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A BILL TO BE ENTITLED
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AN ACT
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relating to presumptive eligibility for the Medicaid and child |
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health plan programs for certain children. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 62.101, Health and Safety Code, is |
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amended by adding Subsections (d) and (e) to read as follows: |
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(d) As authorized by 42 U.S.C. Section 1397gg, the executive |
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commissioner of the commission shall adopt rules providing for the |
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determination and certification of presumptive eligibility for the |
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child health plan program of a child under 19 years of age who: |
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(1) has been released from: |
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(A) confinement in a correctional facility, as |
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defined by Section 1.07, Penal Code; or |
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(B) placement, detention, or commitment in a |
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facility or other setting under Title 3, Family Code; and |
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(2) applies for and meets the basic eligibility |
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requirements for the child health plan program. |
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(e) The rules adopted under Subsection (d) must: |
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(1) specify the period during which a child may apply |
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for presumptive eligibility for the child health plan program |
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following the date of the child's release from a facility or other |
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setting described in Subsection (d)(1); |
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(2) require that a qualified entity that is making a |
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presumptive eligibility determination for a child accept as |
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verification of the child's release from a facility or other |
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setting described in Subsection (d)(1) any discharge or release |
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papers provided to the child on the child's release; and |
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(3) identify the services and benefits, which must |
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include mental health and substance abuse services, prescription |
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drug benefits, and primary care services, that a child who is |
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presumptively eligible for the child health plan program may |
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receive under that program. |
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SECTION 2. Section 62.154(b), Health and Safety Code, is |
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amended to read as follows: |
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(b) A child is not subject to a waiting period adopted under |
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Subsection (a) if: |
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(1) the family lost coverage for the child as a result |
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of: |
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(A) termination of employment because of a layoff |
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or business closing; |
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(B) termination of continuation coverage under |
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the Consolidated Omnibus Budget Reconciliation Act of 1985 (Pub. |
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L. No. 99-272); |
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(C) change in marital status of a parent of the |
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child; |
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(D) termination of the child's Medicaid |
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eligibility because: |
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(i) the child's family's earnings or |
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resources increased; or |
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(ii) the child reached an age at which |
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Medicaid coverage is not available; or |
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(E) a similar circumstance resulting in the |
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involuntary loss of coverage; |
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(2) the family terminated health benefits plan |
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coverage for the child because the cost to the child's family for |
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the coverage exceeded 10 percent of the family's net income; |
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(3) the child has access to group-based health |
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benefits plan coverage and is required to participate in the health |
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insurance premium payment reimbursement program administered by |
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the commission; [or] |
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(4) the child is certified as presumptively eligible |
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for the child health plan program under rules adopted under Section |
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62.101(d); or |
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(5) the commission has determined that other grounds |
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exist for a good cause exception. |
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SECTION 3. Section 32.026, Human Resources Code, is amended |
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by adding Subsections (h) and (i) to read as follows: |
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(h) As authorized by 42 U.S.C. Section 1396r-1a, the |
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executive commissioner of the Health and Human Services Commission |
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shall adopt rules providing for the determination and certification |
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of presumptive eligibility for medical assistance for a child under |
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19 years of age who: |
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(1) has been released from: |
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(A) confinement in a correctional facility, as |
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defined by Section 1.07, Penal Code; or |
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(B) placement, detention, or commitment in a |
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facility or other setting under Title 3, Family Code; and |
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(2) applies for and meets the basic eligibility |
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requirements for medical assistance. |
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(i) The rules adopted under Subsection (h) must: |
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(1) specify the period during which a child may apply |
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for presumptive eligibility for medical assistance following the |
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date of the child's release from a facility or other setting |
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described in Subsection (h)(1); |
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(2) require that a qualified entity that is making a |
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presumptive eligibility determination for a child accept as |
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verification of the child's release from a facility or other |
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setting described in Subsection (h)(1) any discharge or release |
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papers provided to the child on the child's release; and |
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(3) identify the services and benefits, which must |
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include mental health and substance abuse services, prescription |
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drug benefits, and primary care services, that a child who is |
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presumptively eligible for medical assistance may receive under the |
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medical assistance program. |
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SECTION 4. The executive commissioner of the Health and |
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Human Services Commission shall adopt the rules required by Section |
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62.101(d), Health and Safety Code, as added by this Act, and Section |
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32.026(h), Human Resources Code, as added by this Act, not later |
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than January 1, 2016. |
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SECTION 5. The changes in law made by this Act apply to a |
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child who is released from a facility or other setting described by |
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Section 62.101(d)(1), Health and Safety Code, as added by this Act, |
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or Section 32.026(h)(1), Human Resources Code, as added by this |
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Act, on or after January 1, 2016, regardless of the date the child |
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was confined in, placed in, detained in, or committed to the |
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facility or other setting. |
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SECTION 6. 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 7. 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, 2015. |