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SENATE RESOLUTION
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BE IT RESOLVED by the Senate of the State of Texas, 87th |
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Legislature, Regular Session, 2021, That Senate Rule 12.03 be |
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suspended in part as provided by Senate Rule 12.08 to enable the |
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conference committee appointed to resolve the differences on |
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House Bill 2658 (the Medicaid program, including the |
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administration and operation of the Medicaid managed care |
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program) to consider and take action on the following matter: |
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Senate Rule 12.03(4) is suspended to permit the committee |
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to add text on a matter not included in either the house or senate |
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version of the bill by adding the following new SECTION to the |
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bill: |
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SECTION 8. 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. (a) This section |
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applies only to a child younger than 19 years of age who is |
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determined eligible for medical assistance under this chapter. |
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(b) The executive commissioner shall adopt rules in |
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accordance with 42 U.S.C. Section 1396a(e)(12), as amended, to |
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provide for two consecutive periods of [a period of continuous] |
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eligibility for a child between each certification and |
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recertification of the child's eligibility, subject to |
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Subsections (f) and (h) [under 19 years of age who is determined |
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to be eligible for medical assistance under this chapter]. |
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(c) The first of the two consecutive periods of |
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eligibility described by Subsection (b) must be continuous in |
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accordance with Subsection (d). The second of the two |
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consecutive periods of eligibility is not continuous and may be |
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affected by changes in a child's household income, regardless of |
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whether those changes occurred or whether the commission became |
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aware of the changes during the first or second of the two |
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consecutive periods of eligibility. |
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(d) A [The rules shall provide that the] child remains |
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eligible for medical assistance during the first of the two |
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consecutive periods of eligibility, without additional review by |
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the commission and regardless of changes in the child's household |
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[resources or] income, until [the earlier of: |
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[(1)] the end of the six-month period following the |
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date on which the child's eligibility was determined, except as |
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provided by Subsections (f)(1) and (h) [; or |
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[(2) the child's 19th birthday]. |
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(e) During the sixth month following the date on which a |
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child's eligibility for medical assistance is certified or |
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recertified, the commission shall, in a manner that complies with |
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federal law, including verification plan requirements under 42 |
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C.F.R. Section 435.945(j), review the child's household income |
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using electronic income data available to the commission. The |
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commission may conduct this review only once during the child's |
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two consecutive periods of eligibility. Based on the review: |
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(1) the commission shall, if the review indicates |
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that the child's household income does not exceed the maximum |
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income for eligibility for the medical assistance program, |
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provide for a second consecutive period of eligibility for the |
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child until the child's required annual recertification, except |
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as provided by Subsection (h) and subject to Subsection (c); or |
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(2) the commission may, if the review indicates that |
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the child's household income exceeds the maximum income for |
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eligibility for the medical assistance program, request |
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additional documentation to verify the child's household income |
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in a manner that complies with federal law. |
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(f) If, after reviewing a child's household income under |
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Subsection (e), the commission determines that the household |
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income 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 |
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does not exceed the maximum income for eligibility; and |
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(2) the child's parent or guardian fails to provide |
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the documentation during the period described by Subdivision |
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(1). |
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(g) If a child's parent or guardian provides to the |
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commission within the period described by Subsection (f) |
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documentation demonstrating that the child's household income |
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does not exceed the maximum income for eligibility for the |
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medical assistance program, the commission shall provide for a |
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second consecutive period of eligibility for the child until the |
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child's required annual recertification, except as provided by |
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Subsection (h) and subject to Subsection (c). |
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(h) Notwithstanding any other period prescribed by this |
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section, a child's eligibility for medical assistance ends on the |
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child's 19th birthday. |
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(i) The commission may not recertify a child's |
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eligibility for medical assistance more frequently than every 12 |
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months as required by federal law. |
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(j) If a child's parent or guardian fails to provide to |
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the commission within the period described by Subsection (f) |
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documentation demonstrating that the child's household income |
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does not exceed the maximum income for eligibility for the |
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medical assistance program, the commission shall provide the |
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child's parent or guardian with written notice of termination |
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following that period. The notice must include a statement that |
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the child may be eligible for enrollment in the child health plan |
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under Chapter 62, Health and Safety Code. |
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(k) In developing the notice, the commission shall |
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consult with health care providers, children's health care |
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advocates, family members of children enrolled in the medical |
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assistance program, and other stakeholders to determine the most |
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user-friendly method to provide the notice to a child's parent or |
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guardian. |
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(l) The executive commissioner may adopt rules as |
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necessary to implement this section. |
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Explanation: This addition is necessary to provide for |
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continuous eligibility and a periodic eligibility review for a |
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child for Medicaid. |
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_______________________________ |
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President of the Senate |
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I hereby certify that the |
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above Resolution was adopted by |
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the Senate on May 30, 2021, by |
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the following vote: Yeas 31, |
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Nays 0. |
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_______________________________ |
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Secretary of the Senate |