Bill Text: TX HB4530 | 2019-2020 | 86th Legislature | Introduced
Bill Title: Relating to a review of Medicaid dental services provided to children.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2019-03-26 - Referred to Human Services [HB4530 Detail]
Download: Texas-2019-HB4530-Introduced.html
86R13607 MM-D | ||
By: Lucio III | H.B. No. 4530 |
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relating to a review of Medicaid dental services provided to | ||
children. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. (a) In this section: | ||
(1) "Abuse" and "fraud" have the meanings assigned by | ||
Section 531.1011, Government Code. | ||
(2) "Commission" means the Health and Human Services | ||
Commission. | ||
(3) "Office of inspector general" means the | ||
commission's office of inspector general. | ||
(b) The office of inspector general shall conduct a thorough | ||
review of the provision of Texas Health Steps therapeutic dental | ||
benefits to children to determine whether fraud, waste, or abuse is | ||
probably occurring with respect to the provision of those benefits. | ||
The office shall conduct the review in conjunction with other | ||
appropriate divisions of the commission and collaborate with and | ||
seek input from stakeholders in the dental industry in this state. | ||
(c) In determining whether fraud, waste, or abuse is | ||
probably occurring in the provision of Texas Health Steps | ||
therapeutic dental benefits to children, the office of inspector | ||
general and the commission shall: | ||
(1) review a randomly selected representative sample | ||
of those services in a quantity sufficient to allow for the | ||
extrapolation of results; and | ||
(2) use the American Academy of Pediatric Dentistry | ||
clinical guidelines and appropriate pediatric dentist peer review | ||
to: | ||
(A) determine dental necessity for provided | ||
services; and | ||
(B) assess other factors relevant to determining | ||
whether fraud, waste, or abuse is probably occurring. | ||
(d) Not later than November 1, 2020, the office of inspector | ||
general and the commission shall submit a joint report on the | ||
results of the review to the standing committees of the senate and | ||
house of representatives having primary jurisdiction over | ||
Medicaid. The report must include: | ||
(1) a description of any policy changes implemented | ||
through commission rules as a result of the review; and | ||
(2) recommendations for statutory changes, including | ||
any proposed legislation, to address any fraud, waste, and abuse | ||
identified as probably occurring in the provision of Texas Health | ||
Steps therapeutic dental benefits to children. | ||
SECTION 2. This Act takes effect September 1, 2019. |