SB2628 - Relating to the provision and evaluation of Medicaid reimbursement for dental services provided to certain Medicaid recipients.

  89R14175 JG-D     By: Blanco S.B. No. 2628       A BILL TO BE ENTITLED   AN ACT   relating to the provision and evaluation of Medicaid reimbursement   for dental services provided to certain Medicaid recipients.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 32.054, Human Resources Code, is amended   by adding Subsections (g) and (h) to read as follows:           (g)     In addition to dental services already covered under the   medical assistance program, the commission shall provide medical   assistance reimbursement for recipients who are 21 years of age or   older, including recipients with a disability, for dental services   needed for pain relief, infections, restoration of teeth, and   maintenance of dental health, including:                 (1)  preventative services; and                 (2)     therapeutic services for dental disease that, if   left untreated, may become acute dental problems or may cause   irreversible damage to the teeth or supporting structures.           (h)     Notwithstanding Subsection (g), the commission may not   provide medical assistance reimbursement for the provision of   dental services under that subsection if, based on the data   evaluated under Section 32.0545, the Legislative Budget Board finds   that the provision of medical assistance reimbursement for those   services resulted in an increase in overall spending under the   medical assistance program.          SECTION 2.  Subchapter B, Chapter 32, Human Resources Code,   is amended by adding Section 32.0545 to read as follows:           Sec.   32.0545.     EVALUATION OF REIMBURSEMENT FOR CERTAIN   DENTAL SERVICES. (a)   The commission shall:                 (1)     analyze data related to the provision of medical   assistance reimbursement for dental services provided to   recipients under Section 32.054(g); and                 (2)     provide to the Legislative Budget Board the data   described by Subdivision (1) in the form and manner the board   requires.           (b)     The data analyzed by the commission and provided to the   Legislative Budget Board under Subsection (a) must:                 (1)     relate to three consecutive years, beginning with   the year immediately preceding the year in which medical assistance   reimbursement for the provision of dental services under Section   32.054(g) is initially provided; and                 (2)  include at least the following:                       (A)     the number of recipients who received those   dental services; and                       (B)     the type of dental services for which medical   assistance reimbursement was provided.           (c)     The commission shall ensure the analysis under   Subsection (a) includes:                 (1)     appropriate demographic categories, including   recipient age, disability, and income; and                 (2)     the average cost per recipient for providing   dental services under the medical assistance program.           (d)     Using the data the commission provides under Subsection   (a), the Legislative Budget Board shall evaluate cost and   utilization trends to determine whether providing medical   assistance reimbursement for the provision of dental services to   recipients under Section 32.054(g) resulted in an increase in   overall spending on the provision of dental services under the   medical assistance program.           (e)     Not later than February 1, 2029, the Legislative Budget   Board shall:                 (1)     prepare and publish on the board's Internet   website a written report of its evaluation under Subsection (d);   and                   (2)     publish a summary of its findings, including a   specific finding regarding whether providing medical assistance   reimbursement for the provision of dental services to recipients   under Section 32.054(g) resulted in an increase in overall spending   on the provision of dental services under the medical assistance   program.           (f)     The Legislative Budget Board shall provide to the   commission a draft of the report described by Subsection (e)(1) not   later than the 30th day before the date the board publishes the   report on the board's Internet website.           (g)  If the Legislative Budget Board finds that:                 (1)     providing medical assistance reimbursement for   the provision of dental services under Section 32.054(g) resulted   in an increase in overall spending on the provision of dental   services under the medical assistance program:                       (A)     the commission shall immediately discontinue   providing reimbursement for those services; and                       (B)     Sections 32.054(g) and (h) and this section   expire; or                 (2)     providing medical assistance reimbursement for   the provision of dental services under Section 32.054(g) did not   result in an increase in overall spending on the provision of dental   services under the medical assistance program, Section 32.054(h)   and this section expire.          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, 2025.