87R30256 KKR-F
 
  By: Frank H.R. No. 1994
 
 
R E S O L U T I O N
 
         BE IT RESOLVED by the House of Representatives of the State of
  Texas, 87th Legislature, Regular Session, 2021, That House Rule 13,
  Section 9(a), be suspended in part as provided by House Rule 13,
  Section 9(f), to enable the conference committee appointed to
  resolve the differences on House Bill 2658 (the Medicaid program,
  including the administration and operation of the Medicaid managed
  care program) to consider and take action on the following matter:
         House Rule 13, Section 9(a)(4), is suspended to permit the
  committee to add text on a matter not included in either the house
  or senate version of the bill by adding the following new SECTION to
  the bill:
         SECTION 8.  Section 32.0261, Human Resources Code, is
  amended to read as follows:
         Sec. 32.0261.  CONTINUOUS ELIGIBILITY.  (a) This section
  applies only to a child younger than 19 years of age who is
  determined eligible for medical assistance under this chapter.
         (b)  The executive commissioner shall adopt rules in
  accordance with 42 U.S.C. Section 1396a(e)(12), as amended, to
  provide for two consecutive periods of [a period of continuous]
  eligibility for a child between each certification and
  recertification of the child's eligibility, subject to Subsections
  (f) and (h) [under 19 years of age who is determined to be eligible
  for medical assistance under this chapter].
         (c)  The first of the two consecutive periods of eligibility
  described by Subsection (b) must be continuous in accordance with
  Subsection (d). The second of the two consecutive periods of
  eligibility is not continuous and may be affected by changes in a
  child's household income, regardless of whether those changes
  occurred or whether the commission became aware of the changes
  during the first or second of the two consecutive periods of
  eligibility.
         (d)  A [The rules shall provide that the] child remains
  eligible for medical assistance during the first of the two
  consecutive periods of eligibility, without additional review by
  the commission and regardless of changes in the child's household
  [resources or] income, until [the earlier of:
               [(1)]  the end of the six-month period following the
  date on which the child's eligibility was determined, except as
  provided by Subsections (f)(1) and (h) [; or
               [(2)  the child's 19th birthday].
         (e)  During the sixth month following the date on which a
  child's eligibility for medical assistance is certified or
  recertified, the commission shall, in a manner that complies with
  federal law, including verification plan requirements under 42
  C.F.R. Section 435.945(j), review the child's household income
  using electronic income data available to the commission. The
  commission may conduct this review only once during the child's two
  consecutive periods of eligibility.  Based on the review:
               (1)  the commission shall, if the review indicates that
  the child's household income does not exceed the maximum income for
  eligibility for the medical assistance program, provide for a
  second consecutive period of eligibility for the child until the
  child's required annual recertification, except as provided by
  Subsection (h) and subject to Subsection (c); or
               (2)  the commission may, if the review indicates that
  the child's household income exceeds the maximum income for
  eligibility for the medical assistance program, request additional
  documentation to verify the child's household income in a manner
  that complies with federal law.
         (f)  If, after reviewing a child's household income under
  Subsection (e), the commission determines that the household income
  exceeds the maximum income for eligibility for the medical
  assistance program, the commission shall continue to provide
  medical assistance to the child until:
               (1)  the commission provides the child's parent or
  guardian with a period of not less than 30 days to provide
  documentation demonstrating that the child's household income does
  not exceed the maximum income for eligibility; and
               (2)  the child's parent or guardian fails to provide the
  documentation during the period described by Subdivision (1).
         (g)  If a child's parent or guardian provides to the
  commission within the period described by Subsection (f)
  documentation demonstrating that the child's household income does
  not exceed the maximum income for eligibility for the medical
  assistance program, the commission shall provide for a second
  consecutive period of eligibility for the child until the child's
  required annual recertification, except as provided by Subsection
  (h) and subject to Subsection (c).
         (h)  Notwithstanding any other period prescribed by this
  section, a child's eligibility for medical assistance ends on the
  child's 19th birthday.
         (i)  The commission may not recertify a child's eligibility
  for medical assistance more frequently than every 12 months as
  required by federal law.
         (j)  If a child's parent or guardian fails to provide to the
  commission within the period described by Subsection (f)
  documentation demonstrating that the child's household income does
  not exceed the maximum income for eligibility for the medical
  assistance program, the commission shall provide the child's parent
  or guardian with written notice of termination following that
  period. The notice must include a statement that the child may be
  eligible for enrollment in the child health plan under Chapter 62,
  Health and Safety Code.
         (k)  In developing the notice, the commission shall consult
  with health care providers, children's health care advocates,
  family members of children enrolled in the medical assistance
  program, and other stakeholders to determine the most user-friendly
  method to provide the notice to a child's parent or guardian.
         (l)  The executive commissioner may adopt rules as necessary
  to implement this section.
         Explanation: This addition is necessary to provide for
  continuous eligibility and a periodic eligibility review for a
  child for Medicaid.