Tex.
Gov't Code Section 531.084
Medicaid Long-term Care Cost Containment Strategies
(a)
The commission shall make every effort to achieve cost efficiencies within the Medicaid long-term care program. To achieve those efficiencies, the commission shall:(1)
establish a fee schedule for reimbursable incurred medical expenses for dental services controlled in long-term care facilities;(2)
implement a fee schedule for reimbursable incurred medical expenses for durable medical equipment in nursing facilities and ICF-IID facilities;(3)
implement a durable medical equipment fee schedule action plan;(4)
establish a system for private contractors to secure and coordinate the collection of Medicare funds for recipients who are dually eligible for Medicare and Medicaid;(5)
create additional partnerships with pharmaceutical companies to obtain discounted prescription drugs for Medicaid recipients; and(6)
develop and implement a system for auditing the Medicaid hospice care system that provides services in long-term care facilities to ensure correct billing for pharmaceuticals.(b)
The executive commissioner and the commissioner of aging and disability services shall jointly appoint persons to serve on a work group to assist the commission in developing the fee schedule required by Subsection (a)(1). The work group must consist of providers of long-term care services, including dentists and long-term care advocates.(c)
In developing the fee schedule required by Subsection (a)(1), the commission shall consider:(1)
the need to ensure access to dental services for residents of long-term care facilities who are unable to travel to a dental office to obtain care;(2)
the most recent Comprehensive Fee Report published by the National Dental Advisory Service;(3)
the difficulty of providing dental services in long-term care facilities;(4)
the complexity of treating medically compromised patients; and(5)
time-related and travel-related costs incurred by dentists providing dental services in long-term care facilities.(d)
The commission shall annually update the fee schedule required by Subsection (a)(1).
Source:
Section 531.084 — Medicaid Long-term Care Cost Containment Strategies, https://statutes.capitol.texas.gov/Docs/GV/htm/GV.531.htm#531.084
(accessed Apr. 20, 2024).