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A BILL TO BE ENTITLED
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AN ACT
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relating to the establishment of a health care pilot program for |
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low-income individuals. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subtitle C, Title 2, Health and Safety Code, is |
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amended by adding Chapter 65 to read as follows: |
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CHAPTER 65. HEALTH CARE PILOT PROGRAM FOR LOW-INCOME INDIVIDUALS |
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Sec. 65.001. DEFINITIONS. In this chapter: |
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(1) "Commissioner" means the commissioner of |
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insurance. |
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(2) "Department" means the Texas Department of |
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Insurance. |
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(3) "Pilot program" means the health care pilot |
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program for low-income individuals established under this chapter. |
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Sec. 65.002. ESTABLISHMENT OF PILOT PROGRAM; RULEMAKING |
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AUTHORITY. (a) The department shall establish and maintain in |
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accordance with this chapter a pilot program for health benefits |
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coverage for certain low-income individuals residing in an area |
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designated by the department under Section 65.003. |
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(b) The commissioner may adopt rules as necessary to |
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implement this chapter. |
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Sec. 65.003. DESIGNATION OF AREAS UNDER PILOT PROGRAM. (a) |
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The commissioner by rule shall adopt standards in accordance with |
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this subsection for the designation of an area to be served under |
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the pilot program. To be eligible for the pilot program: |
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(1) the percentage of adults in the area who do not |
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have coverage or benefits for health care services under a public or |
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private plan or program must be higher than the state average; |
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(2) the area must be designated as a health |
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professional shortage area by the United States Department of |
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Health and Human Services; and |
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(3) the area must be served on or before January 1, |
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2015, by one or more promotoras trained under Chapter 48. |
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(b) The department shall designate 10 areas in this state |
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for inclusion in the pilot program in accordance with the standards |
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under Subsection (a) and rules adopted under this chapter. |
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(c) The department may establish an application process to |
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allow an area to apply for inclusion in the pilot program. |
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Sec. 65.004. PROMOTORA DUTIES. A promotora serving an area |
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designated for the pilot program may assist the department in |
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coordination of health care under the pilot program, in monitoring |
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the compliance of individuals enrolled in the pilot program, and in |
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establishing an application process. |
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Sec. 65.005. INDIVIDUAL ELIGIBILITY. To be eligible to |
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receive services under the pilot program, an individual must have |
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an income of less than 138 percent of the federal poverty level and |
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be a parent of a child currently enrolled in the state health plan |
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or health benefits plan for children under Chapter 62 or 63 or the |
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state Medicaid program operated under Chapter 32, Human Resources |
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Code. |
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Sec. 65.006. HEALTH COVERAGE UNDER PILOT PROGRAM. The |
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commissioner by rule shall develop the health benefits coverage |
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under the pilot program, including the benefits offered under the |
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pilot program and the method of providing benefits. |
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Sec. 65.007. FUNDING. Notwithstanding Section 6(e)(2), |
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Chapter 615 (S.B. 1367), Acts of the 83rd Legislature, Regular |
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Session, 2013, the department shall fund the pilot program with |
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available funds transferred to the department under that Act. The |
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commissioner may adopt rules necessary to facilitate the funding of |
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the pilot program under this section. |
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Sec. 65.008. REPORT. (a) The department shall contract |
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with an independent third party to evaluate the pilot program and |
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develop a report under this section. |
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(b) Not later than December 1, 2016, the third party |
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contracting with the department under Subsection (a) shall |
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distribute a report that evaluates the pilot program to the |
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governor, lieutenant governor, speaker of the house of |
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representatives, and chairs of the standing committees of the |
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senate and house of representatives with primary jurisdiction |
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regarding health care or insurance. |
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Sec. 65.009. ADVISORY COMMITTEE. The commissioner shall |
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appoint an advisory committee composed of five members to advise |
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the department on the implementation of this chapter. The |
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committee must include: |
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(1) two individuals eligible to obtain coverage under |
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the pilot program; |
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(2) a representative of the insurance industry; |
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(3) a representative of a university hospital system; |
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and |
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(4) a health care provider providing services in an |
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area included in the pilot program. |
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Sec. 65.010. EXPIRATION OF CHAPTER. This chapter expires |
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August 31, 2019. |
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SECTION 2. Not later than January 1, 2016, the Texas |
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Department of Insurance shall establish the indigent health care |
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pilot program described by Chapter 65, Health and Safety Code, as |
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added by this Act. |
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SECTION 3. This Act takes effect September 1, 2015. |