HBA-MPM C.S.H.B. 3636 76(R)BILL ANALYSIS Office of House Bill AnalysisC.S.H.B. 3636 By: Naishtat Human Services 4/25/1999 Committee Report (Substituted) BACKGROUND AND PURPOSE Currently, nursing home residents receiving Medicaid can receive dental services in two ways: _if the individual is able to pay for necessary services up front, Medicaid will reimburse them for incurred medical expenses (IMEs) at a later date; or _if the individual cannot pay for services up front, the individual may only receive dental care in emergency situations, when treatment becomes imperative. As a result of these limited dental options, adequate care is rarely received, and the resident's oral health often reaches emergency status before the problem is identified. Dental care in these instances is much more expensive than preventive care. C.S.H.B. 3636 provides for annual dental examinations, diagnostic dental x-rays, and cleanings for residents receiving Medicaid. This bill also directs the Health and Human Services Commission to conduct a study for the need for and cost of expanding dental services provided by this Act. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the Texas Department of Human Services, in cooperation with the Health and Human Services Commission, in SECTION 2 of this bill. SECTION BY SECTION ANALYSIS SECTION 1. Amends Section 32.024, Human Resources Code, by adding Subsection (v) to require the Texas Department of Human Services (department) to provide dental services annually to a resident of a nursing facility who is a recipient of medical assistance under this chapter. Provides that the dental services must include a dental examination by a licensed dentist; a prophylaxis (cleaning) by a licensed dentist or dental hygienist, if practical considering the resident's health; and diagnostic dental x-rays. SECTION 2. Requires the department, in cooperation with the Health and Human Services Commission (commission), by rule, to develop a fee schedule for dental services added by this Act. SECTION 3. Requires the commission to conduct a study regarding the need for and cost of expanding the dental services provided as added by this Act and, no later than December 1, 2000, to report to the governor, lieutenant governor, speaker of the house of representatives, and the presiding officers of the standing committees of the senate and house of representatives having primary jurisdiction over the commission the results of this study. Provides that the study includes an analysis of the costs, benefits, and feasibility of expanding the services provided as added by this Act. SECTION 4. Requires a state agency affected by a provision of this Act to request a waiver or authorization from a federal agency if it is determined that a waiver or authorization is needed to implement any provision of this Act and to delay implementation of that provision until the waiver or authorization is granted. SECTION 5. Effective date: September 1, 1999. SECTION 6. Emergency clause. COMPARISON OF ORIGINAL TO SUBSTITUTE C.S.H.B. 3636 differs from the original in SECTION 1 by modifying proposed Section 32.024(v), Human Resources Code, to include a prophylaxis by a licensed dentist or dental hygienist, if practical considering the resident's health, among those dental services provided under this section. The substitute also specifies that the examination required be performed by a licensed dentist.