§ 32.055. CATASTROPHIC CASE MANAGEMENT. (a) The
department shall develop and implement a catastrophic case
management system to be used in providing medical assistance to
persons with catastrophic health problems.
(b) The system must provide for the assignment of a case
manager to a recipient of medical assistance with catastrophic
health problems that are likely to:
(1) require the services of multiple, specialized
health care providers; and
(2) result in major medical costs.
(c) The department shall identify the services to be
provided by a case manager assigned under the system. The services
must include assessment of the recipient's needs and coordination
of all available medical services and payment options. The
services may include other support services such as:
(1) assistance with making arrangements to receive
care from medical facilities;
(2) assistance with travel and lodging in connection
with receipt of medical care;
(3) education of the recipient and the recipient's
family members regarding the nature of the recipient's health
(4) referral to appropriate support groups; and
(5) any other service likely to result in better care
provided in a cost-effective manner.
(d) Not later than January 15 of each odd-numbered year, the
department shall report to the legislature on the implementation of
the system. The report must include a statement of:
(1) the number of recipients of medical assistance who
received catastrophic case management services under the system
during the preceding two years; and
(2) the estimated savings under the medical assistance
program resulting from implementation of the system during the
preceding two years.
Added by Acts 2001, 77th Leg., ch. 408, § 1, eff. Sept. 1, 2001.
Renumbered from V.T.C.A., Human Resources Code § 32.053 by Acts
2003, 78th Leg., ch. 1275, § 2(99), eff. Sept. 1, 2003.