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A BILL TO BE ENTITLED
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AN ACT
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relating to the administration and funding of and eligibility for |
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the child health plan, medical assistance, and other programs. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 531.021(e), Government Code, is amended |
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to read as follows: |
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(e) Notwithstanding any other provision of Chapter 32, |
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Human Resources Code, Chapter 533, or this chapter, the commission: |
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(1) may adjust the fees, charges, and rates paid to |
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Medicaid providers as necessary to achieve the objectives of the |
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Medicaid program in a manner consistent with the considerations |
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described by Subsection (d); and |
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(2) shall adjust the fees, charges, and rates paid for |
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primary care and nursing home services annually to, at a minimum, |
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account for inflation. |
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SECTION 2. Subchapter B, Chapter 531, Government Code, is |
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amended by adding Sections 531.02417, 531.02418, 531.02419, and |
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531.02420 to read as follows: |
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Sec. 531.02417. ENROLLMENT AND RETENTION MODIFICATIONS FOR |
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RECEIPT OF FEDERAL BONUS PAYMENTS. (a) Notwithstanding any other |
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provision of this chapter, Chapter 62, Health and Safety Code, |
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Chapter 32, Human Resources Code, or any other law, the commission |
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shall take all necessary actions to modify enrollment and retention |
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processes employed in the child health plan and Medicaid programs |
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to ensure that this state receives federal performance bonus |
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payments made available under Section 2105(a)(3), Social Security |
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Act (42 U.S.C. Section 1397ee(a)(3)), or, if an enrollment and |
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retention process employed in those programs does not require a |
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modification, maintain the process to ensure receipt of those |
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payments. |
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(b) Actions the commission is required to take under |
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Subsection (a) include implementing or maintaining the following |
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with respect to children younger than 19 years of age: |
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(1) a 12-month period of continuous eligibility for |
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the child health plan and Medicaid programs, as required by Section |
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62.102, Health and Safety Code, and Section 32.0261, Human |
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Resources Code, respectively; |
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(2) liberalizing asset test requirements for |
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eligibility determinations for the child health plan and Medicaid |
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programs, which may include: |
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(A) eliminating the asset test regardless of |
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whether the test is specifically authorized by statute; or |
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(B) permitting an applicant, or the applicant's |
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parent or guardian, to certify under penalty of perjury information |
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relating to assets or using an asset verification process that does |
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not require an applicant, or the applicant's parent or guardian, to |
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provide documentation except when discrepancies are discovered or |
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under other circumstances that justify requiring documentation, as |
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determined by the executive commissioner in accordance with federal |
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law; |
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(3) eliminating any personal interview requirements |
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for determining eligibility for the child health plan or Medicaid |
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programs, notwithstanding any other law; |
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(4) using the same application, set of supplemental |
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forms, if applicable, and information verification process for |
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determining eligibility for the child health plan and Medicaid |
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programs; and |
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(5) using automatic, administrative processes for |
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recertifying eligibility for the child health plan and Medicaid |
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programs that comply with the requirements specified by Section |
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2105(a)(4)(E), Social Security Act (42 U.S.C. Section |
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1397ee(a)(4)(E)), including: |
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(A) providing a preprinted form completed by the |
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commission or a person contracting with the commission to perform |
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eligibility and enrollment functions that is based on available |
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information, unless other information is provided or obtained |
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through verification; and |
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(B) using an ex parte process under which no |
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personal interview is required unless the commission, or the person |
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contracting with the commission to perform eligibility and |
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enrollment functions, does not have sufficient information to |
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recertify eligibility and that information cannot be acquired from |
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other sources without the participation of an applicant or the |
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applicant's parent or guardian. |
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Sec. 531.02418. RECEIPT OF TEMPORARY INCREASED MEDICAID |
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FMAP AND DSH ALLOTMENT. (a) In this section: |
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(1) "DSH allotment" means the federal funding |
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allotment provided under the disproportionate share hospital |
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supplemental payment program. |
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(2) "Medicaid FMAP" means the federal medical |
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assistance percentage by which state Medicaid expenditures are |
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matched with federal funds. |
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(b) The commission shall take all actions necessary to |
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qualify this state for the temporary increase in the Medicaid FMAP |
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authorized by Section 5001, American Recovery and Reinvestment Act |
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of 2009 (Pub. L. No. 111-5), and for the temporary increase in this |
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state's DSH allotment authorized by Section 5002, American Recovery |
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and Reinvestment Act of 2009 (Pub. L. No. 111-5). If necessary, the |
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commission shall, with assistance from the Texas Workforce |
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Commission, monitor the state unemployment increase percentage as |
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defined by Section 5001(c)(4), American Recovery and Reinvestment |
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Act of 2009 (Pub. L. No. 111-5), and assist in providing accurate |
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data regarding that percentage to the federal government for |
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purposes of ensuring receipt of the additional Medicaid FMAP |
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increase authorized by Section 5001(c) of that Act, if applicable. |
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(c) This section expires September 2, 2011. |
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Sec. 531.02419. MAINTENANCE OF ELIGIBILITY; PROMPT PAYMENT |
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REQUIREMENTS. (a) In this section, "Medicaid FMAP" has the meaning |
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assigned by Section 531.02418. |
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(b) Notwithstanding any other law, including any Act of the |
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81st Legislature that is enacted and becomes law, the commission |
