Amend CSSB 43 by striking all below the enacting clause and
substituting the following:
SECTION 1. Section 62.103(b), Health and Safety Code, is
amended to read as follows:
(b) The form and procedures must be coordinated with forms
and procedures under the Medicaid program and those used by the
Texas Healthy Kids Corporation to ensure that<, to the extent
possible,> there is a single consolidated application to seek
assistance under this chapter or the Medicaid program or from the
corporation.
SECTION 2. Section 32.025, Human Resources Code, is amended
by adding Subsections (d), (e), and (f) to read as follows:
(d) The department shall adopt an application form and
procedures for a request for medical assistance provided to a child
under 19 years of age. To the extent allowed by federal law and
except as otherwise provided by this section, the application form
and procedures must be the same as the form and procedures adopted
under Section 62.103, Health and Safety Code. The department shall
coordinate the form and procedures adopted under this subsection
with the form and procedures adopted under Section 62.103, Health
and Safety Code, to ensure that there is a single consolidated
application for a child under 19 years of age to seek medical
assistance or to request coverage under the state child health plan
under Chapter 62, Health and Safety Code.
(e) The department shall permit an application requesting
medical assistance for a child under 19 years of age to be
conducted by mail instead of through a personal appearance at a
department office.
(f) The commissioner by rule may develop procedures by
which:
(1) any office of a health and human services agency
may accept an application requesting medical assistance for a child
under 19 years of age; and
(2) the department may contract with hospital
districts and county health departments to accept applications
requesting medical assistance for a child under 19 years of age.
SECTION 3. Section 32.026, Human Resources Code, is amended
by adding Subsections (d), (e), and (f) to read as follows:
(d) In adopting rules under this section, the department
shall ensure, to the extent allowed by federal law, that
documentation and verification procedures used in determining and
certifying the eligibility and need for medical assistance of a
child under 19 years of age, including the documentation and
verification procedures used to evaluate the assets and resources
of the child, the child's parents, or the child's other caretaker
for that purpose, are the same as the documentation and
verification procedures used to determine and certify a child's
eligibility for coverage under Chapter 62, Health and Safety Code,
except that the documentation and verification procedures adopted
in accordance with this subsection may not be more stringent than
the documentation and verification procedures existing on January
1, 2001, for determination and certification of a child's
eligibility for coverage under Chapter 62, Health and Safety Code.
(e) The department shall permit a recertification review of
the eligibility and need for medical assistance of a child under 19
years of age to be conducted by telephone or mail instead of
through a personal appearance at a department office.
(f) In adopting rules under this section, the department
shall ensure, to the extent allowed by federal law, that forms and
procedures used in conducting a recertification review of the
eligibility and need for medical assistance of a child under 19
years of age, including documentation and verification procedures,
are the same as the forms and procedures used to determine and
certify a child's renewal of coverage under Chapter 62, Health and
Safety Code.
SECTION 4. Subchapter B, Chapter 32, Human Resources Code, is
amended by adding Sections 32.0261, 32.0262, and 32.0263 to read as
follows:
Sec. 32.0261. CONTINUOUS ELIGIBILITY. The department shall
adopt rules in accordance with 42 U.S.C. Section 1396a(e)(12), as
amended, to provide for a period of continuous eligibility for a
child under 19 years of age who is determined to be eligible for
medical assistance under this chapter. The rules shall provide
that the child remains eligible for medical assistance, without
additional review by the department and regardless of changes in
the child's resources or income, until the earlier of:
(1) the first anniversary of the date on which the
child's eligibility was determined; or
(2) the child's 19th birthday.
Sec. 32.0262. ELIGIBILITY TRANSITION. (a) The department
shall develop procedures to ensure that all necessary information
regarding a child who will be denied continued medical assistance
under this chapter because of an increase in income, assets, or
resources but who is eligible for enrollment in the child health
plan under Chapter 62, Health and Safety Code, is promptly
transmitted to the child health plan in accordance with the
standards established under Section 62.104(d), Health and Safety
Code.
(b) The department shall develop procedures to ensure that
the parent or caretaker of a child who will be denied continued
medical assistance under this chapter because of a failure to keep
an appointment, including an appointment for recertification of
eligibility, a failure to provide information, or for another
procedural reason, is promptly contacted and informed of:
(1) the need to recertify eligibility for continued
medical assistance under this chapter; and
(2) the availability of medical coverage under the
child health plan under Chapter 62, Health and Safety Code.
(c) The department shall develop materials under this
section in consultation with the Health and Human Services
Commission and the appropriate agencies administering all or part
of the child health plan under Chapter 62, Health and Safety Code.
(d) The department by rule shall adopt procedures to assist
a family whose child loses eligibility for medical assistance under
this chapter in making a transition to the child health plan under
Chapter 62, Health and Safety Code, with no interruption in
coverage.
