Highlights 77th Texas Legislature - Senate

HEALTH AND HUMAN
SERVICES
CHIP
ERVICES/Medicaid /Medicaid and
77 th Texas Legislature
improve the rate-setting methodologies. The report must be delivered to the commissioner and legislature.
Sets out what the task force must consider in preparing the report.
Requires the task force to continue to monitor the information evaluated in the report and submit another
report with any additional recommendations to the commissioner and legislature not later than December 1,
2004.
Operation of Statewide Rural Health Care System - S.B. 1394
by Senators Fraser and Madla
House Sponsor: Representative Hawley
The statewide rural health care system (RHCS) is the state-designated rural health care system. The
system has coordinated with private sector program partners to create a model for a viable rural health care
system. Allowing RHCS to participate in a voluntary Medicaid demonstration could enable RHCS to
implement the model, which emphasizes preventive care, disease management, care coordination, and
quality improvement and which could extend health care services to uninsured individuals who live in rural
communities.
Authorizes the commissioner of health and human services to use RHCS for a voluntary pilot or
demonstration program that evaluates the use of an insured model for beneficiaries of a medical assistance
program in a rural area that is not currently included in an existing Medicaid managed care pilot program
area and that incorporates the principles of prevention and disease management and for a study of the use
of promotoras.
Provides that if RHCS seeks to sponsor, arrange for, or provide such health care services under a private
or commercial program, RHCS must comply with all requirements under the Insurance Code imposed on
health plans, including health maintenance organizations.
Preventing Fraud in Medicaid Dental Services - S.B. 1411
by Senator Moncrief
House Sponsors: Representative Maxey, et al.
Prohibits providing a dental service or product under the medical assistance program (program) unless
there is a dental necessity for the service or product.
Requires the Health and Human Services Commission (HHSC) or an agency operating part of the program,
in providing dental services under the program, to:
• ensure that stainless steel crowns are not used as preventive measures;
• require a dentist participating in the program to document the dental necessity before applying
such a crown;
Senate Research Center 145