89R6229 KKR-D
	By: Bhojani	H.B. No. 4459

	A BILL TO BE ENTITLED
	AN ACT
	relating to the provision of certain services under the Medicaid
	managed care program to recipients who are victims of family
	violence.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  Chapter 540, Government Code, as effective April
	1, 2025, is amended by adding Subchapter T to read as follows:
	SUBCHAPTER T.  FAMILY VIOLENCE SERVICES
	Sec. 540.0951.  DEFINITIONS. In this subchapter:
	(1)  "Family violence" has the meaning assigned by
	Section 71.004, Family Code.
	(2)  "Family violence services provider" means a
	licensed health care provider, licensed mental health or behavioral
	health provider, or other provider designated by commission rule
	who provides family violence services.
	(3)  "Family violence services" means services that
	provide trauma-informed care to a recipient who is a survivor of
	family violence, including health care services, mental and
	behavioral health services, and other services designated by
	commission rule as family violence services.
	(4)  "Service coordination" includes:
	(A)  contact between a recipient and a service
	coordinator for a Medicaid managed care organization;
	(B)  coordination, including with providers, to
	assist a recipient in accessing benefits provided by the
	organization; and
	(C)  coordination, including with providers as
	appropriate, to assist a recipient in accessing services provided
	by other entities or service providers in the recipient's
	community.
	Sec. 540.0952.  FAMILY VIOLENCE SERVICES; SERVICE
	COORDINATION.  (a)  A contract between a Medicaid managed care
	organization and the commission to provide health care services to
	recipients must:
	(1)  require the contracting Medicaid managed care
	organization to:
	(A)  ensure recipients who are survivors of family
	violence have access to family violence services providers and
	family violence services; and
	(B)  provide family violence services
	coordination to those recipients; and
	(2)  include performance metrics designed to assist the
	commission in evaluating the organization's coordination and
	provision of those services, including metrics related to:
	(A)  the number of family violence screenings
	conducted;
	(B)  the number and types of referrals for family
	violence services; and
	(C)  the organization's engagement with family
	violence services providers.
	(b)  In implementing family violence services coordination
	for recipients, a Medicaid managed care organization must:
	(1)  establish partnerships with licensed family
	violence services providers to develop service coordination
	pathways for recipients who are survivors of family violence;
	(2)  develop protocols for integrating the provision of
	trauma-informed family violence services with health care and
	mental health services provided to recipients in a manner that
	meets a recipient's specific needs;
	(3)  require health care and mental health providers
	participating in the organization's provider network to conduct
	screenings of recipients to identify signs that a recipient is a
	survivor of family violence that:
	(A)  use evidence-based screening methods
	sensitive to a recipient's needs; and
	(B)  are conducted by personnel with appropriate
	training about trauma-informed care, family violence awareness,
	and culturally competent support practices;
	(4)  develop a streamlined process for referring
	recipients to domestic violence services providers that ensures
	continuity of care and provides access to specialized services and
	family violence resources, including emergency shelters and
	organizations providing legal support; and
	(5)  ensure recipients have access to mental and
	behavioral health services that specifically address trauma
	experienced by survivors of domestic violence, including:
	(A)  counseling to address the immediate and
	long-term mental health needs of a recipient; and
	(B)  group counseling or support groups.
	Sec. 540.0953.  SERVICE COORDINATOR TRAINING. A Medicaid
	managed care organization must ensure that each individual who
	provides family violence service coordination to recipients under
	this subchapter receive training on trauma-informed care, family
	violence awareness, and culturally competent support practices.
	Sec. 540.0954.  MEDICAID MANAGED CARE ORGANIZATION ANNUAL
	REPORT. A Medicaid managed care organization shall annually submit
	to the commission a written report detailing the organization's
	efforts to comply with this subchapter during the preceding year.
	The report must include data on:
	(1)  the number of family violence screenings conducted
	by providers included in the organization's provider network;
	(2)  the number and type of recipient referrals for
	family violence services made by providers; and
	(3)  the scope of family violence mental health and
	behavioral health services provided to recipients.
	Sec. 540.0955.  ANNUAL AUDIT. (a)  The commission shall
	annually conduct a performance audit of a Medicaid managed care
	organization to:
	(1)  ensure the organization is providing family
	violence services coordination; and
	(2)  evaluate the organization's performance in
	providing family violence services and service coordination to
	recipients under this subchapter.
	(b)  In evaluating a Medicaid managed care organization's
	performance under Subsection (a), the commission shall:
	(1)  use the metrics included in the organization's
	contract with the commission; and
	(2)  assess the quality of care and service
	coordination provided to recipients by the organization.
	Sec. 540.0956.  RULES. The executive commissioner shall
	adopt rules necessary to implement this subchapter, including rules
	designating:
	(1)  services that are considered family violence
	services; and
	(2)  health care providers that may receive Medicaid
	reimbursement for providing family violence services.
	SECTION 2.  Section 32.024, Human Resources Code, is amended
	by adding Subsection (ss) to read as follows:
	(ss) The commission shall ensure that medical assistance
	reimbursement is provided to a family violence services provider
	for providing family violence services to a recipient under
	Subchapter T, Chapter 540, Government Code.
	SECTION 3.  (a) The Health and Human Services Commission
	shall, in a contract between the commission and a managed care
	organization under Chapter 540, Government Code, as effective April
	1, 2025, that is entered into or renewed on or after the effective
	date of this Act, require that the managed care organization comply
	with Subchapter T, Chapter 540, Government Code, as added by this
	Act.
	(b)  The Health and Human Services Commission shall seek to
	amend contracts entered into with managed care organizations under
	Chapter 533, Government Code, or under Chapter 540, Government
	Code, as effective April 1, 2025, before the effective date of this
	Act to require those managed care organizations to comply with
	Subchapter T, Chapter 540, Government Code, as added by this Act.
	To the extent of a conflict between Subchapter T, Chapter 540,
	Government Code, as added by this Act, and a provision of a contract
	with a managed care organization entered into before the effective
	date of this Act, the contract provision prevails.
	SECTION 4.  If before implementing any provision of this Act
	a state agency determines that a waiver or authorization from a
	federal agency is necessary for implementation of that provision,
	the agency affected by the provision shall request the waiver or
	authorization and may delay implementing that provision until the
	waiver or authorization is granted.
	SECTION 5.  This Act takes effect September 1, 2025.