Sec. 32.0263. HEALTH CARE ORIENTATION. (a) The department
shall require that the parent or guardian of a child under 19 years
of age who originally establishes eligibility for medical
assistance must:
(1) attend an in-person counseling session with a
department representative not later than the 31st day after the
date the child originally establishes eligibility; or
(2) accompany the child to an appointment with a
health care provider for a comprehensive health care orientation
not later than the 61st day after the date the child originally
establishes eligibility.
(b) The commissioner by rule shall develop procedures to
verify that:
(1) the parent or guardian of the child who originally
establishes eligibility complies with the requirement of Subsection
(a)(2), if applicable; and
(2) the child is provided a comprehensive health care
orientation at the appointment with the health care provider.
SECTION 5. Subchapter B, Chapter 32, Human Resources Code, is
amended by adding Section 32.053 to read as follows:
Sec. 32.053. COMPLIANCE WITH TEXAS HEALTH STEPS. The
commissioner by rule shall develop procedures to ensure that
parents of children who are recipients of medical assistance comply
with the regimen of care prescribed by the Texas Health Steps
Comprehensive Care Program.
SECTION 6. Subchapter A, Chapter 533, Government Code, is
amended by adding Section 533.0076 to read as follows:
Sec. 533.0076. LIMITATIONS ON RECIPIENT DISENROLLMENT. (a)
Except as provided by Subsections (b) and (c), and to the extent
permitted by federal law, the commission may prohibit a recipient
from disenrolling in a managed care plan under this chapter and
enrolling in another managed care plan during the 12-month period
after the date the recipient initially enrolls in a plan.
(b) At any time before the 91st day after the date of a
recipient's initial enrollment in a managed care plan under this
chapter, the recipient may disenroll in that plan for any reason
and enroll in another managed care plan under this chapter.
(c) The commission shall allow a recipient who is enrolled
in a managed care plan under this chapter to disenroll in that plan
at any time for cause in accordance with federal law.
SECTION 7. If before implementing any provision of this Act a
state agency determines that a waiver or authorization from a
federal agency is necessary for implementation, the state agency
shall request the waiver or authorization and may delay
implementing that provision until the waiver or authorization is
granted.
SECTION 8. (a) Notwithstanding Section 32.0261, Human
Resources Code, as added by this Act, the Health and Human Services
Commission or the appropriate state agency operating part of the
medical assistance program under Chapter 32, Human Resources Code,
shall adopt rules in accordance with 42 U.S.C. Section
1396a(e)(12), as amended, to provide for a period of continuous
eligibility for a child under 19 years of age who is determined to
be eligible for medical assistance under that chapter. The rules
shall provide that the child remains eligible for medical
assistance, without additional review by the agency and regardless
of changes in the child's resources or income, until the earlier
of:
(1) the 180th day after the date on which the child's
eligibility was determined; or
(2) the child's 19th birthday.
(b) The Health and Human Services Commission or the
appropriate state agency operating part of the medical assistance
program under Chapter 32, Human Resources Code, shall adopt rules
required by this section not later than February 1, 2002. The
rules must provide for a six-month period of continuous eligibility
in accordance with this section for a child whose initial or
continued eligibility is determined on or after the effective date
of the rules. The rules adopted under this subsection remain in
effect until superseded by the rules adopted under Section 32.0261,
Human Resources Code, as added by this Act.
(c) This section expires on the date that the rules adopted
under Section 32.0261, Human Resources Code, as added by this Act,
take effect.
SECTION 9. (a) The Medicaid legislative oversight committee
created under S.B. No. 1156, Acts of the 77th Legislature, Regular
Session, 2001, may review and make recommendations regarding
legislation necessary to accomplish the purposes of Sections
32.025, and 32.026, Human Resources Code, as amended by this Act,
and Section 32.0261, Human Resources Code, as added by this Act.
(b) Subsection (a) of this section takes effect only if
S.B. No. 1156, Acts of the 77th Legislature, Regular Session, 2001,
authorizes the creation of the Medicaid legislative oversight
committee and is enacted and becomes law. If S.B. No. 1156 does
not authorize the creation of the committee, is not enacted, or
does not become law, this section has no effect.
SECTION 10. (a) Except as otherwise provided by this Act,
this Act takes effect January 1, 2002.
(b) Section 32.0261, Human Resources Code, as added by this
Act, takes effect September 1, 2002, but the appropriate state
agency may not implement the 12-month period of continuous
eligibility prescribed by that section until the date on which the
rules adopted under Subsection (c) of this section take effect.
(c) The Health and Human Services Commission or the
appropriate state agency operating part of the medical assistance
program under Chapter 32, Human Resources Code, shall adopt rules
required by Section 32.0261, Human Resources Code, as added by this
Act, so that the rules take effect in accordance with that section
not earlier than September 1, 2002, or later than June 1, 2003. The
rules must provide for a 12-month period of continuous eligibility
in accordance with that section for a child whose initial or
continued eligibility is determined on or after the effective date
of the rules.
(d) The Health and Human Services Commission or the
appropriate agency operating part of the medical assistance program
under Chapter 32, Human Resources Code, shall adopt rules required
by Section 32.0262, Human Resources Code, as added by this Act, not
later than February 1, 2002.