Sec. 531.0996. PREGNANCY MEDICAL HOME PILOT PROGRAM. (a) The commission shall develop a pilot program to establish pregnancy medical homes that provide coordinated evidence-based maternity care management to women who reside in a pilot program area and are recipients of Medicaid through a Medicaid managed care model or arrangement under Chapter 533. The commission shall implement the pilot program in:
(1) at least two counties with populations of more than two million;
(2) at least one county with a population of more than 100,000 and less than 500,000; and
(3) at least one rural county with high rates of maternal mortality and morbidity as determined by the commission in consultation with the Maternal Mortality and Morbidity Task Force established under Chapter 34, Health and Safety Code.
(b) In implementing the pilot program, the commission shall ensure each pregnancy medical home provides a maternity management team that:
(1) consists of health care providers, including obstetricians, gynecologists, family physicians, physician assistants, certified nurse midwives, nurse practitioners, and social workers, who provide health care services at the same location;
(2) conducts a risk assessment of each pilot program participant on her entry into the program to determine the risk classification for her pregnancy;
(3) based on the assessment conducted under Subdivision (2), establishes an individual pregnancy care plan for each participant; and
(4) follows each participant throughout her pregnancy to reduce poor birth outcomes.
(c) The commission may incorporate as a component of the pilot program financial incentives for health care providers who participate in a maternity management team.
(d) The commission may waive a requirement of this section for a pregnancy medical home located in a rural county.
(e) The commission may:
(1) provide home telemonitoring services and necessary durable medical equipment to pilot program participants who are at risk of experiencing pregnancy-related complications, as determined by a physician, to the extent the commission anticipates the services and equipment will reduce unnecessary emergency room visits or hospitalizations; and
(2) reimburse providers under Medicaid for the provision of home telemonitoring services and durable medical equipment under the pilot program.
(f) Not later than January 1, 2021, the commission shall submit to the legislature a report on the pilot program. The report must include:
(1) an evaluation of the pilot program's success in reducing poor birth outcomes; and
(2) a recommendation on whether the pilot program should continue, be expanded, or be terminated.
(g) The executive commissioner may adopt rules to implement this section.
(h) This section expires September 1, 2023.
Added by Acts 2019, 86th Leg., R.S., Ch. 973 (S.B. 748), Sec. 8, eff. September 1, 2019.
Amended by:
Acts 2021, 87th Leg., R.S., Ch. 915 (H.B. 3607), Sec. 9.009, eff. September 1, 2021.
Structure Texas Statutes
Subtitle I - Health and Human Services
Chapter 531 - Health and Human Services Commission
Subchapter B. Powers and Duties
Section 531.021. Administration of Medicaid
Section 531.0211. Managed Care Medicaid Program: Rules; Education Programs
Section 531.02111. Biennial Medicaid Financial Report
Section 531.02113. Optimization of Medicaid Financing
Section 531.02114. Dental Director
Section 531.02118. Streamlining Medicaid Provider Enrollment and Credentialing Processes
Section 531.021182. Use of National Provider Identifier Number
Section 531.021191. Medicaid Enrollment of Certain Eye Health Care Providers
Section 531.0212. Medicaid Bill of Rights and Bill of Responsibilities
Section 531.0213. Support Services for Medicaid Recipients
Section 531.02131. Grievances Related to Medicaid
Section 531.0214. Medicaid Data Collection System
Section 531.02141. Medicaid Information Collection and Analysis
Section 531.02142. Public Access to Certain Medicaid Data
Section 531.02143. Data Regarding Postnatal Alcohol and Controlled Substance Treatment
Section 531.0215. Compilation of Statistics Relating to Fraud
Section 531.02164. Medicaid Services Provided Through Home Telemonitoring Services
Section 531.0217. Reimbursement for Certain Medical Consultations
Section 531.02171. Reimbursement for Certain Telehealth Services
Section 531.02172. Reimbursement for Teledentistry Dental Services
Section 531.02174. Additional Authority Regarding Telemedicine Medical Services
Section 531.02175. Reimbursement for Online Medical Consultations
