80R1659 CLG/DLF-D
 
  By: Williams S.B. No. 738
 
 
 
   
 
 
A BILL TO BE ENTITLED
AN ACT
relating to long-term care insurance and a partnership for
long-term care program.
       BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
       SECTION 1.  Chapter 32, Human Resources Code, is amended by
adding Subchapter C to read as follows:
SUBCHAPTER C. PARTNERSHIP FOR LONG-TERM CARE PROGRAM
       Sec. 32.101.  DEFINITIONS. In this subchapter:
             (1)  "Approved plan" means a long-term care benefit
plan that is approved by the Texas Department of Insurance under
Subchapter C, Chapter 1651, Insurance Code.
             (2)  "Asset disregard" means the total equity value of
assets and resources not exempt under rules governing the medical
assistance program that are disregarded in determining eligibility
for the medical assistance program and in determining estate
recovery obligations.
             (3)  "Asset protection" means the right extended to a
plan holder of an approved plan to dollar-for-dollar asset
disregard under the medical assistance program.
             (4)  "Dollar-for-dollar asset disregard" means an
asset disregard in which the amount of the disregard is equal to the
sum of qualifying benefit payments made on behalf of the qualified
plan holder.
             (5)  "Executive commissioner" means the executive
commissioner of the Health and Human Services Commission.
             (6)  "Partnership for long-term care program" means the
program established under this subchapter and Subchapter C, Chapter
1651, Insurance Code.
       Sec. 32.102.  PARTNERSHIP FOR LONG-TERM CARE PROGRAM. The
partnership for long-term care program is administered as part of
the medical assistance program by the department with the
assistance of the Texas Department of Insurance.  The program must
be consistent with provisions governing the expansion of a state
long-term care partnership program established under the federal
Deficit Reduction Act of 2005 (Pub. L. No. 109-171).
       Sec. 32.103.  ASSET DISREGARD.  (a)  To the extent allowed
by the federal Deficit Reduction Act of 2005 (Pub. L. No. 109-171)
and other federal law, the executive commissioner, in adopting
rules and standards governing the medical assistance program, shall
allow for dollar-for-dollar asset disregard to provide medical
assistance to an individual receiving long-term care services if
the individual is or was covered by a long-term care benefit plan
providing coverage for long-term care that meets the applicable
minimum benefit standards of the commissioner of the Texas
Department of Insurance under Subchapter C, Chapter 1651, Insurance
Code, and other requirements for approval under the partnership for
long-term care program.
       (b)  The department may not consider the resources of an
individual who has used all or part of the individual's benefits
under an approved plan to the extent those resources are the subject
of a dollar-for-dollar asset disregard in determining:
             (1)  eligibility for medical assistance under the
medical assistance program;
             (2)  the amount of medical assistance provided; or
             (3)  any subsequent recovery by this state from the
individual's estate for medical assistance provided to the
individual.
       (c)  The department may not provide to an individual eligible
for medical assistance under this section those medical assistance
services covered under the medical assistance program that are also
covered by the individual's benefits under the approved plan until
the individual has fully exhausted the individual's benefits under
the plan.
       Sec. 32.104.  RECIPROCAL AGREEMENTS.  The department may
enter into reciprocal agreements with other states to extend asset
protection to a resident of this state who purchased a long-term
care benefit plan in another state that has a substantially similar
asset disregard program.
       Sec. 32.105.  TECHNICAL ASSISTANCE AND INFORMATION. The
Health and Human Services Commission shall provide information and
technical assistance to the Texas Department of Insurance regarding
that department's role in ensuring that each individual who sells a
long-term care benefit plan under the partnership for long-term
care program receives training and demonstrates evidence of an
understanding of these plans and how the plans relate to other
public and private coverage of long-term care.
       Sec. 32.106.  RULES.  (a)  The executive commissioner shall
adopt rules as necessary to administer the partnership for
long-term care program and to implement this subchapter.
       (b)  In adopting rules under this section, the executive
commissioner shall:
             (1)  provide for dollar-for-dollar asset disregard and
