By: Nelson S.B. No. 1057
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to information about private health care insurance
  coverage and the health insurance exchange for individuals applying
  for certain Department of State Health Services health or mental
  health benefits, services, and assistance.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter D, Chapter 1001, Health and Safety
  Code, is amended by adding Sections 1001.080 and 1001.081 to read as
  follows:
         Sec. 1001.080.  HEALTH INSURANCE COVERAGE INFORMATION.
  (a)  In this section, "individual's legally authorized
  representative" means:
               (1)  a parent, managing conservator, or guardian of an
  individual, if the individual is a minor;
               (2)  a guardian of an individual, if the individual has
  been adjudicated incompetent to manage the individual's personal
  affairs; or
               (3)  an agent of the individual authorized under a
  durable power of attorney for health care.
         (b)  This section applies to health or mental health
  benefits, services, or assistance provided by the department that
  the department anticipates will be impacted by a health insurance
  exchange as defined by Section 1001.081(a), including:
               (1)  community primary health care services provided
  under Chapter 31;
               (2)  women's and children's health services provided
  under Chapter 32;
               (3)  services for children with special health care
  needs provided under Chapter 35;
               (4)  epilepsy program assistance provided under
  Chapter 40;
               (5)  hemophilia program assistance provided under
  Chapter 41;
               (6)  kidney health care services provided under Chapter
  42;
               (7)  human immunodeficiency virus infection and
  sexually transmitted disease prevention programs and services
  provided under Chapter 85;
               (8)  immunization programs provided under Chapter 161;
               (9)  programs and services provided by the Rio Grande
  State Center under Chapter 252;
               (10)  mental health services for adults provided under
  Chapter 534;
               (11)  mental health services for children provided
  under Chapter 534;
               (12)  the NorthSTAR Behavioral Health Program provided
  under Chapter 534;
               (13)  programs and services provided by community
  mental health hospitals under Chapter 552;
               (14)  programs and services provided by state mental
  health hospitals under Chapter 552; and
               (15)  any other health or mental health program or
  service designated by the department.
         (c)  Subject to Subsection (d), the department may not
  provide health or mental health benefits, services, or assistance
  described in Subsection (b) unless the individual applying to
  receive the benefits, services, or assistance submits to the
  department on the form prescribed by the department:
               (1)  a statement by the individual or the individual's
  legally authorized representative attesting that the individual
  does not have access to private health care insurance that provides
  coverage for the benefit, service, or assistance; or
               (2)  if the individual has access to private health
  care insurance that provides coverage for the benefit, service, or
  assistance, the information and authorization necessary for the
  department to submit a claim for reimbursement from the insurer for
  the benefit, service, or assistance.
         (d)  The department may waive the prohibition under
  Subsection (c) for an individual or for health or mental health
  benefits, services, or assistance described in Subsection (b) if
  the department determines that a benefit, service, or assistance is
  necessary during a crisis or emergency.
         (e)  The executive commissioner shall adopt rules necessary
  to implement this section.
         Sec. 1001.081.  HEALTH INSURANCE EXCHANGE INFORMATION.
  (a)  In this section:
               (1)  "Health insurance exchange" means an American
  Health Benefit Exchange administered by the federal government
  under 42 U.S.C. Section 18041 or created under 42 U.S.C. Section
  18031.
               (2)  "Individual's legally authorized representative"
  has the meaning assigned by Section 1001.080(a).
         (b)  The department may develop informational materials
  regarding health care insurance coverage and subsidies available
  under a health insurance exchange.
         (c)  The department shall provide the informational
  materials regarding health care insurance coverage and subsidies
  available under a health insurance exchange to an individual or the
  individual's legally authorized representative who:
               (1)  applies to receive health or mental health
  benefits, services, or assistance described in Section
  1001.080(b); and
               (2)  has an income above 100 percent of the federal
  poverty level.
         (d)  The executive commissioner shall adopt rules necessary
  to implement this section.
         SECTION 2.  As soon as practicable after the effective date
  of this Act, the Department of State Health Services shall
  prescribe the form required by Section 1001.080, Health and Safety
  Code, as added by this Act.
         SECTION 3.  As soon as possible after the effective date of
  this Act, the Health and Human Services Commission shall apply for
  any waiver or other authorization necessary to implement this Act.  
  The commission may delay implementing this Act until the waiver or
  authorization is granted.
         SECTION 4.  This Act takes effect immediately if it receives
  a vote of two-thirds of all the members elected to each house, as
  provided by Section 39, Article III, Texas Constitution.  If this
  Act does not receive the vote necessary for immediate effect, this
  Act takes effect September 1, 2013.