Section 531.0218. Long-Term Care Medicaid Programs
Section 531.02191. Public Input
Section 531.02192. Federally Qualified Health Center and Rural Health Clinic Services
Section 531.02193. Certain Conditions on Medicaid Reimbursement of Rural Health Clinics Prohibited
Section 531.02194. Reimbursement Methodology for Rural Hospitals
Section 531.022. Coordinated Strategic Plan for Health and Human Services
Section 531.0222. Local Mental Health Authority Group Regional Planning
Section 531.0224. Planning and Policy Direction of Temporary Assistance for Needy Families Program
Section 531.0225. Mental Health and Substance Abuse Services
Section 531.02251. Ombudsman for Behavioral Health Access to Care
Section 531.02253. Telehealth Treatment for Substance Use Disorders
Section 531.0226. Chronic Health Conditions Services Medicaid Waiver Program
Section 531.0227. Person First Respectful Language Promotion
Section 531.023. Submission of Plans and Updates by Agencies
Section 531.024. Planning and Delivery of Health and Human Services; Data Sharing
Section 531.0241. Streamlining Delivery of Services
Section 531.02411. Streamlining Administrative Processes
Section 531.024115. Service Delivery Area Alignment
Section 531.02412. Service Delivery Audit Mechanisms
Section 531.02413. Billing Coordination System
Section 531.024131. Expansion of Billing Coordination and Information Collection Activities
Section 531.02414. Nonemergency Transportation Services Under Medical Transportation Program
Section 531.02415. Electronic Eligibility Information Pilot Project
Section 531.024163. Accessibility of Information Regarding Medicaid Prior Authorization Requirements
Section 531.024164. External Medical Review
Section 531.024165. Medical Review of Medicaid Service Denials for Foster Care Youth
Section 531.02417. Medicaid Nursing Services Assessments
Section 531.024171. Therapy Services Assessments
Section 531.024172. Electronic Visit Verification System
Section 531.0242. Use of Agency Staff
Section 531.0244. Ensuring Appropriate Care Setting for Persons With Disabilities
Section 531.02444. Medicaid Buy-in Programs for Certain Persons With Disabilities
Section 531.02445. Transition Services for Youth With Disabilities
Section 531.02447. Employment-First Policy
Section 531.02448. Competitive and Integrated Employment Initiative for Certain Medicaid Recipients
Section 531.0245. Permanency Planning for Certain Children
Section 531.0246. Regional Management of Health and Human Services Agencies
Section 531.0247. Annual Business Plan
Section 531.0248. Community-Based Support Systems
Section 531.02481. Community-Based Support and Service Delivery Systems for Long-Term Care Services
Section 531.02491. Joint Training for Certain Caseworkers
Section 531.02492. Delivery of Health and Human Services to Young Texans
Section 531.025. Statewide Needs Appraisal Project
Section 531.027. Appropriations Request by Agencies
Section 531.0271. Health and Human Services Agencies Operating Budgets
Section 531.0273. Information Resources Planning and Management
Section 531.02731. Report of Information Resources Manager to Commission
Section 531.0274. Coordination and Approval of Caseload Estimates
Section 531.028. Monitoring and Effective Management of Funds
Section 531.031. Management Information and Cost Accounting System
Section 531.0312. Texas Information and Referral Network
Section 531.0313. Electronic Access to Health and Human Services Referral Information
Section 531.03131. Electronic Access to Child-Care and Education Services Referral Information
Section 531.0317. Health and Human Services Information Made Available Through the Internet
Section 531.0318. Long-Term Care Consumer Information Made Available Through the Internet
Section 531.0319. Outreach Campaigns for Aging Adults With Visual Impairments
Section 531.032. Application of Other Laws
Section 531.0335. Prohibition on Punitive Action for Failure to Immunize
Section 531.035. Dispute Arbitration
Section 531.036. Public Hearings
Section 531.037. Notice of Public Hearings
Section 531.038. Gifts and Grants
Section 531.0381. Certain Gifts and Grants to Health and Human Services Agencies
Section 531.0391. Subrogation and Third-Party Reimbursement Collection Contract
Section 531.0392. Recovery of Certain Third-Party Reimbursements Under Medicaid
Section 531.040. Reference Guide; Dictionary
Section 531.041. General Powers and Duties
Section 531.0411. Rules Regarding Refugee Resettlement
Section 531.042. Information and Assistance Regarding Care and Support Options
