Relating to authorizing Medicaid managed care organizations to offer nutrition support services in lieu of other state Medicaid plan services.

Contracts

• MCO-State Agreements: Prepare for amendments to the Uniform Managed Care Contract (UMCC) incorporating the new ILOS provisions.
• Vendor Agreements (New): Legal teams must draft service agreements for Medically Tailored Meal providers. These contracts must include strict indemnification clauses regarding food safety, spoilage, and allergen control, as the MCO is effectively "prescribing" food.
• Provider Amendments: Existing network agreements with Registered Dietitians (RDs) must be amended to include the specific fee schedules for the new "in lieu of" service codes once published by HHSC.

Hiring/Training

• Credentialing: Network teams must establish credentialing workflows for MTM vendors (non-traditional medical providers).
• Case Management Training: Intake staff must be trained to screen pregnant members for specific eligibility criteria: gestational diabetes, preeclampsia, hypertension, or obesity.
• Referral Loops: Staff must be trained on "closed-loop" referrals—verifying not just that a meal was ordered, but that it was delivered and accepted by the member.

Reporting & Record-Keeping

• Outcome Correlation: IT systems must be upgraded to link nutrition service claims with clinical health outcomes (e.g., maternal blood pressure, infant birth weight) to satisfy the legislative reporting mandate.
• Compliance Tracking: For the Pilot Program, MCOs must track the member's *compliance rate* (i.e., did the patient actually consume the meals?). This requires data sharing integration with meal vendors.
• Cost-Effectiveness: Finance teams must document that the ILOS provided was less expensive than the standard state plan service it replaced (e.g., nutrition counseling vs. hospitalization).

Fees & Costs

• IT Overhaul: The Fiscal Note anticipates costs for "establishing a new provider type." MCOs should budget for internal claims system updates to recognize non-clinical meal vendors as payees.
• Reimbursement Strategy: While the services are "in lieu of" (cost-neutral or savings-generating), there will be upfront administrative costs to establish the provider network.