Relating to the continuation of the maternal opioid misuse model of care for certain Medicaid recipients.

Contracts

• MCO Amendments: Managed Care Organizations must update provider agreements and manuals to reflect the program's extension through September 1, 2029.
• Grant Agreements: Entities receiving direct funding must review contracts for new stipulations regarding the "supplanting vs. supplementing" of funds, as the revenue source is now statutorily tied to the Opioid Abatement Trust Fund.

Hiring/Training

• Care Coordination: Continue cross-training staff on integrated somatic (OB/GYN) and behavioral health protocols. The "model of care" requires active case management; siloed treatment remains non-compliant.
• Eligibility Screening: Admissions staff must maintain dual-eligibility screening protocols (Pregnancy/Postpartum status + OUD diagnosis) without interruption.

Reporting & Record-Keeping

• Fund Segregation: Finance departments must establish distinct cost centers or ledger codes for funds received via the Opioid Abatement Account. Commingling these funds with general operating revenue creates significant audit risk.
• Outcome Data: HHSC is required to report on program benefits. Providers must proactively document and retain data on:
• Maternal retention in treatment.
• Neonatal Abstinence Syndrome (NAS) severity and costs.
• Postpartum relapse rates.

Fees & Costs

• No New Fees: The legislation does not impose new fees on providers.
• Cost Absorption: Providers are expected to absorb administrative costs associated with continued compliance within existing reimbursement rates.