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).