Honorable James B. Frank, Chair, House Committee on Human Services
FROM:
John McGeady, Assistant Director Sarah Keyton, Assistant Director Legislative Budget Board
IN RE:
HB1016 by Martinez (Relating to eligibility determinations for the STAR+PLUS home and community based services (HCBS) program.), As Introduced
No significant fiscal implication to the State is anticipated.
The bill would require the Health and Human Services Commission (HHSC) to determine Medicaid eligibility for an applicant to the STAR+PLUS home and community-based services (HCBS) program within 20 days after the date the applicant submits the application or within 45 days after the date an applicant submits an application if the applicant is applying on the basis of a disability. The bill would also require a managed care organization to complete and submit an applicant's individual service plan (ISP) and medical necessity and level of care assessment to the Medicaid claims administrator within 30 days after the date an applicant submits the application. The bill would take effect September 1, 2019.
It is assumed that the provisions of the bill relating to the timeframe for processing applications for individuals applying for STAR+PLUS HCBS could be absorbed using existing resources. This analysis assumes that the shortened timeframe would not result in a significant increase in workload for eligibility determination staff, as the total number of eligibility determinations would not change directly as a result of implementing the provisions of the bill. This analysis assumes that certain individuals may be enrolled up to one month earlier, but the overall caseload impact would be minimal. HHSC indicates that an ISP and Medical Necessity and Level of Care assessment must be received before Medicaid eligibility can be approved. If the managed care organizations do not provide that information until after the 20th day, but before the 30th day, as authorized by the provision of the bill, the eligibility determination could be delayed.
Local Government Impact
No significant fiscal implication to units of local government is anticipated.