, including a service plan, that meets the recipient's   needs and coordinating the provision of Medicaid benefits in a   manner that is consistent with the plan of care. The term is   synonymous with "case management," "service coordination," and   "service management."           (b)     The commission shall streamline and clarify the   provision of care coordination benefits across Medicaid programs   and services for recipients receiving benefits under a managed care   delivery model. In streamlining and clarifying the provision of   care coordination benefits under this section, the commission shall   at a minimum:                 (1)     subject to Subsection (c), establish a process for   determining and designating a single entity as the primary entity   responsible for a recipient's care coordination;                 (2)     evaluate and eliminate duplicative services   intended to achieve recipient care coordination, including care   coordination or related benefits provided:                       (A)  by a Medicaid managed care organization;                       (B)  by a recipient's medical or health home;                       (C)     through a disease management program   provided by a Medicaid managed care organization;                         (D)     by a provider of targeted case management and   psychiatric rehabilitation services; and                       (E)     through a program of case management for   high-risk pregnant women and high-risk children established under   Section 22.0031, Human Resources Code;                 (3)     evaluate and, if the commission determines it   appropriate, modify the capitation rate paid to Medicaid managed   care organizations to account for the provision of care   coordination benefits by a person not affiliated with the   organization; and                 (4)     establish and use a consistent set of terms for   care coordination provided under a managed care delivery model.           (c)     In establishing a process under Subsection (b)(1), the   commission shall ensure that:                 (1)     for a recipient who receives targeted case   management and psychiatric rehabilitation services, the default   entity to act as the primary entity responsible for the recipient's   care coordination under Subsection (b)(1) is the provider of   targeted case management and psychiatric rehabilitation services;   and                 (2)     for recipients other than those described by   Subdivision (1), the process includes an evaluation process   designed to identify the provider that would best meet the care   coordination needs of a recipient and that the commission   incorporates into Medicaid managed care program contracts.           Sec.   540.0716.     CARE COORDINATOR CASELOAD STANDARDS. (a)   In this section:                 (1)     "Care coordination" has the meaning assigned by   Section 540.0715.                 (2)     "Care coordinator" means a person, including a   case manager, engaged by a Medicaid managed care organization to   provide care coordination benefits.           (b)     The executive commissioner by rule shall establish   caseload standards for care coordinators providing care   coordination under the STAR+PLUS home and community-based services   supports (HCBS) program.           (c)     The executive commissioner by rule may, if the executive   commissioner determines it appropriate, establish caseload   standards for care coordinators providing care coordination under   Medicaid programs other than the STAR+PLUS home and community-based   services supports (HCBS) program.           (d)     In determining whether to establish caseload standards   for a Medicaid program under Subsection (c), the executive   commissioner shall consider whether implementing the standards   would improve:                 (1)     Medicaid managed care organization contract   compliance;                 (2)     the quality of care coordination provided under   the program;                 (3)  recipient health outcomes; and                 (4)     transparency regarding the availability of care   coordination benefits to recipients and interested stakeholders.           Sec. 540.0717.  INFORMATION SHARING. (a) In this section:                 (1)     "Care coordination" has the meaning assigned by   Section 540.0715.                 (2)     "Care coordinator" has the meaning assigned by   Section 540.0716.           (b)     To the extent permitted under applicable federal and   state law enacted to protect the confidentiality and privacy of   patients' health information, Medicaid managed care organizations   shall ensure the sharing of information, including recipient   medical records, among care coordinators and health care providers   as appropriate to provide care coordination benefits. For purposes   of implementing this section, a Medicaid managed care organization   may allow a care coordinator to share a recipient's service plan   with health care providers, subject to the limitations of this   section.          SECTION 1.03.  Subchapter B, Chapter 137, Human Resources   Code, is amended by adding Section 137.061 to read as follows:           Sec.   137.061.     GEOGRAPHIC RISK MAPPING FOR PREVENTION AND   EARLY INTERVENTION SERVICES. (a) The commission shall use   existing risk terrain modeling systems, predictive analytics, or   geographic risk assessments to:                 (1)     identify geographic areas that have high risk   indicators of child maltreatment and child fatalities resulting   from abuse or neglect; and                 (2)     target the implementation and use of prevention   and early intervention services to those geographic areas.           (b)     The commission may not use data gathered under this   section to identify a specific family or individual.          SECTION 1.04.  If before implementing any provision of this   article 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 1.05.  This article takes effect September 1, [Text truncated for display. 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