BILL ANALYSIS

Senate Research Center	S.B. 1695
88R11332 BDP-F	By: Blanco
	Health & Human Services
	4/14/2023
	As Filed

AUTHOR'S / SPONSOR'S STATEMENT OF INTENT

Beginning in April of 2023, approximately 2.3 million Texans will have to recertify their eligibility for Medicaid benefits with the Texas Health and Human Services Commission (HHSC) due to the end of the federal public health emergency. In preparation, HHSC has worked with Texas-managed care organizations (MCOs) and dental contractors to train voluntary providers to become case assistance affiliates under the Community Partner Program (CPP) that supports Medicaid and CHIP members enrolled with each plan during the redetermination process.

Over the last decade, the CPP has connected thousands of Texans with community-based organizations that assist with applying and managing state benefits. Healthcare plans are in a unique position to continue to provide additional support to their Medicaid recipients to assist them in accessing benefits, navigating the redetermination application process, and conducting simple administrative adjustments to their online accounts, like resetting their passwords or updating their contact information, which both result in hundreds of hours of agency resources and employee bandwidth.

S.B. 1695 codifies the HHSC case assistance affiliates program. The bill provides a training and certification process for program managers and case assistants providing services under the program and a mechanism for the suspension, revocation, and, as appropriate, periodic renewal of a case assistant's or program manager's certification.

As proposed, S.B. 1695 amends current law relating to the establishment of the case assistance affiliate program to provide certain assistance to Medicaid recipients and child health plan program enrollees.

RULEMAKING AUTHORITY

Rulemaking authority is expressly granted to the executive commissioner of the Health and Human Services Commission in SECTION 1 (Section 531.805, Government Code) of this bill.

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Chapter 531, Government Code, by adding Subchapter T, as follows:

SUBCHAPTER T. CASE ASSISTANCE AFFILIATE PROGRAM

Sec. 531.801. DEFINITIONS. Defines "case assistance affiliate," "case assistant," "enrollee," "program," "program manager," "recipient," and "virtual case assistance website."

Sec. 531.802. ESTABLISHMENT OF CASE ASSISTANCE AFFILIATE PROGRAM. (a) Requires the Health and Human Services Commission (HHSC), to:

(1) establish a statewide case assistance affiliate program (program) under which managed care organizations and dental maintenance organizations that participate in Medicaid or the child health plan program are allowed to operate as case assistance affiliates by maintaining virtual case assistance websites; and

(2) provide a training and certification process for program managers and case assistants providing services under the program.

(b) Provides that HHSC, in establishing the program:

(1) is required to consult with:

(A) experts, as determined by HHSC; and

(B) other interested persons, including managed care organizations and dental maintenance organizations participating in Medicaid or the child health plan program; and

(2) is authorized to establish a work group or advisory committee that includes interested persons to advise HHSC on the establishment of the program.

Sec. 531.803. VIRTUAL CASE ASSISTANCE WEBSITES. (a) Requires a case assistance affiliate to establish and maintain Internet websites for purposes of providing virtual application and renewal assistance and benefit case management services to the recipients and enrollees served by those organizations.

(b) Authorizes a case assistance affiliate, in providing benefit case management services, to use its virtual case assistance website to assist a recipient or enrollee with applying for and managing the recipient's or enrollee's benefits under other public assistance programs, including nutritional and financial assistance benefits.

(c) Requires HHSC to ensure that a virtual case assistance website allows a recipient or enrollee to access the website from any electronic device that provides Internet access.

Sec. 531.804. ADMINISTRATIVE EXPENSE. Requires HHSC to allow a case assistance affiliate to categorize the services the affiliate provides under the program as administrative expenses.

Sec. 531.805. RULES: PROGRAM REQUIREMENTS AND STANDARDS. Requires the executive commissioner of HHSC (executive commissioner) to adopt rules necessary to implement the program, including rules:

(1) establishing requirements for a managed care organization or dental maintenance organization to participate in the program;

(2) establishing the training and certification process required by Section 531.802(a)(2);

(3) providing for the suspension, revocation, and, as appropriate, periodic renewal of a case assistant's or program manager's certification;

(4) protecting the confidentiality of recipients' and enrollees' information; and

(5) establishing any other standards or requirements the executive commissioner determines necessary.

SECTION 2. Requires a state agency, if necessary for implementation of a provision of this Act, to request a waiver or authorization from a federal agency, and authorizes a delay of implementation until such a waiver or authorization is granted.

SECTION 3. Effective date: upon passage or September 1, 2023.