86R27731 JG-D

By: Cortez, Rose, Davis of Harris, Bernal, H.B. No. 342

Sheffield, et al.

Substitute the following for H.B. No. 342:

By: Hinojosa C.S.H.B. No. 342

A BILL TO BE ENTITLED

AN ACT

relating to eligibility for the medical assistance program and enrollment in the child health plan program.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 32.0261, Human Resources Code, is amended to read as follows:

Sec. 32.0261. CONTINUOUS ELIGIBILITY. The executive commissioner shall adopt rules in accordance with 42 U.S.C. Section 1396a(e)(12), as amended, to provide for a period of continuous eligibility for a child under 19 years of age who is determined to be eligible for medical assistance under this chapter. The rules shall provide that the child remains eligible for medical assistance, without additional review by the commission and regardless of changes in the child's [resources or] income, until the earlier of:

(1) the end of the six-month period following the date on which the child's eligibility was determined; or

(2) the child's 19th birthday.

SECTION 2. Subchapter B, Chapter 32, Human Resources Code, is amended by adding Section 32.02612 to read as follows:

Sec. 32.02612. PERIODIC ELIGIBILITY REVIEW FOR CERTAIN RECIPIENTS; ENROLLMENT IN CHILD HEALTH PLAN. (a) During the sixth month following the date on which a child's eligibility for medical assistance is certified or recertified, the commission may:

(1) review the child's household income; and

(2) if the review indicates that the child's household income exceeds the maximum income for eligibility for the medical assistance program, request additional documentation to verify the child's household income.

(b) The commission:

(1) may conduct the review under Subsection (a) using electronic means, if available; and

(2) shall conduct the review under Subsection (a) using information obtained through a third party database.

(c) If, after reviewing a child's household income under Subsection (a), the commission determines that the household income exceeds the maximum income for eligibility for the medical assistance program, the commission shall continue to provide medical assistance to the child until:

(1) the commission provides the child's parent or guardian with a period of not less than 30 days to provide documentation demonstrating that the child's household income does not exceed the maximum income for eligibility; and

(2) the child's parent or guardian fails to provide the documentation during the period described by Subdivision (1).

(d) The commission shall provide the child's parent or guardian with written notice of the termination under Subsection (c), if applicable. The notice must include a statement that the child may be eligible for enrollment in the child health plan under Chapter 62, Health and Safety Code.

(e) In developing the notice required under Subsection (d), the commission shall consult with health care providers, children's health care advocates, family members of children enrolled in the medical assistance program, and other stakeholders to determine the most user-friendly method to provide the notice to a child's parent or guardian.

(f) The commission shall automatically enroll in the child health plan under Chapter 62, Health and Safety Code, a child whose household income as determined under this section:

(1) exceeds the maximum income for eligibility for the medical assistance program; and

(2) establishes eligibility for the child to receive benefits under the child health plan.

(g) The commission shall track and, not later than September 1 of each year, prepare and submit a written report to the legislature on:

(1) the number of children who lose eligibility for medical assistance due to a procedural matter during the review conducted under this section or during the recertification process;

(2) the procedural matters described by Subdivision (1) that cause a child to lose eligibility for medical assistance;

(3) the number of children who lose eligibility for medical assistance following the review conducted under this section, not including children described by Subdivision (1);

(4) the number of and rate at which children described by Subdivisions (1) and (3) are enrolled in the child health plan under Chapter 62, Health and Safety Code, during the review conducted under this section or during the recertification process; and

(5) the number of children who lose eligibility for medical assistance following the review conducted under this section and who are automatically enrolled by the commission under Subsection (f) in the child health plan under Chapter 62, Health and Safety Code.

(h) The executive commissioner may adopt rules as necessary to implement this section.

SECTION 3. If before implementing any provision of this Act a state agency determines that a waiver or authorization from a federal agency is necessary for implementation of that provision, the agency affected by the provision shall request the waiver or authorization and may delay implementing that provision until the waiver or authorization is granted.

SECTION 4. This Act takes effect September 1, 2019.