88R18765 SCP-D
 
  By: Bucy, Harless, Oliverson, Jetton, Bonnen, H.B. No. 1599
      et al.
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to implementation of an express lane option for
  determining eligibility and enrolling certain individuals in
  Medicaid or the child health plan program.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 62.1011, Health and Safety Code, is
  amended to read as follows:
         Sec. 62.1011.  VERIFICATION OF INCOME. (a) Except as
  provided by Subsection (b) and subject to Subsection (c), the [The]
  commission shall continue employing methods of verifying the
  individual incomes of the individuals considered in the calculation
  of an applicant's household income.
         (b)  The commission shall verify income under this section
  unless the applicant reports a household income that exceeds the
  income eligibility level established under Section 62.101(b).
         (c)  The commission may verify income using the verification
  process described in Section 62.1012.
         SECTION 2.  Subchapter C, Chapter 62, Health and Safety
  Code, is amended by adding Section 62.1012 to read as follows:
         Sec. 62.1012.  EXPRESS LANE OPTION ELIGIBILITY; ENROLLMENT.
  (a) In this section:
               (1)  "Express lane agency" means a governmental entity
  that:
                     (A)  determines eligibility for assistance under
  a public assistance program of this state; and
                     (B)  is designated by the executive commissioner
  as capable of making determinations of one or more eligibility
  requirements under the child health plan program.
               (2)  "Public assistance program" includes:
                     (A)  the Medicaid program under Chapter 32, Human
  Resources Code;
                     (B)  the financial assistance program under
  Chapter 31, Human Resources Code;
                     (C)  the nutritional assistance programs under
  Chapter 33, Human Resources Code, including the supplemental
  nutrition assistance program under that chapter; and
                     (D)  other programs identified by the commission.
         (b)  Notwithstanding any other law and in accordance with
  Sections 1902(e)(13) and 2107(e)(1)(H) of the Social Security Act
  (42 U.S.C. Sections 1396a(e)(13) and 1397gg(e)(1)(H)), the
  commission shall implement an express lane option under which the
  commission may rely on findings made by an express lane agency,
  including a division of an express lane agency, in determining a
  child's eligibility for coverage under the child health plan,
  including a child's eligibility for reenrollment in the plan. The
  commission shall use express lane eligibility by evaluating data
  received from an applicant under other public assistance programs
  to determine the applicant's eligibility for coverage under the
  child health plan.
         (c)  In accordance with Section 1902(e)(13)(D) of the Social
  Security Act (42 U.S.C. Section 1396a(e)(13)(D)), the commission
  shall enroll in the child health plan program a child who is
  determined to be eligible for the program under this section,
  except that the child may only be enrolled in the program if the
  child's parent, legal guardian, or custodial relative
  affirmatively consents to the enrollment.  The consent:
               (1)  must be provided in accordance with identity
  verification standards the commission establishes; and
               (2)  may be provided:
                     (A)  orally;
                     (B)  by telephone;
                     (C)  in writing, including:
                           (i)  by electronic signature; or
                           (ii)  in an application for coverage or
  benefits under a public assistance program; or
                     (D)  by any other manner the commission determines
  appropriate.
         (d)  The commission and each express lane agency shall
  include in each application for coverage or benefits under a public
  assistance program, including any online application, and on the
  commission's or agency's Internet website a conspicuous notice
  clearly explaining that:
               (1)  the information disclosed in the application may
  be used to determine a child's eligibility for coverage under the
  child health plan program using the express lane option implemented
  under this section;
               (2)  the child's parent, legal guardian, or custodial
  relative may elect not to have the information disclosed for that
  purpose; and
               (3)  the child's parent, legal guardian, or custodial
  relative must provide affirmative consent before the child may be
  enrolled in the child health plan program using the express lane
  option implemented under this section.
         (e)  In accordance with 42 C.F.R. Section 457.340(e), the
  commission shall provide to the parent, legal guardian, or
  custodial relative of a child determined eligible for coverage
  under the child health plan program using the express lane option
  implemented under this section notice of that determination. The
  notice may be provided by mail, e-mail, or any other manner the
  commission determines appropriate.
