89R5364 SCF-F     By: Oliverson H.B. No. 2946       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.