Relating to authorizing Medicaid managed care organizations to offer nutrition support services in lieu of other state Medicaid plan services, the official text

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