Enrolled Bill Summary

            Senate Bill 43 amends the Health and Safety Code and Human Resources Code to simplify enrollment and reenrollment in the medical assistance program. The bill requires that the Health and Human Services Commission, or the agency operating part of the medical assistance program, adopt an application form and procedures that are the same as those for the state child health plan, to ensure the use of a single consolidated application for a child under age 19 to seek medical assistance or request coverage under the state child health plan. The bill requires documentation and verification procedures used to certify and recertify eligibility in the medical assistance program to be the same as procedures under the state child health plan, and they may not be more stringent than the current procedures. The bill provides that an application for medical assistance may be conducted by mail, rather than by personal appearance at an office, and also provides that a child under age 19 who is eligible for medical assistance must remain eligible with no additional review until the earlier of the first anniversary on which the child's eligibility was determined or the child's 19th birthday.

            The bill requires the development of procedures to forward an applicant's information to the state child health plan if the applicant is eligible for coverage under that plan and was denied coverage under the medical assistance program. It requires the parent or caretaker of a child who will be denied continued medical assistance because of failure to keep an appointment to be contacted and informed of the need to recertify eligibility and the availability of coverage under the state child health plan. It requires parents or guardians to attend a health care orientation within a specified time after originally establishing eligibility in the medical assistance program. It also includes a requirement for the development of procedures to ensure compliance with Texas Health Steps and places limitations on a recipient from disenrolling in a managed care plan for a 12-month period.