Bill > HB5488

This bill establishes a new provision in Texas law requiring Medicaid to reimburse providers for coordinated specialty care services for individuals experiencing their first episode of psychosis. The bill defines "coordinated specialty care for first episode psychosis" as a comprehensive treatment approach that includes psychotherapy, medication management, case management, family education and support, and employment assistance, drawing from the National Institute of Mental Health's RAISE early treatment program study. The care can be triggered by medical conditions, serious mental illness, or substance use. To receive reimbursement, providers must contract with the state's health commission or a managed care organization and adhere to the specific treatment model's fidelity standards. If a credentialed psychiatrist or clinical leader leads a treatment team, all team members are considered credentialed. Importantly, the bill does not require providers to offer every possible coordinated care service to receive reimbursement. The legislation is set to take effect on September 1, 2025, and allows for potential delays if federal waivers or authorizations are required for implementation.

Health and Social Services

https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB5488