5 Things Texas: Medicaid redeterminations, Conversation w/Carelon Behavioral Health, Health bills we’re watching


Eli Kirshbaum


This edition features information about the work state leaders are doing to prepare for Medicaid redeterminations, a conversation with Carelon Behavioral Health’s Kevin Denmark about the company’s recent rebranding, and some some health-related bills of interest.

Thanks for reading!


Eli Kirshbaum
State of Reform

1. State leaders discuss Medicaid redeterminations

With the Medicaid eligibility renewal process beginning next month, HHSC is planning to stagger redeterminations by focusing on enrollees who likely no longer qualify for Medicaid first and proceeding with remaining beneficiaries over the next 12 months. The agency told State of Reform that individuals who submit timely responses to their renewal packets will retain coverage until HHSC completes a full redetermination of their eligibility.

During a panel on Medicaid redeterminations at last week’s 2023 Texas State of Reform conference, HHSC’s Valerie Mayes explained that individuals who might not be eligible anymore will be sorted into three groups that will be redetermined consecutively: individuals most likely to no longer be eligible, individuals who are likely to move to a different type of Medicaid coverage, and individuals who are most likely to still be eligible. Stacey Pogue, senior policy analyst at Every Texan, said Texas’s weak eligibility system hinders the redetermination process and must be addressed.


2. Q&A: Carelon Behavioral Health’s Kevin Denmark on rebranding

As of March 1st, Beacon Health Options is now known as Carelon Behavioral Health. VP of Client Partnerships Kevin Denmark discussed the company’s rebranding and its future work in the behavioral health space in a recent Q&A with State of Reform. Carelon’s goals include continuing to strengthen school-based behavioral healthcare and supporting 988 crisis centers with local resources and wraparound services.

“What we need to do is continue building the connective tissue between all the important players throughout the state of Texas,” Denmark said. “But everyone needs to be at the table for connectivity purposes. Each part of the system needs to know what the other part of the system is doing. The opportunities are about linking care, creating that connectivity, and making sure that every member has access to care—where and when they need it.”


3. Republican leaders focused on workforce, healthcare access

With the bill introduction deadline having recently passed in the Texas Legislature, Rep. Stephanie Klick and Rep. Brian Harrison spoke about their health policy work this session at last week’s 2023 Texas State of Reform conference. Klick, chair of the House Public Health Committee, discussed the nurse loan forgiveness program she’s sponsoring, saying it would help retain long-term care nurses in the state who otherwise might leave to practice in higher-paying acute care settings.

To promote healthcare accessibility, both lawmakers support efforts to enter interstate licensure compacts. Harrison has introduced a bill that would allow providers licensed in other states to practice in Texas either in-person or through telemedicine. “We, through CMS, allowed reimbursements for telehealth and medicine that had previously not been permitted,” Harrison said. “And that’s actually something I don’t think we should ever turn back the clock on.”


4. Primary care policy priorities

The Texas Primary Care Consortium recently laid out its 2023 policy priorities, which focus on increasing access to care, promoting value-based care, and strengthening the primary care system. The consortium supports extending the postpartum Medicaid coverage period from six to 12 months, and strengthening broadband infrastructure to increase the potential of telehealth.

Updating Texas’s Medicaid infrastructure is also a priority for the organization, particularly in light of upcoming redeterminations. The consortium supports using waivers to renew Medicaid using SNAP data and modernizing the state’s website to make enrollment easier.


5. Other health bills we’re watching

Democratic lawmakers are promoting efforts to ensure access to contraceptive drugs, including a bill that would require Medicaid CHIP plans to cover prescribed contraceptive resources. Texas is currently one of two states whose CHIP program doesn’t cover these services. Additional bills in the House and the Senate would extend this requirement to commercial health plans.

We’re also monitoring a bill that would create the Mental Healthcare Enterprise Fund to grant license reciprocity for providers to practice mental healthcare. Daniel Spinks of the Texas Behavioral Health Council told State of Reform it’s critical to attract more individuals to training programs like this. “You could have us working at 100% peak efficiency and we’re probably not going to be able to cure that shortage,” Spinks said. “And the reason [for that] is because you’ve got a bottleneck further up in the supply chain. You’ve only got so many training programs.”