HB 26

H.B. No. 26
  AN ACT
  relating to authorizing Medicaid managed care organizations to
  offer nutrition support services in lieu of other state Medicaid
  plan services.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 540.0272, Government Code, is amended to
  read as follows:
         Sec. 540.0272.  CERTAIN SERVICES PERMITTED IN LIEU OF STATE
  MEDICAID PLAN SERVICES [OTHER MENTAL HEALTH OR SUBSTANCE USE
  DISORDER SERVICES]; ANNUAL REPORT.  (a) A contract to which this
  subchapter applies must contain language permitting the
  contracting Medicaid managed care organization to offer medically
  appropriate, cost-effective, evidence-based mental health or
  substance use services or nutrition counseling and instruction
  services from a list of services approved by the state Medicaid
  managed care advisory committee and included in the contract in
  lieu of [mental health or substance use disorder] services
  specified in the state Medicaid plan.  A recipient is not required
  to use a service from the list included in the contract in lieu of
  another [mental health or substance use disorder] service specified
  in the state Medicaid plan.
         (b)  The commission shall:
               (1)  prepare and submit to the legislature an annual
  report on the number of times during the preceding year a service
  from the list included in the contract is used; and
               (2)  consider the actual cost and use of any services
  from the list included in the contract that are offered by a
  Medicaid managed care organization when setting the capitation
  rates for that organization under the contract.
         (c)  In approving the list of nutrition counseling and
  instruction services that are permitted in lieu of services
  specified in the state Medicaid plan under this section, the state
  Medicaid managed care advisory committee may only include nutrition
  counseling and instruction.  The list may not include:
               (1)  home-delivered meals;
               (2)  food prescriptions; or
               (3)  grocery support.
         SECTION 2.  Subchapter F, Chapter 540, Government Code, is
  amended by adding Section 540.02721 to read as follows:
         Sec. 540.02721.  PILOT PROGRAM TO PROVIDE ADDITIONAL
  NUTRITION SUPPORT SERVICES TO CERTAIN PREGNANT RECIPIENTS IN LIEU
  OF STATE MEDICAID PLAN SERVICES.  (a)  In this section:
               (1)  "Participant" means a recipient who participates
  in the pilot program.
               (2)  "Pilot program" means the pilot program
  established by the commission under authority of this section.
               (3)  "Medically tailored meal" means a meal designed by
  a registered dietician as part of a treatment plan to improve an
  individual's health outcomes and chronic disease management.
         (b)  The commission may establish a pilot program under which
  Medicaid managed care organizations are authorized to offer and
  provide nutrition support services in lieu of services specified in
  the state Medicaid plan to a recipient who is:
               (1)  pregnant; and
               (2)  diagnosed with a chronic health condition or
  disease that may contribute to a high-risk pregnancy or birth
  complications, including:
                     (A)  gestational diabetes;
                     (B)  hypertension; and
                     (C)  obesity.
         (c)  Notwithstanding Section 540.0272, a Medicaid managed
  care organization may offer the following services under the pilot
  program in lieu of services specified in the state Medicaid plan:
               (1)  nutrition counseling and instruction services
  authorized under Section 540.0272;
               (2)  medically tailored meals, provided the meals are
  provided with nutrition counseling and instruction services
  authorized under Section 540.0272; and
               (3)  other evidence-based nutrition support services
  designed to improve maternal and infant health outcomes, as
  determined by the commission.
         (d)  The commission shall collect and analyze data on the
  impact to maternal and infant health outcomes that nutrition
  support services have on pilot program participants.  The data the
  commission collects and analyzes must include:
               (1)  the rate by which pilot program participants
  comply with a medically tailored meal plan or other nutrition
  support services provided under the pilot program;
               (2)  health outcomes associated with each participant's
  pregnancy;
               (3)  the impact of nutrition support services on a
  participant's chronic health condition or disease-related
  symptoms; and
               (4)  newborn and infant health outcomes for children
  born to participants.
         (e)  As soon as practicable after the termination of the
  pilot program, the commission shall prepare and submit to the
  legislature a written report that includes:
               (1)  a summary of the pilot program outcomes, including
  a summary of the data the commission collects and analyzes under
  Subsection (d); and
               (2)  recommendations for legislative or other action.
         (f)  The pilot program, if established, terminates August
  31, 2030.
         (g)  This section expires September 1, 2031.
         SECTION 3.  The changes in law made by this Act apply to a
  contract entered into or renewed on or after the effective date of
  this Act.  A contract entered into or renewed before that date is
  governed by the law in effect on the date the contract was entered
  into or renewed, and the former law is continued in effect for that
  purpose.
         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.
  ______________________________
  ______________________________
     President of the Senate
  Speaker of the House     
         I certify that H.B. No. 26 was passed by the House on April
  23, 2025, by the following vote:  Yeas 132, Nays 13, 1 present, not
  voting; and that the House concurred in Senate amendments to H.B.
  No. 26 on May 29, 2025, by the following vote:  Yeas 130, Nays 9, 1
  present, not voting.
  ______________________________
  Chief Clerk of the House   
         I certify that H.B. No. 26 was passed by the Senate, with
  amendments, on May 26, 2025, by the following vote:  Yeas 30, Nays
  1.
  ______________________________
  Secretary of the Senate   
  APPROVED: __________________
                  Date       
           __________________
                Governor