Relating to requiring contracts with Medicaid managed care organizations to permit the organizations to offer nutrition counseling and instruction services in lieu of other state Medicaid plan services.
relating to requiring contracts with Medicaid managed care
organizations to permit the organizations to offer nutrition
counseling and instruction services in lieu of other state Medicaid
plan 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 medically
appropriate, cost-effective, evidence-based mental health or
substance use services or nutrition counseling and instruction
services from a list of services approved by the state Medicaid
managed care advisory committee and included in the contract 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
another [mental health or substance use disorder] service specified
in the state Medicaid plan.
(b) The commission shall:
(1) prepare and submit to the legislature 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.
(c) In approving the list of nutrition counseling and
instruction services that are permitted in lieu of services
specified in the state Medicaid plan under this section, the state
Medicaid managed care advisory committee may only include nutrition
counseling and instruction. The list may not include:
(1) home-delivered meals;
(2) food prescriptions; or
(3) grocery support.
SECTION 2. 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 3. 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 4. This Act takes effect September 1, 2025.
