Texas House bill by Rep. Hull mandates nutrition counseling options in Medicaid managed care contracts

Passed bill authored by State Rep. Lacey Hull seeks to expand Medicaid managed care contracts to include medically appropriate and cost-effective nutrition counseling, aiming to provide recipients with alternative service options, according to the Texas Legislature website.

In the House, 51 Democrats and 79 Republicans voted in favor of the bill, while six Democrats and three Republicans opposed it.

Meanwhile, in the Senate, 10 Democrats and 20 Republicans voted in favor, while one Democrat voted against it.

Lacey Hull introduced the bill in the Texas House on Wednesday, March 5, during the 89th regular legislative session.

Hull graduated from the University of Houston with a BS.

Hull, a Republican, was elected to the Texas State House in 2021 to represent the state’s 138th House district, replacing previous state representative Dwayne Bohac.

According to the Texas Legislature, the bill’s official text was summarized as follows: ‘Relating to authorizing Medicaid managed care organizations to offer nutrition support services in lieu of other state Medicaid plan services’.

The following is our breakdown, based on the actual bill text, and may include interpretation to clarify its provisions.

In essence, this bill mandates that contracts with Medicaid managed care organizations (MCOs) in Texas must include language allowing MCOs to offer medically appropriate, cost-effective, and evidence-based nutrition counseling and instruction services, as approved by the state Medicaid managed care advisory committee, in place of certain state Medicaid plan services. Recipients can choose whether or not to use these alternative services. Additionally, an annual report must be prepared for the legislature detailing the use of these services. The bill also stipulates that, when setting capitation rates, the commission should factor in the actual cost and usage of such services offered by MCOs. The bill prohibits the inclusion of home-delivered meals, food prescriptions, and grocery support in the list of permissible nutrition services. Contracts formed or renewed on or after September 1, 2025, must comply with these provisions.

The bill was co-authored by Rep. James Frank (Republican – District 69), Rep. Toni Rose (Democrat – District 110), and Rep. Jolanda Jones (Democrat – District 147), along with seven other authors.

The bill received its final legislative approval on Thursday, May 29, and was signed into law by Gov. Greg Abbott on Friday, June 20.

Bills in Texas go through a multi-step legislative process, including committee review, debates, and votes in both chambers before reaching a final decision. Each session, there are typically thousands of bills introduced, but only a portion successfully navigate the process to become law.

You can read more about the bills and other measures here.