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A BILL TO BE ENTITLED
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AN ACT
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relating to a transitional health plan program for certain children |
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previously enrolled in the Medicaid or the state child health plan |
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program. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Chapter 62, Health and Safety Code, is amended by |
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adding Subchapter E to read as follows: |
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SUBCHAPTER E. TRANSITIONAL CHILD HEALTH PLAN PROGRAM |
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Sec. 62.201. AUTHORITY TO ESTABLISH PROGRAM. The |
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commission may establish a transitional child health plan program |
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to provide health benefits coverage for children previously |
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enrolled in the medical assistance program under Chapter 32, Human |
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Resources Code, or the child health plan program under this chapter |
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who are no longer eligible for medical assistance or benefits under |
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those programs. |
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Sec. 62.202. ELIGIBILITY. A child is eligible for health |
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benefits coverage under the transitional child health plan program |
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if the child: |
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(1) is younger than 19 years of age; |
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(2) is not eligible for: |
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(A) medical assistance under the medical |
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assistance program under Chapter 32, Human Resources Code; or |
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(B) covered benefits under the child health plan |
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program under this chapter; |
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(3) is not covered by a private health benefits plan |
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offering adequate benefits, as determined by the commission; and |
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(4) satisfies any other eligibility standard imposed |
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by the commission. |
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Sec. 62.203. BENEFITS COVERAGE. (a) Each health plan |
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provider that provides coverage under the child health plan program |
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shall offer health benefits coverage to a child determined to be |
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eligible for coverage under Section 62.202. |
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(b) A child remains eligible for those benefits until the |
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earlier of: |
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(1) the first anniversary of the date the child |
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enrolls in a health plan under Subsection (a); or |
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(2) the individual's 19th birthday. |
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Sec. 62.204. PREMIUM PAYMENTS. (a) The commission shall |
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determine the amount of the health plan premium for a child |
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participating in the transitional child health plan program under |
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this subchapter. The amount of the premium may not exceed the |
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premium amount paid by the state to cover a child enrolled in the |
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child health plan program. |
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(b) The commission may not pay any amount of the premium, |
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deductible, copayment, coinsurance, or other cost-sharing |
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obligation related to health benefits coverage offered under the |
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transitional child health plan program. |
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(c) A participant's health plan coverage under this |
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subchapter shall be terminated on failure to make timely payments |
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of the premium to be paid for the coverage. |
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Sec. 62.205. RULES; GUIDELINES. The executive |
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commissioner of the commission by rule shall establish: |
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(1) eligibility standards for participants in the |
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transitional child health plan program under this subchapter; and |
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(2) guidelines for premium payments for health plans |
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under the program. |
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SECTION 2. Not later than January 1, 2008, the executive |
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commissioner of the Health and Human Services Commission shall |
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adopt the rules and guidelines necessary to implement Subchapter E, |
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Chapter 62, Health and Safety Code, as added by this Act. |
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SECTION 3. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2007. |