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


Office of House Bill AnalysisC.S.H.B. 3636
By: Naishtat
Human Services
4/25/1999
Committee Report (Substituted)

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. 

C.S.H.B. 3636 provides for annual dental examinations, diagnostic dental
x-rays, and cleanings 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 dental examination by a
licensed dentist; a prophylaxis (cleaning) by a licensed dentist or dental
hygienist, if practical considering the resident's health; 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.

COMPARISON OF ORIGINAL TO SUBSTITUTE

C.S.H.B. 3636 differs from the original in SECTION 1 by modifying proposed
Section 32.024(v), Human Resources Code, to include a prophylaxis by a
licensed dentist or dental hygienist, if practical considering the
resident's health, among those dental services provided under this section.
The substitute also specifies that the examination required be performed by
a licensed dentist.