asset protection for purchasers of an approved plan; and
             (2)  count benefits paid under the approved plan toward
the dollar-for-dollar asset disregard to the extent the benefits
are provided for covered services under the approved plan.
       Sec. 32.107.  BIENNIAL REPORT.  (a)  Not later than January
1 of each odd-numbered year, the department shall submit a report to
the legislature on the progress of the partnership for long-term
care program during the preceding biennium.  The report must
include:
             (1)  the number of approved plans sold during each year
of the preceding biennium;
             (2)  the average age of individuals purchasing approved
plans during each year of the preceding biennium; and
             (3)  a recommendation on whether to continue the
program.
       (b)  The department may request information from the Texas
Department of Insurance as necessary to prepare the report required
by this section.
       SECTION 2.  Chapter 1651, Insurance Code, is amended by
adding Subchapter C to read as follows:
SUBCHAPTER C. PARTNERSHIP FOR LONG-TERM CARE PROGRAM
       Sec. 1651.101.  DEFINITIONS. In this subchapter:
             (1)  "Approved plan" means a long-term care benefit
plan that is approved by the department under this subchapter.
             (2)  "Dollar-for-dollar asset disregard" and "asset
protection" have the meanings assigned by Section 32.101, Human
Resources Code.
             (3)  "Medical assistance program" means the medical
assistance program established under Chapter 32, Human Resources
Code.
             (4)  "Partnership for long-term care program" means the
program established under Subchapter C, Chapter 32, Human Resources
Code, and this subchapter.
       Sec. 1651.102.  APPLICABILITY.  Except to the extent of a
conflict, Subchapters A and B apply to a plan issued in accordance
with this subchapter.
       Sec. 1651.103.  ASSISTANCE OF DEPARTMENT.  The department
shall assist the Health and Human Services Commission as necessary
for the commission to perform its duties and functions with respect
to the administration of the partnership for long-term care
program.
       Sec. 1651.104.  LONG-TERM CARE INSURANCE POLICY FOR
PARTNERSHIP FOR LONG-TERM CARE PROGRAM.  The commissioner, in
consultation with the Health and Human Services Commission, shall
adopt minimum standards for a long-term care benefit plan that may
qualify as an approved plan under the partnership for long-term
care program.  The standards must be consistent with provisions
governing the expansion of a state long-term care partnership
program established under the federal Deficit Reduction Act of 2005
(Pub. L. No. 109-171).
       Sec. 1651.105.  EFFECT OF DISCONTINUATION OF PROGRAM ON
POLICY.  If the partnership for long-term care program is
discontinued, an individual who purchased an approved plan before
the date the program is discontinued remains eligible to receive
dollar-for-dollar asset disregard and asset protection under the
medical assistance program.
       Sec. 1651.106.  RULES.  The commissioner may adopt rules as
necessary to implement this subchapter.
       SECTION 3.  Subchapter B, Chapter 531, Government Code, is
amended by adding Section 531.0841 to read as follows:
       Sec. 531.0841.  LONG-TERM CARE INSURANCE AWARENESS AND
EDUCATION CAMPAIGN.  (a) The commission, in consultation with the
Department of Aging and Disability Services and the Texas
Department of Insurance, shall develop and implement a public
awareness and education campaign designed to:
             (1)  educate the public on the cost of long-term care,
including the limits of Medicaid eligibility and the limits of
Medicare benefits;
             (2)  educate the public on the value and availability
of long-term care insurance; and
             (3)  encourage individuals to obtain long-term care
insurance.
       (b)  The Department of Aging and Disability Services and the
Texas Department of Insurance shall cooperate with and assist the
commission in implementing the campaign under this section.
       (c)  The commission may coordinate the implementation of the
campaign under this section with any other state outreach campaign
or activity relating to long-term care issues.
       SECTION 4.  The Health and Human Services Commission shall
amend this state's Medicaid plan as necessary to allow for
dollar-for-dollar asset disregard and asset protection for
purchasers of an approved policy under the partnership for
long-term care program established under Subchapter C, Chapter 32,
Human Resources Code, as added by this Act.
       SECTION 5.  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 of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
       SECTION 6.  This Act takes effect September 1, 2007.