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