87(R) HB 133 - Enrolled version - Bill Text

	H.B.  No.  133

	AN ACT
	relating to the provision of certain benefits under Medicaid and
	the Healthy Texas Women program, including the transition of case
	management for children and pregnant women program services and
	Healthy Texas Women program services to a managed care program.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION  1.    Subchapter A, Chapter 533, Government Code, is
	amended by adding Section 533.002555 to read as follows:
	Sec.  533.002555.    TRANSITION OF CASE MANAGEMENT FOR CHILDREN
	AND PREGNANT WOMEN PROGRAM RECIPIENTS TO MANAGED CARE PROGRAM. (a)
	In this section, "children and pregnant women program" means the
	benefits program provided under Medicaid and administered by the
	Department of State Health Services that provides case management
	services to children who have a health condition or health risk and
	pregnant women who have a high-risk condition.
	(b)    The commission shall transition to a Medicaid managed
	care model all case management services provided to recipients
	under the children and pregnant women program. In transitioning
	services under this section, the commission shall ensure a
	recipient is provided case management services through the managed
	care plan in which the recipient is enrolled.
	(c)    In implementing this section, the commission shall
	ensure:
	(1)    a seamless transition in case management for
	recipients receiving benefits under the children and pregnant women
	program; and
	(2)    case management services provided under the
	program are not interrupted.
	SECTION  2.    Subchapter F, Chapter 32, Health and Safety
	Code, is amended by amending Section 32.152 and adding Sections
	32.156 and 32.157 to read as follows:
	Sec.  32.152.    [ASSESSING] PROVISION OF HEALTHY TEXAS WOMEN
	PROGRAM SERVICES THROUGH MANAGED CARE. (a) The commission shall
	contract [assess:
	[(1)    the feasibility and cost-effectiveness of
	contracting] with Medicaid managed care organizations to provide
	Healthy Texas Women program services [through managed care in one
	or more health care service regions in this state if the Healthy
	Texas Women Section 1115 Demonstration Waiver is approved; and
	[(2)    the potential impact of that delivery model on
	women receiving services under the program].
	(b)    In implementing this section, the commission shall:
	(1)    consult with the state Medicaid managed care
	advisory committee before contracting with Medicaid managed care
	organizations to provide Healthy Texas Women program services under
	this section;
	(2)    identify barriers that prevent women from
	obtaining Healthy Texas Women program services and seek
	opportunities to mitigate those barriers; and
	(3)    designate Healthy Texas Women program service
	providers as significant traditional providers until at least the
	third anniversary of the date the commission initially contracts
	with Medicaid managed care organizations to provide program
	services. [This section expires September 1, 2021.]
	Sec.  32.156.    INFORMATION ABOUT AVAILABILITY OF SUBSIDIZED
	HEALTH INSURANCE COVERAGE. (a)  The commission and each managed
	care organization participating in the Healthy Texas Women program
	shall provide a written notice containing information about
	eligibility requirements for and enrollment in a health benefit
	plan for which an enrollee receives a premium subsidy under the
	Patient Protection and Affordable Care Act (Pub. L. No.  111-148),
	based on family income, to a woman who:
	(1)    is enrolled in the Healthy Texas Women program;
	and
	(2)    has a household income that is more than 100
	percent but not more than 200 percent of the federal poverty level.
	(b)    The commission, in consultation with the Texas
	Department of Insurance, shall develop the form and content of the
	notice required under this section.  The notice must include:
	(1)    the latest information written in clear and easily
	understood language on available options for obtaining a subsidized
	health benefit plan described by Subsection (a); and
	(2)    resources for receiving assistance applying for
	and enrolling in that health benefit plan.
	Sec.  32.157.    ASSESSING AUTOMATIC ENROLLMENT OF CERTAIN