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A BILL TO BE ENTITLED
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AN ACT
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relating to eligibility for the medical assistance program and |
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enrollment in the child health plan program. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. 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 executive |
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commissioner 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 commission and |
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regardless of changes in the child's [resources or] income, until |
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the earlier of: |
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(1) the end of the six-month period following the date |
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on which the child's eligibility was determined; or |
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(2) the child's 19th birthday. |
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SECTION 2. Subchapter B, Chapter 32, Human Resources Code, |
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is amended by adding Section 32.02612 to read as follows: |
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Sec. 32.02612. PERIODIC ELIGIBILITY REVIEW FOR CERTAIN |
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RECIPIENTS; ENROLLMENT IN CHILD HEALTH PLAN. (a) During the sixth |
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month following the date on which a child's eligibility for medical |
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assistance is certified or recertified, the commission may: |
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(1) review the child's household income; and |
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(2) if the review indicates that the child's household |
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income exceeds the maximum income for eligibility for the medical |
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assistance program, request additional documentation to verify the |
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child's household income. |
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(b) The commission: |
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(1) may conduct the review under Subsection (a) using |
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electronic means, if available; and |
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(2) shall conduct the review under Subsection (a) |
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using information obtained through a third party database. |
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(c) If, after reviewing a child's household income under |
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Subsection (a), the commission determines that the household income |
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exceeds the maximum income for eligibility for the medical |
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assistance program, the commission shall continue to provide |
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medical assistance to the child until: |
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(1) the commission provides the child's parent or |
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guardian with a period of not less than 30 days to provide |
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documentation demonstrating that the child's household income does |
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not exceed the maximum income for eligibility; and |
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(2) the child's parent or guardian fails to provide the |
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documentation during the period described by Subdivision (1). |
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(d) The commission shall provide the child's parent or |
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guardian with written notice of the termination under Subsection |
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(c), if applicable. The notice must include a statement that the |
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child may be eligible for enrollment in the child health plan under |
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Chapter 62, Health and Safety Code. |
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(e) In developing the notice required under Subsection (d), |
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the commission shall consult with health care providers, children's |
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health care advocates, family members of children enrolled in the |
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medical assistance program, and other stakeholders to determine the |
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most user-friendly method to provide the notice to a child's parent |
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or guardian. |
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(f) The commission shall automatically enroll in the child |
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health plan under Chapter 62, Health and Safety Code, a child whose |
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household income as determined under this section: |
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(1) exceeds the maximum income for eligibility for the |
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medical assistance program; and |
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(2) establishes eligibility for the child to receive |
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benefits under the child health plan. |
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(g) The commission shall track and, not later than September |
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1 of each year, prepare and submit a written report to the |
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legislature on: |
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(1) the number of children who lose eligibility for |
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medical assistance due to a procedural matter during the review |
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conducted under this section or during the recertification process; |
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(2) the procedural matters described by Subdivision |
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(1) that cause a child to lose eligibility for medical assistance; |
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(3) the number of children who lose eligibility for |
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medical assistance following the review conducted under this |
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section, not including children described by Subdivision (1); |
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(4) the number of and rate at which children described |
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by Subdivisions (1) and (3) are enrolled in the child health plan |
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under Chapter 62, Health and Safety Code, during the review |
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conducted under this section or during the recertification process; |
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and |
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(5) the number of children who lose eligibility for |
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medical assistance following the review conducted under this |
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section and who are automatically enrolled by the commission under |
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Subsection (f) in the child health plan under Chapter 62, Health and |
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Safety Code. |
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(h) The executive commissioner may adopt rules as necessary |
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to implement this section. |
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SECTION 3. 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 4. This Act takes effect September 1, 2019. |