HBA-MPM H.B. 3636 76(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 3636
By: Naishtat
Human Services
4/19/1999
Introduced

BACKGROUND AND PURPOSE 

Currently, nursing home residents receiving Medicaid can receive dental
services in two ways: 

_if the individual is able to pay for necessary services up front, Medicaid
will reimburse them for incurred medical expenses (IMEs) at a later date;
or 
_if the individual cannot pay for services up front, the individual may
only receive dental care in emergency situations, when treatment becomes
imperative. 

As a result of these limited dental options, adequate care is rarely
received, and the resident's oral health often reaches emergency status
before the problem is identified.  Dental care in these instances is much
more expensive than preventive care. 

H.B. 3636 provides for annual dental examinations for residents receiving
Medicaid.  This bill also directs the Health and Human Services Commission
to conduct a study for the need for and cost of expanding dental services
provided by this Act. 

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that rulemaking
authority is expressly delegated to the Texas Department of Human Services,
in cooperation with the Health and Human Services Commission, in SECTION 2
of this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Section 32.024, Human Resources Code, by adding
Subsection (v) to require the Texas Department of Human Services
(department) to provide dental services annually to a resident of a nursing
facility who is a recipient of medical assistance under this chapter.
Provides that the dental services must include a routine dental examination
and cleaning and diagnostic dental x-rays. 

SECTION 2.  Requires the department, in cooperation with the Health and
Human Services Commission (commission), by rule, to develop a fee schedule
for dental services added by this Act. 

SECTION 3.  Requires the commission to conduct a study regarding the need
for and cost of expanding the dental services provided as added by this Act
and, no later than December 1, 2000, to report to the governor, lieutenant
governor, speaker of the house of representatives, and the presiding
officers of the standing committees of the senate and house of
representatives having primary jurisdiction over the commission the results
of this study.  Provides that the study includes an analysis of the costs,
benefits, and feasibility of expanding the services provided as added by
this Act. 

SECTION 4.  Requires a state agency affected by a provision of this Act to
request a waiver or authorization from a federal agency if it is determined
that a waiver or authorization is needed to implement any provision of this
Act and to delay implementation of that provision until the waiver or
authorization is granted. 

SECTION 5.  Effective date:  September 1, 1999.

SECTION 6.  Emergency clause.