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Relating to maternal and newborn health care.
The fiscal implications of the provisions of the bill cannot be determined at this time because potential changes to utilization and provider reimbursement and savings related to improved outcomes are unknown. The fiscal implications related to the Newborn Screening Preservation Account cannot be determined because they depend on appropriations decisions and the adoption of new rules.
The Department of State Health Services (DSHS) and the executive commissioner of the Health and Human Services Commission (HHSC) are not required to establish a high-risk maternal care coordination services pilot program, unless a specific appropriation for its implementation is provided in a general appropriations act of the 86th Legislature.
HB 1111 would require the Health and Human Services Commission (HHSC) to conduct a study on the costs and benefits of permitting Medicaid reimbursement for prenatal and postpartum care delivered through telemedicine medical services and telehealth services. HHSC would also be required to 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. The executive commissioner would establish the amounts charged for newborn screening fees, including fees assessed for follow-up services, tracking confirmatory testing, and diagnosis. The amounts charged for newborn screening fees would be sufficient to cover the costs of performing the screening.
HB 1111 would create the Newborn Screening Preservation Account, a dedicated account in the general revenue fund, created solely for the perpetual care and preservation of newborn screening in this state.
HHSC would submit a written report summarizing the actions taken to address maternal morbidity and reduce maternal mortality rates. The report must include information from programs and initiatives created to address maternal morbidity and reduce maternal mortality rates in this state.
The bill would also require the Health and Human Services Commission to adopt additional rules relating to the level of care designations for hospitals. The bill would create a process to appeal a level of care designation. In adopting rules relating to hospitals, the bill would require that the use of telemedicine medical services by a physician providing on-call services is sufficient to satisfy certain requirements pertaining to Level I, II, or III level of care designation. These elements are originally from SB 749 and were added to this bill in the Senate committee substitute.
Texas Action remains neutral on HB 1111 because of conflicting principles. We generally oppose the growth of government by creating new accounts for legislative appropriations, but we support the use of telemedicine and telehealth services that will inevitably reduce unnecessary emergency room visits or hospitalizations, and the overall cost of healthcare. Elsewhere this session we were neutral on SB 749 which is now incorporated in HB 1111.