Amend CSSB 1188 (House Committee Printing) by adding the
following appropriately numbered SECTION to the bill and
renumbering subsequent SECTIONS of the bill accordingly:
SECTION __. ADMINISTRATIVE AND JUDICIAL REVIEW OF MEDICAID
DECISIONS. (a) Subchapter A, Chapter 531, Government Code, is
amended by adding Section 531.019 to read as follows:
Sec. 531.019. ADMINISTRATIVE AND JUDICIAL REVIEW OF CERTAIN
DECISIONS. (a) In this section, "medical assistance benefits"
means benefits provided under the medical assistance program under
Chapter 32, Human Resources Code.
(b) The proceedings of a hearing related to a decision
regarding medical assistance benefits contested by an applicant for
or recipient of the benefits that is conducted by the commission or
a health and human services agency to which the commission
delegates a function related to the benefits must be recorded
electronically. Notwithstanding Section 2001.177, the cost of
preparing the record and transcript required to be sent to a
reviewing court may not be charged to the applicant for or recipient
of the benefits.
(c) Before an applicant for or recipient of medical
assistance benefits may appeal a decision of a hearing officer for
the commission or a health and human services agency related to
those benefits, the applicant or recipient must request an
administrative review by an appropriate attorney of the commission
or a health and human services agency, as applicable, in accordance
with rules of the executive commissioner. Not later than the 15th
business day after the date the attorney receives the request for
administrative review, the attorney shall complete an
administrative review of the decision and notify the applicant or
recipient in writing of the results of that review.
(d) Except as provided by this section, Subchapters G and H,
Chapter 2001, govern an appeal of a decision made by a hearing
officer for the commission or a health and human services agency
related to medical assistance benefits brought by an applicant for
or recipient of the benefits.
(e) For purposes of Section 2001.171, an applicant for or
recipient of medical assistance benefits has exhausted all
available administrative remedies and a decision, including a
decision under Section 32.035, Human Resources Code, is final and
appealable on the date that, after a hearing:
(1) the hearing officer for the commission or a health
and human services agency reaches a final decision related to the
benefits; and
(2) the appropriate attorney completes an
administrative review of the decision and notifies the applicant or
recipient in writing of the results of that review.
(f) For purposes of Section 2001.171, an applicant for or
recipient of medical assistance benefits is not required to file a
motion for rehearing with the commission or a health and human
services agency, as applicable.
(g) Judicial review of a decision made by a hearing officer
for the commission or a health and human services agency related to
medical assistance benefits is under the substantial evidence rule
and is instituted by filing a petition with a district court in
Travis County, as provided by Subchapter G, Chapter 2001.
(h) An appeal described by Subsection (d) takes precedence
over all civil cases except workers' compensation and unemployment
compensation cases.
(i) The appellee is the commission.
(b) Section 2001.223, Government Code, is amended to read as
follows:
Sec. 2001.223. EXCEPTIONS FROM DECLARATORY JUDGMENT, COURT
ENFORCEMENT, AND CONTESTED CASE PROVISIONS. Section 2001.038 and
Subchapters C through H do not apply to:
(1) except as provided by Section 531.019, the
granting, payment, denial, or withdrawal of financial or medical
assistance or benefits under service programs that were operated by
the former [of the] Texas Department of Human Services before
September 1, 2003, and are operated on and after that date by the
Health and Human Services Commission or a health and human services
agency, as defined by Section 531.001;
(2) action by the Banking Commissioner or the Finance
Commission of Texas regarding the issuance of a state bank or state
trust company charter for a bank or trust company to assume the
assets and liabilities of a financial institution that the
commissioner considers to be in hazardous condition as defined by
Section 31.002(a) or 181.002(a), Finance Code, as applicable;
(3) a hearing or interview conducted by the Board of
Pardons and Paroles or the pardons and paroles division of the Texas
Department of Criminal Justice relating to the grant, rescission,
or revocation of parole or other form of administrative release; or
(4) the suspension, revocation, or termination of the
certification of a breath analysis operator or technical supervisor
under the rules of the Department of Public Safety.
(c) The changes in law made by this section apply only to an
appeal of a final decision by the Health and Human Services
Commission or a health and human services agency to which the
commission delegates a function related to medical assistance
benefits under Chapter 32, Human Resources Code, that is rendered
on or after the effective date of this Act. A final decision
rendered by the commission or a health and human services agency
before the effective date of this Act is governed by the law in
effect on the date the decision was rendered, and the former law is
continued in effect for that purpose.