bill letting Medicaid plans offer meals instead of other services

The text as introduced · 913 words

89R5364 SCF-F

By: Johnson
S.B. No. 1661

A BILL TO BE ENTITLED

AN ACT

relating to the provision of nutrition support services to Medicaid

recipients in lieu of other state Medicaid plan services and a

report on the health outcomes of providing those services.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 540.0272, Government Code, as effective

April 1, 2025, is amended to read as follows:

Sec. 540.0272. CERTAIN SERVICES PERMITTED IN LIEU OF STATE

MEDICAID PLAN SERVICES [ OTHER MENTAL HEALTH OR SUBSTANCE USE

DISORDER SERVICES ]; ANNUAL REPORT. (a) A contract to which this

subchapter applies must contain language permitting the

contracting Medicaid managed care organization to offer recipients

enrolled in the organization's managed care plan medically

appropriate, cost-effective, evidence-based mental health or

substance use services or, subject to Section 540.02721, nutrition

support services from a list of services approved by the commission

[ state Medicaid managed care advisory committee ] and included in

the contract as services the organization may provide recipients in

lieu of [ mental health or substance use disorder ] services

specified in the state Medicaid plan. A recipient is not required

to use a service from the list included in the contract in lieu of a

[ another mental health or substance use disorder ] service specified

in the state Medicaid plan.

(b) The commission shall:

(1) not later than November 1 of each year, prepare and

submit to the legislature a [ an annual ] report on the number of

times during the preceding year a service from the list included in

the contract is used; and

(2) consider the actual cost and use of any services

from the list included in the contract that are offered by a

Medicaid managed care organization when setting the capitation

rates for that organization under the contract.

SECTION 2. Subchapter F, Chapter 540, Government Code, as

effective April 1, 2025, is amended by adding Section 540.02721 to

read as follows:

Sec. 540.02721. NUTRITION SUPPORT SERVICES; BIENNIAL

REPORT. (a) In this section:

(1) "Community-based nutrition support organization"

means an organization that:

(A) provides nutrition support services;

(B) has an established agreement with a health

care provider to implement nutrition support services under this

section; and

(C) employs:

(i) at least one registered dietitian

nutritionist;

(ii) culinary personnel; and

(iii) support personnel capable of

providing patient referrals to a health care provider, sourcing

ingredients, and packaging and delivering meals to eligible

recipients.

(2) "Food prescription program" means a program under

which a health care provider prescribes nutritious food, including

fresh fruits and vegetables, to an individual who has or is at risk

of developing a diet-related chronic disease to, as appropriate,

treat the disease or reduce the individual's risk of developing the

disease by increasing the patient's access to and consumption of

healthy food.

(3) "Medically tailored meal" means food prepared as

prescribed by a dietician or other health care provider to treat an

individual's diet-related chronic disease or health condition and

any associated symptoms.

(b) In approving the list of nutrition support services that

are permitted in lieu of services specified in the state Medicaid

plan under Section 540.0272, the commission shall consider

including the following services:

(1) case management services related to food and

nutrition access;

(2) nutrition counseling and guidance that is specific

to an individual's needs or designed to improve health outcomes;

(3) the provision of medically tailored meals;

(4) food prescription programs; and

(5) any other nutrition support service the commission

determines to be appropriate, evidence-based, and cost-effective.

(c) In implementing Section 540.0272 as it relates to

nutrition support services and this section, the commission shall

ensure that:

(1) community-based nutrition support organizations

may provide nutrition support services to recipients under

Medicaid; and

(2) a recipient does not receive duplicate services

under Medicaid.

(d) The executive commissioner shall establish a separate

provider type for community-based nutrition support organizations

for purposes of enrollment and reimbursement as a provider under

Medicaid.

(e) Not later than November 1 of each even-numbered year,

the commission shall prepare and submit to the legislature a

biennial report on the health outcomes of providing nutrition

support services in lieu of services specified in the state

Medicaid plan. The report must include:

(1) the number of recipients receiving nutrition

support services during the preceding two-year period; and

(2) an assessment of those individuals' health

outcomes based on relevant National Committee for Quality Assurance

Healthcare Effectiveness Data and Information Set (HEDIS)

measures, including:

(A) hemoglobin A1c levels;

(B) blood pressure control;

(C) birth weight, if applicable;

(D) emergency room visits; and

(E) any other measure of the health outcomes the

commission determines relevant to evaluate the effectiveness of

nutrition support services.

SECTION 3. The changes in law made by this Act apply to a

contract entered into or renewed on or after the effective date of

this Act. A contract entered into or renewed before that date is

governed by the law in effect on the date the contract was entered

into or renewed, and that law is continued in effect for that

purpose.

SECTION 4. 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 5. This Act takes effect September 1, 2025.