Menéndez Bill Has Medicaid Pay Full Cost Of Seizure Detectors

The text as introduced · 567 words

90R1840 AB-D

By: Menéndez
S.B. No. 136

A BILL TO BE ENTITLED

AN ACT

relating to Medicaid coverage and reimbursement for seizure

detection devices and a public awareness campaign related to those

devices.

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 32.03142 to read as follows:

Sec. 32.03142. SEIZURE DETECTION DEVICES; AWARENESS

CAMPAIGN. (a) In this section, "seizure detection device" means a

telemonitoring device approved by the United States Food and Drug

Administration, including any related service or subscription that

supports the device's prescribed use, that:

(1) provides ongoing patient monitoring and alert

services to detect seizure activity;

(2) transmits notice of a patient's seizure activity

to a caregiver for appropriate medical response; or

(3) collects data on a patient's seizure activity for a

health care provider to diagnose or appropriately treat a health

care condition causing the seizure activity.

(b) The commission shall ensure medical assistance

reimbursement is provided to cover in full the cost of a seizure

detection device for a medical assistance recipient if the

recipient's health care provider determines the device:

(1) is medically appropriate based on the recipient's

medical condition or status; and

(2) will likely:

(A) assist in reducing bodily harm to or death of

the recipient as a result of a seizure; or

(B) provide data to the health care provider

necessary to appropriately diagnose or treat the recipient's health

condition causing the seizure activity.

(c) For purposes of providing reimbursement under this

section, a seizure detection device is durable medical equipment

and the commission shall ensure the reimbursement rate for related

service and subscription fees is at least equal to the

reimbursement rate for home telemonitoring services under

Subchapter F, Chapter 548, Government Code.

(d) The commission shall conduct a biennial review of the

seizure detection devices covered under this section and update the

list of covered devices as necessary based on technology

advancements and guidance issued by the United States Food and Drug

Administration.

(e) The commission shall implement a statewide public

awareness campaign to educate health care providers, medical

assistance recipients, and the general public on the availability,

benefits, and coverage of seizure detection devices and related

services and subscriptions under this section.

(f) The campaign under Subsection (e) must be designed to:

(1) clearly inform health care providers and

recipients that the full cost of seizure detection devices and

related services and subscriptions for the device's use are

reimbursable under this section;

(2) emphasize the ability of seizure detection devices

to help reduce the risk of seizure-related injuries and enhance the

quality of life for individuals living with epilepsy and their

families;

(3) provide essential information on sudden,

unexpected death from epilepsy, including the associated risks and

how seizure detection devices reduce the risk of sudden, unexpected

death from epilepsy by enabling timely intervention during

seizures; and

(4) provide resources for further education and

support for those at risk of sudden, unexpected death from

epilepsy.

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, 2027.