         SECTION 3.  Sections 32.026(e) and (g), Human Resources
  Code, are amended to read as follows:
         (e)  The executive commissioner shall permit a
  recertification review of the eligibility and need for medical
  assistance of a child under 19 years of age to be conducted by
  telephone or mail instead of through a personal appearance at an
  office, unless the commission determines that the information
  needed to verify eligibility cannot be obtained in that manner or
  may be obtained in the manner specified by Section 32.026102. The
  executive commissioner by rule may develop procedures to determine
  whether there is a need for a recertification review of a child
  described by this subsection to be conducted through a personal
  interview with a commission representative. Procedures developed
  under this subsection shall be based on objective, risk-based
  factors and conditions and shall focus on a targeted group of
  recertification reviews for which there is a high probability that
  eligibility will not be recertified.
         (g)  Notwithstanding any other provision of this code, the
  commission may use information obtained from a third party to
  verify the assets and resources of a person for purposes of
  determining the person's eligibility and need for medical
  assistance to the extent that verification is applicable under
  federal law. Third-party information includes information
  obtained from:
               (1)  a consumer reporting agency, as defined by Section
  20.01, Business & Commerce Code;
               (2)  an appraisal district; [or]
               (3)  the Texas Department of Motor Vehicles vehicle
  registration record database; or
               (4)  an express lane agency as defined by Section
  32.026102.
         SECTION 4.  Subchapter B, Chapter 32, Human Resources Code,
  is amended by adding Section 32.026102 to read as follows:
         Sec. 32.026102.  EXPRESS LANE OPTION ELIGIBILITY;
  ENROLLMENT. (a) In this section:
               (1)  "Express lane agency" means a governmental entity
  that:
                     (A)  determines eligibility for assistance under
  a public assistance program of this state; and
                     (B)  is designated by the executive commissioner
  as capable of making determinations of one or more eligibility
  requirements under the medical assistance program.
               (2)  "Public assistance program" includes:
                     (A)  the child health plan program under Chapters
  62 and 63, Health and Safety Code;
                     (B)  the financial assistance program under
  Chapter 31;
                     (C)  the nutritional assistance programs under
  Chapter 33, including the supplemental nutrition assistance
  program under that chapter; and
                     (D)  other programs identified by the commission.
         (b)  Notwithstanding any other law and in accordance with
  Section 1902(e)(13) of the Social Security Act (42 U.S.C. Section
  1396a(e)(13)), the commission shall implement an express lane
  option under which the commission may rely on findings made by an
  express lane agency, including a division of an express lane
  agency, in determining a child's eligibility for medical
  assistance, including the recertification of a child's eligibility
  for medical assistance benefits. The commission shall use express
  lane eligibility by evaluating data received from an applicant
  under other public assistance programs to determine the applicant's
  eligibility for benefits under the medical assistance program.
         (c)  In accordance with Section 1902(e)(13)(D) of the Social
  Security Act (42 U.S.C. Section 1396a(e)(13)(D)), the commission
  shall enroll in the medical assistance program a child who is
  determined to be eligible for the program under this section,
  except that the child may only be enrolled in the program if the
  child's parent, legal guardian, or custodial relative
  affirmatively consents to the enrollment.  The consent:
               (1)  must be provided in accordance with identity
  verification standards the commission establishes; and
               (2)  may be provided:
                     (A)  orally;
                     (B)  by telephone;
                     (C)  in writing, including:
                           (i)  by electronic signature; or
                           (ii)  in an application for coverage or
  benefits under a public assistance program; or
                     (D)  by any other manner the commission determines
  appropriate.
         (d)  The commission and each express lane agency shall
  include in each application for coverage or benefits under a public
  assistance program, including any online application, and on the
  commission's or agency's Internet website a conspicuous notice
  clearly explaining that:
               (1)  the information disclosed in the application may
  be used to determine a child's eligibility for medical assistance
  benefits using the express lane option implemented under this
  section;
               (2)  the child's parent, legal guardian, or custodial
  relative may elect not to have the information disclosed for that
  purpose; and
               (3)  the child's parent, legal guardian, or custodial
  relative must provide affirmative consent before the child may be
  enrolled in the medical assistance program using the express lane
  option implemented under this section.
         (e)  In accordance with 42 C.F.R. Section 435.917, the
  commission shall provide to the parent, legal guardian, or
  custodial relative of a child determined eligible for benefits
  under the medical assistance program using the express lane option
  implemented under this section notice of that determination.  The
  notice may be provided by mail, e-mail, or any other manner the
  commission determines appropriate.
         SECTION 5.  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 6.  This Act takes effect September 1, 2023.