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).Tex. Gov't. Code § 531.084
Amended by Acts 2015, Texas Acts of the 84th Leg. - Regular Session, ch. 1,Sec. 2.117, eff. 4/2/2015.Added by Acts 2005, 79th Leg., Ch. 349, Sec. 5(a), eff. 9/1/2005.