Government Code § 532.0505

Sec. 532.0505. INITIAL MEDICAL AND NONMEDICAL HEALTH-RELATED SCREENINGS OF CERTAIN RECIPIENTS. (a) A Medicaid managed care organization that provides health care services to a pregnant woman under the STAR Medicaid managed care program shall conduct an initial health needs screening and nonmedical health-related needs screening of each pregnant recipient to determine, regardless of whether the recipient is considered to have a high-risk pregnancy, if the recipient: (1) is eligible for service coordination benefits to be provided by the managed care organization; or (2) should be referred for program services. (b) Service coordination benefits described by Subsection (a) must include identifying and coordinating the provision of non-covered services, community supports, and other resources the Medicaid managed care organization determines will improve the recipient's health outcomes. (c) A Medicaid managed care organization must use the results of the screenings conducted under Subsection (a) to determine if a recipient requires a more comprehensive assessment for purposes of determining whether the recipient is eligible for service coordination benefits or program services. Added by Acts 2023, 88th Leg., R.S., Ch. 316 (H.B. 1575), Sec. 3, eff. September 1, 2023. Transferred, redesignated and amended from Government Code, Subchapter Q, Chapter 531 by Acts 2025, 89th Leg., R.S., Ch. 204 (H.B. 1620), Sec. 8.028, eff. September 1, 2025.