Amend SB 865 (house committee report) on second reading by 
adding the following appropriately numbered SECTIONS and 
renumbering subsequent SECTIONS of the bill accordingly:
	SECTION ____.  Section 154.182(b), Family Code, is amended 
to read as follows:
	(b)  In determining the manner in which health care coverage 
for the child is to be ordered, the court shall render its order in 
accordance with the following priorities, unless a party shows good 
cause why a particular order would not be in the best interest of 
the child:
		(1)  if health insurance is available for the child 
through a parent's employment or membership in a union, trade 
association, or other organization at reasonable cost [to the 
parent], the court shall order that parent to include the child in 
the parent's health insurance;
		(2)  if health insurance is not available for the child 
under Subdivision (1) but is available to a parent at reasonable 
cost from another source, including the program under Section 
154.1826 to provide health insurance in Title IV-D cases [and at a 
reasonable cost], the court may order that parent to provide health 
insurance for the child; or
		(3)  if health insurance coverage is not available for 
the child under Subdivision (1) or (2), the court shall order the 
obligor to pay the obligee, in addition to any amount ordered under 
the guidelines for child support, an amount, not to exceed nine 
percent of the obligor's annual [monthly] resources, as described 
by Section 154.062(b), as cash medical support for the child.
	SECTION ____.  Subchapter D, Chapter 154, Family Code, is 
amended by adding Sections 154.1826 and 154.1827 to read as 
follows:
	Sec. 154.1826.  HEALTH CARE PROGRAM FOR CERTAIN CHILDREN IN 
TITLE IV-D CASES.  (a)  In this section:
		(1)  "Health benefit plan issuer" means an insurer, 
health maintenance organization, or other entity authorized to 
provide health benefits coverage under the laws of this state.
		(2)  "Health care provider" means a physician or other 
person who is licensed, certified, or otherwise authorized to 
provide a health care service in this state.
		(3)  "Program" means the child health care program 
developed under this section.
		(4)  "Reasonable cost" has the meaning assigned by 
Section 154.181(e).
		(5)  "Third-party administrator" means a person who is 
not a health benefit plan issuer or agent of a health benefit plan 
issuer and who provides administrative services for the program, 
including processing enrollment of eligible children in the program 
and processing premium payments on behalf of the program.
	(b)  In consultation with the Texas Department of Insurance, 
the Health and Human Services Commission, and representatives of 
the insurance industry in this state, the Title IV-D agency shall 
develop and implement a statewide program to address the health 
care needs of children in Title IV-D cases for whom health insurance 
is not available to either parent at reasonable cost under Section 
154.182(b)(1) or under Section 154.182(b)(2) from a source other 
than the program.
	(c)  The director of the Title IV-D agency may establish an 
advisory committee to consult with the director regarding the 
implementation and operation of the program.  If the director 
establishes an advisory committee, the director may appoint any of 
the following persons to the advisory committee:
		(1)  representatives of appropriate public and private 
entities, including state agencies concerned with health care 
management;
		(2)  members of the judiciary;                                         
		(3)  members of the legislature; and                                   
		(4)  representatives of the insurance industry.                        
	(d)  The principal objective of the program is to provide 
basic health care services, including office visits with health 
care providers, hospitalization, and diagnostic and emergency 
services, to eligible children in Title IV-D cases at reasonable 
cost to the parents obligated by court order to provide medical 
support for the children.
	(e)  The Title IV-D agency may use available private 
resources, including gifts and grants, in administering the 
program.
	(f)  The Title IV-D agency shall adopt rules as necessary to 
implement the program.  The Title IV-D agency shall consult with the 
Texas Department of Insurance and the Health and Human Services 
Commission in establishing policies and procedures for the 
administration of the program and in determining appropriate 
benefits to be provided under the program.
	(g)  A health benefit plan issuer that participates in the 
program may not deny health care coverage under the program to 
eligible children because of preexisting conditions or chronic 
illnesses.  A child who is determined to be eligible for coverage 
under the program continues to be eligible until the termination of 
the parent's duty to pay child support as specified by Section 
154.006.  Enrollment of a child in the program does not preclude the 
subsequent enrollment of the child in another health care plan that 
becomes available to the child's parent at reasonable cost, 
including a health care plan available through the parent's 
employment or the state child health plan under Chapter 62, Health 
and Safety Code.
	(h)  The Title IV-D agency shall contract with an independent 
third-party administrator to provide necessary administrative 
services for operation of the program.
	(i)  A person acting as a third-party administrator under 
Subsection (h) is not considered an administrator for purposes of 
Chapter 4151, Insurance Code.
	(j)  The Title IV-D agency shall solicit applications for 
participation in the program from health benefit plan issuers that 
meet requirements specified by the agency.  Each health benefit 
plan issuer that participates in the program must hold a 
certificate of authority issued by the Texas Department of 
Insurance.
	(k)  The Title IV-D agency shall promptly notify the courts 
of this state when the program has been implemented and is available 
to provide for the health care needs of children described by 
Subsection (b).  The notification must specify a date beginning on 
which children may be enrolled in the program.
	(l)  On or after the date specified in the notification 
required by Subsection (k), a court that orders health care 
coverage for a child in a Title IV-D case shall order that the child 
be enrolled in the program authorized by this section unless other 
health insurance is available for the child at reasonable cost, 
including the state child health plan under Chapter 62, Health and 
Safety Code.
	(m)  Payment of premium costs for the enrollment of a child 
in the program may be enforced by the Title IV-D agency against the 
obligor by any means available for the enforcement of a child 
support obligation, including income withholding under Chapter 
158.
	(n)  The program is not subject to any provision of the 
Insurance Code or other law that requires coverage or the offer of 
coverage of a health care service or benefit.
	(o)  Any health information obtained by the program, or by a 
third-party administrator providing program services, that is 
subject to the Health Insurance Portability and Accountability Act 
of 1996 (42 U.S.C. Section 1320d et seq.) or Chapter 181, Health and 
Safety Code, is confidential and not open to public inspection.  Any 
personally identifiable financial information or supporting 
documentation of a parent whose child is enrolled in the program 
that is obtained by the program, or by a third-party administrator 
providing program services, is confidential and not open to public 
inspection.
	Sec. 154.1827.  ADMINISTRATIVE ADJUSTMENT OF MEDICAL 
SUPPORT ORDER.  (a)  In each Title IV-D case in which a medical 
support order requires that a child be enrolled in a health care 
program under Section 154.1826, the Title IV-D agency may 
administratively adjust the order as necessary on an annual basis 
to reflect changes in the amount of premium costs associated with 
the child's enrollment.
	(b)  The Title IV-D agency shall provide notice of the 
administrative adjustment to the obligor and the clerk of the court 
that rendered the order.
	SECTION ____.  The change in law made by this Act to Section 
154.182(b), Family Code, takes effect September 1, 2009.