HB5152 - Relating to Medicaid reimbursement for services provided to certain recipients under a nurse home visiting program.

      By: Rose H.B. No. 5152       A BILL TO BE ENTITLED   AN ACT   relating to Medicaid reimbursement for services provided to certain   recipients under a nurse home visiting program.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Subchapter B, Chapter 32, Human Resources Code,   is amended by adding Section 32.02482 to read as follows:           Sec.   32.02482.     REIMBURSEMENT FOR SERVICES PROVIDED UNDER   NURSE HOME VISITING PROGRAM. (a)   In this section:                 (1)     "Nurse home visiting program" means a program   that:                       (A)     provides through a registered nurse weekly or   monthly pregnancy- and postpartum-related services to certain   individuals primarily in the home;                       (B)     offers individualized health and education   services to promote healthy birth outcomes and positive child   health and development outcomes; and                       (C)  conforms to a nurse home visit model that:                             (i)     is research-based and grounded in   empirical knowledge;                             (ii)     is associated with a national   organization, higher education institution, or other organization   with comprehensive home visit program standards to ensure superior   service delivery and program improvement; and                             (iii)     satisfies evidence of effectiveness   criteria based on a Home Visiting Evidence of Effectiveness review   administered by the United States Department of Health and Human   Services.                 (2)     "Recipient" means a medical assistance program   recipient.           (b)     The commission shall provide medical assistance   reimbursement to a provider who provides services under a nurse   home visiting program to a recipient who:                 (1)  is pregnant;                 (2)  is not more than 24 months postpartum; or                 (3)  is a child 24 months of age or younger.           (c)     The executive commissioner by rule shall establish a   bundled medical assistance program reimbursement rate for the   reimbursement of services provided to a recipient under a nurse   home visiting program, including education, screening, counseling,   and resource referral services related to:                 (1)  healthy pregnancy;                 (2)  child development;                 (3)  diet and nutrition;                 (4)  stress management;                 (5)  sexually transmitted diseases;                 (6)  tobacco use screening and cessation;                 (7)  alcohol and substance use;                 (8)  antenatal and postpartum depression;                 (9)  domestic and intimate partner violence;                 (10)  breastfeeding support;                 (11)     annual well woman visits and recommended   preventive services;                 (12)  maternal-infant safety assessment;                 (13)     postpartum recovery, family planning, and   newborn needs;                 (14)  selection of a primary care provider;                 (15)     development of parenting skills, parent-child   relationship building, and confidence building;                 (16)     child development screening at major   developmental milestones from birth to two years of age;                 (17)     maternal vitals sign screening, including blood   pressure;                 (18)  well newborn care; and                 (19)     facilitation of access to community or other   resources, including:                       (A)  transportation;                       (B)  housing; and                       (C)  assistance under:                             (i)     the child health plan program under   Chapters 62 and 63, Health and Safety Code;                             (ii)     the financial assistance program under   Chapter 31;                             (iii)     the nutritional assistance programs   under Chapter 33, including the supplemental nutrition assistance   program under that chapter; and                             (iv)     any other public assistance program   the commission administers.           (d)     If a recipient described by Subsection (b) becomes   ineligible for medical assistance, the managed care organization   through which the recipient received benefits under the medical   assistance program shall coordinate with the nurse home visiting   program providing services to the recipient to:                 (1)     arrange for the transfer of the recipient's plan of   care; and                 (2)     ensure the recipient continues to receive coverage   for the nurse home visiting program services.           (e)     Any telehealth services provided to a recipient under a   nurse home visiting program must be provided in a manner that   complies with telehealth requirements the commission establishes.          SECTION 2.  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 3.  This Act takes effect September 1, 2025.