By Kitchen, Chavez, Naishtat, Maxey H.B. No. 2807
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to a demonstration project to extend Medicaid coverage to
1-3 certain low-income individuals.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Subchapter B, Chapter 32, Human Resources Code, is
1-6 amended by adding Section 32.053 to read as follows:
1-7 Sec. 32.053. DEMONSTRATION PROJECT FOR PROVISION OF MEDICAL
1-8 ASSISTANCE TO CERTAIN LOW-INCOME INDIVIDUALS. (a) The Health and
1-9 Human Services Commission shall establish a demonstration project
1-10 to provide medical assistance under this chapter to an adult
1-11 individual who:
1-12 (1) has a family income that is less than or equal to
1-13 the income eligibility limit established under Subsection (b);
1-14 (2) is not otherwise eligible for medical assistance
1-15 at the time the individual's eligibility for participation in the
1-16 demonstration project is determined; and
1-17 (3) is not covered by a health benefits plan offering
1-18 adequate coverage, as determined by the commission.
1-19 (b) The Health and Human Services Commission, in conjunction
1-20 with local governmental entities that make funds available to the
1-21 commission in accordance with this section, shall establish a
1-22 family income eligibility limit for individuals participating in
1-23 the demonstration project so that only an individual whose family
1-24 income is at or below 200 percent of the federal poverty level is
2-1 eligible for participation in the demonstration project.
2-2 (c) The Health and Human Services Commission, in conjunction
2-3 with local governmental entities that make funds available to the
2-4 commission in accordance with this section, shall design the
2-5 components of the demonstration project, including the adoption of
2-6 procedures for the reporting and monitoring of:
2-7 (1) utilization patterns of participants in the
2-8 demonstration project;
2-9 (2) prevention activities related to health status and
2-10 engaged in by participants in the demonstration project; and
2-11 (3) prescription drug usage by participants in the
2-12 demonstration project.
2-13 (d) In establishing the demonstration project, the Health
2-14 and Human Services Commission shall ensure that:
2-15 (1) the demonstration project is financed using funds
2-16 made available by certain local governmental entities, which may
2-17 include a county indigent health care program, to the commission
2-18 for matching purposes to maximize federal funds for the medical
2-19 assistance program; and
2-20 (2) a participant in the demonstration project is not
2-21 subject to a limitation imposed on prescription drug benefits under
2-22 the medical assistance program.
2-23 (e) The manner in which a local governmental entity makes
2-24 funds available for matching purposes under Subsection (d)(1) must
2-25 include an option for the entity to be able to certify the amount
2-26 of funds considered available instead of sending the funds to the
2-27 state.
3-1 (f) The Texas Department of Health shall administer the
3-2 demonstration project at the direction of the Health and Human
3-3 Services Commission.
3-4 (g) The Health and Human Services Commission shall select
3-5 one or more municipalities or counties in which to implement the
3-6 demonstration project, and at least one selected county must have a
3-7 population of more than 725,000 or at least one selected
3-8 municipality must have a population of more than 600,000. The
3-9 demonstration project may be implemented in a multi-county region
3-10 and may include local funds made available through a county
3-11 indigent health care program.
3-12 (h) The Health and Human Services Commission shall appoint
3-13 an advisory committee to assist the commission and the Texas
3-14 Department of Health in establishing and implementing the
3-15 demonstration project. The advisory committee must include health
3-16 care providers and local government officials.
3-17 (i) Not later than December 1 of each even-numbered year,
3-18 the Texas Department of Health shall evaluate the effectiveness,
3-19 including the cost-effectiveness, of the demonstration project in
3-20 providing health care services to project participants. If the
3-21 results of the evaluation indicate that the demonstration project
3-22 is cost-effective, the department shall incorporate a request for
3-23 funding for the continuation or expansion of the demonstration
3-24 project in the department's budget request for the next state
3-25 fiscal biennium.
3-26 (j) Not later than December 1 of each even-numbered year,
3-27 the Texas Department of Health shall submit a report to the
4-1 legislature regarding the operation and cost-effectiveness of the
4-2 demonstration project established under this section.
4-3 SECTION 2. If the Health and Human Services Commission
4-4 determines that a waiver or authorization from a federal agency is
4-5 necessary for implementing any provision of this Act, the
4-6 commission shall request the waiver or authorization not later than
4-7 September 1, 2001, and may delay implementing that provision until
4-8 the waiver or authorization is granted.
4-9 SECTION 3. Not later than January 1, 2002, the Texas
4-10 Department of Health shall implement the demonstration project
4-11 required by Section 32.053, Human Resources Code, as added by this
4-12 Act.
4-13 SECTION 4. This Act takes effect immediately if it receives
4-14 a vote of two-thirds of all the members elected to each house, as
4-15 provided by Section 39, Article III, Texas Constitution. If this
4-16 Act does not receive the vote necessary for immediate effect, this
4-17 Act takes effect September 1, 2001.