Section 531.043. Long-Term Care Vision
Section 531.044. Financial Assistance Recipients Eligible for Federal Programs
Section 531.047. Substitute Care Provider Outcome Standards
Section 531.048. Caseload Standards
Section 531.050. Minimum Collection Goal
Section 531.0501. Medicaid Waiver Programs: Interest List Management
Section 531.0511. Medically Dependent Children Waiver Program: Consumer Direction of Services
Section 531.0512. Notification Regarding Consumer Direction Model
Section 531.0515. Risk Management Criteria for Certain Waiver Programs
Section 531.053. Leases and Subleases of Certain Office Space
Section 531.055. Memorandum of Understanding on Services for Persons Needing Multiagency Services
Section 531.056. Review of Survey Process in Certain Institutions and Facilities
Section 531.057. Volunteer Advocate Program for the Elderly
Section 531.058. Informal Dispute Resolution for Certain Long-Term Care Facilities
Section 531.0581. Long-Term Care Facilities Council
Section 531.0585. Issuance of Materials to Certain Long-Term Care Facilities
Section 531.059. Voucher Program for Transitional Living Assistance for Persons With Disabilities
Section 531.060. Family-Based Alternatives for Children
Section 531.0601. Long-Term Care Services Waiver Program Interest Lists
Section 531.06011. Certain Medicaid Waiver Programs: Interest List Management
Section 531.0602. Medically Dependent Children (Mdcp) Waiver Program Assessments and Reassessments
Section 531.06021. Medically Dependent Children (Mdcp) Waiver Program Quality Monitoring; Report
Section 531.0605. Advancing Care for Exceptional Kids Pilot Program
Section 531.061. Participation by Fathers
Section 531.062. Pilot Projects Relating to Technology Applications
Section 531.066. Participation of Diagnostic Laboratory Service Providers in Certain Programs
Section 531.069. Periodic Review of Vendor Drug Program
Section 531.0693. Prescription Drug Use and Expenditure Patterns
Section 531.0694. Period of Validity for Prescription
Section 531.0696. Considerations in Awarding Certain Contracts
Section 531.070. Supplemental Rebates
Section 531.0701. Value-Based Arrangements
Section 531.071. Confidentiality of Information Regarding Drug Rebates, Pricing, and Negotiations
Section 531.072. Preferred Drug Lists
Section 531.073. Prior Authorization for Certain Prescription Drugs
Section 531.0735. Medicaid Drug Utilization Review Program: Drug Use Reviews and Annual Report
Section 531.0736. Drug Utilization Review Board
Section 531.0737. Drug Utilization Review Board: Conflicts of Interest
Section 531.075. Prior Authorization for High-Cost Medical Services
Section 531.076. Review of Prior Authorization and Utilization Review Processes
Section 531.077. Recovery of Certain Assistance
Section 531.078. Quality Assurance Fees on Certain Waiver Program Services
Section 531.079. Waiver Program Quality Assurance Fee Account
Section 531.080. Reimbursement of Waiver Programs
Section 531.081. Invalidity; Federal Funds
Section 531.082. Expiration of Quality Assurance Fee on Waiver Programs
Section 531.083. Medicaid Long-Term Care System
Section 531.084. Medicaid Long-Term Care Cost Containment Strategies
Section 531.0841. Long-Term Care Insurance Awareness and Education Campaign
Section 531.0843. Durable Medical Equipment Reuse Program
Section 531.085. Hospital Emergency Room Use Reduction Initiatives
Section 531.087. Distribution of Earned Income Tax Credit Information
Section 531.088. Pooled Funding for Foster Care Preventive Services
Section 531.089. Certain Medication for Sex Offenders Prohibited
Section 531.090. Joint Purchasing of Prescription Drugs and Other Medications
Section 531.091. Integrated Benefits Issuance
Section 531.092. Transfer of Money for Community-Based Services
Section 531.0925. Veteran Suicide Prevention Action Plan
Section 531.093. Services for Military Personnel
Section 531.0941. Medicaid Health Savings Account Pilot Program
Section 531.097. Tailored Benefit Packages for Certain Categories of the Medicaid Population
Section 531.0971. Tailored Benefit Packages for Non-Medicaid Populations
Section 531.0972. Pilot Program to Prevent the Spread of Certain Infectious or Communicable Diseases
Section 531.0981. Wellness Screening Program
Section 531.0991. Grant Program for Mental Health Services
Section 531.0992. Grant Program for Mental Health Services for Veterans and Their Families
Section 531.0994. Study; Annual Report
Section 531.0995. Information for Certain Enrollees in the Healthy Texas Women Program