78R5011 CLG-F

By:  Lindsay                                                      S.B. No. 427



A BILL TO BE ENTITLED

AN ACT

relating to authorizing the state to contract with certain local 
governmental entities to provide Medicaid eligibility 
determination services.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Subchapter B, Chapter 32, Human Resources Code, 
is amended by adding Section 32.0252 to read as follows:
	Sec. 32.0252.  CONTRACT TO PROVIDE ELIGIBILITY 
DETERMINATION SERVICES.  (a)  To the extent allowed by federal law, 
and except as otherwise provided by this section, the department 
may contract for the provision of medical assistance eligibility 
determination services with:
		(1)  a hospital district created under the authority of 
Sections 4-11, Article IX, Texas Constitution;
		(2)  a hospital authority created under the authority 
of Chapter 262 or 264, Health and Safety Code, that uses resources 
to provide health care services to indigent persons to some extent;
		(3)  a hospital owned and operated by a municipality or 
county or by a hospital authority created under the authority of 
Chapter 262 or 264, Health and Safety Code;
		(4)  a medical school operated by this state;                          
		(5)  a medical school that receives state money under 
Section 61.093, Education Code, or a chiropractic school that 
receives state money under the General Appropriations Act;
		(6)  a teaching hospital operated by The University of 
Texas System; 
		(7)  a county that is required to provide health care 
assistance to eligible county residents under Subchapter B, Chapter 
61, Health and Safety Code;
		(8)  a governmental entity that is required to provide 
money to a public hospital under Section 61.062, Health and Safety 
Code;
		(9)  a county with a population of more than 400,000 
that provides money to a public hospital and that is not included in 
the boundaries of a hospital district;
		(10)  a hospital owned by a municipality and leased to 
and operated by a nonprofit hospital for a public purpose;
		(11)  a hospital that receives Medicaid 
disproportionate share payments;
		(12)  a community mental health and mental retardation 
center;       
		(13)  a local mental health or mental retardation 
authority;         
		(14)  a local health department or public health 
district;           
		(15)  a school-based health center;                                    
		(16)  a community health center;                                       
		(17)  a federally qualified health center; and                         
		(18)  a health services district created under the 
authority of Chapter 287, Health and Safety Code.
	(b)  The department may contract with an entity described by 
Subsection (a) for the entity to designate one or more employees of 
the entity to process medical assistance application forms and 
conduct client interviews for eligibility determinations.
	(c)  Except as provided by Subsection (d), the contract must 
require each designated employee to submit completed application 
forms to the appropriate agency as determined by the department so 
the appropriate agency can make a final determination of 
eligibility and enroll eligible persons in the program.
	(d)  Notwithstanding Subsection (c), the commissioner may 
apply for federal authorization to allow a designated employee of 
an entity described by Subsection (a) to make a final determination 
of eligibility or enroll an eligible person in the program.
	(e)  The department may:                                                
		(1)  monitor the eligibility and application 
processing program used by an entity with which the department 
contracts; and
		(2)  provide on-site supervision of the program for 
quality control. 
	(f)  The Health and Human Services Commission shall ensure 
that there are adequate protections to avoid a conflict of interest 
with an entity described by Subsection (a) that has a contract for 
eligibility determination services and also has a contract, either 
directly or through an affiliated entity, as a managed care 
organization for the medical assistance program or for the child 
health plan program under Chapter 62, Health and Safety Code.  The 
commission shall ensure that there are adequate protections for 
recipients to freely choose a health plan without being 
inappropriately induced to join an entity's health plan.
	SECTION 2.  This Act takes effect September 1, 2003.