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may not implement any eligibility standard, methodology, or |
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procedure under the Medicaid program, including a Medicaid waiver |
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program, that is more restrictive than the corresponding |
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eligibility standard, methodology, or procedure in effect on July |
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1, 2008, if the implementation of the standard, methodology, or |
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procedure would result in this state's ineligibility under Section |
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5001(f), American Recovery and Reinvestment Act of 2009 (Pub. L. |
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No. 111-5), for an increase in the Medicaid FMAP. |
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(c) The commission and any person under contract with the |
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commission shall comply with the prompt payment requirements with |
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respect to claims subject to Section 1902(a)(37)(A), Social |
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Security Act (42 U.S.C. Section 1396a(a)(37)(A)), to ensure this |
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state's eligibility for an increased Medicaid FMAP. The commission |
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shall report to the United States secretary of health and human |
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services on a quarterly basis as required by Section |
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5001(f)(2)(A)(ii), American Recovery and Reinvestment Act of 2009 |
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(Pub. L. No. 111-5), regarding compliance with those requirements |
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by the commission and persons under contract with the commission. |
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(d) This section expires September 2, 2011. |
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Sec. 531.02420. USE OF ADDITIONAL FEDERAL FUNDS; REPORT TO |
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FEDERAL GOVERNMENT. (a) Notwithstanding any other law, funds |
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received as a result of the increased Medicaid FMAP, as defined by |
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Section 531.02418, and any other federal funds received for |
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purposes of the Medicaid program as a result of the enactment of the |
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American Recovery and Reinvestment Act of 2009 (Pub. L. No. 111-5), |
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shall be credited to the general revenue fund and may not be |
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credited to the economic stabilization fund established under |
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Section 3.49-g, Article III, Texas Constitution, or another similar |
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fund established as a reserve fund for the future needs of this |
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state. |
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(b) Not later than September 30, 2011, the commission shall |
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submit a report to the United States secretary of health and human |
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services in the form and manner required by the secretary regarding |
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the use of additional Medicaid FMAP funds received by this state |
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resulting from the American Recovery and Reinvestment Act of 2009 |
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(Pub. L. No. 111-5). |
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(c) This section expires December 1, 2011. |
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SECTION 3. Section 531.02444(a), Government Code, is |
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amended to read as follows: |
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(a) The executive commissioner shall develop and implement |
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a Medicaid buy-in program for persons with disabilities as |
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authorized by the Ticket to Work and Work Incentives Improvement |
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Act of 1999 (Pub. L. No. 106-170) or the Balanced Budget Act of 1997 |
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(Pub. L. No. 105-33). The commission may conduct a community |
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outreach campaign to provide information relating to the |
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availability of Medicaid coverage through the buy-in program and to |
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promote enrollment of eligible persons in the program. |
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SECTION 4. Section 32.0261, Human Resources Code, is |
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amended to read as follows: |
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Sec. 32.0261. CONTINUOUS ELIGIBILITY. The department |
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shall adopt rules in accordance with 42 U.S.C. Section |
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1396a(e)(12), as amended, to provide for a period of continuous |
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eligibility for a child under 19 years of age who is determined to |
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be eligible for medical assistance under this chapter. The rules |
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shall provide that the child remains eligible for medical |
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assistance, without additional review by the department and |
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regardless of changes in the child's resources or income, until the |
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earlier of: |
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(1) the first anniversary of [end of the six-month
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period following] the date on which the child's eligibility was |
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determined; or |
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(2) the child's 19th birthday. |
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SECTION 5. (a) In this section: |
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(1) "Benefits program" means any program operated by |
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the Health and Human Services Commission or a health and human |
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services agency, as defined by Section 531.001, Government Code, |
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that provides benefits to persons whose eligibility for the program |
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is determined using TIERS, including: |
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(A) the child health plan program under Chapter |
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62, Health and Safety Code; |
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(B) the financial assistance program under |
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Chapter 31, Human Resources Code; |
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(C) the medical assistance program under Chapter |
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32, Human Resources Code; and |
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(D) the food stamp program under Chapter 33, |
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Human Resources Code. |
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(2) "TIERS" means the Texas Integrated Eligibility |
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Redesign System. |
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(b) The Health and Human Services Commission shall develop |
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and implement reforms to: |
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(1) improve the operation of TIERS and the accuracy of |
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eligibility determinations for benefits programs made through |
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TIERS; and |
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(2) ensure that eligibility determinations for |
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benefits programs made through TIERS are made within the timelines |
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required under state and federal law. |
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(c) Reforms the commission may consider implementing |
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include establishing minimum staffing levels for the operation of |
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TIERS, qualifications and training for TIERS staff, and maximum |
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caseloads per staff person. |
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SECTION 6. The changes in law made by this Act apply to an |
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initial determination of eligibility or a recertification of |
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eligibility for the child health plan program under Chapter 62, |
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Health and Safety Code, or the medical assistance program under |
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Chapter 32, Human Resources Code, made on or after September 1, |
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2009. |
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SECTION 7. 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 8. In the event of a conflict between a provision of |
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this Act and another Act passed by the 81st Legislature, Regular |
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Session, 2009, that becomes law, this Act prevails regardless of |
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the relative dates of enactment. |
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SECTION 9. 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, 2009. |