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A BILL TO BE ENTITLED
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AN ACT
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relating to authorizing certain health benefit exchanges to make |
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eligibility determinations under Medicaid and the child health plan |
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program. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 62.1011, Health and Safety Code, is |
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amended to read as follows: |
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Sec. 62.1011. VERIFICATION OF INCOME. (a) Except as |
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provided by Subsection (b), the [The] commission shall continue |
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employing methods of verifying the individual incomes of the |
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individuals considered in the calculation of an applicant's |
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household income. The commission shall verify income under this |
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section unless the applicant reports a household income that |
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exceeds the income eligibility level established under Section |
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62.101(b). |
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(b) The commission may not verify the income of a child |
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determined eligible for coverage under the child health plan by a |
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health benefit exchange in accordance with Section 62.1012. |
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SECTION 2. Subchapter C, Chapter 62, Health and Safety |
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Code, is amended by adding Section 62.1012 to read as follows: |
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Sec. 62.1012. DETERMINATION OF ELIGIBILITY BY HEALTH |
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BENEFIT EXCHANGE; ENROLLMENT. (a) In this section, "health |
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benefit exchange" means an American Health Benefit Exchange |
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administered by the federal government or an exchange created under |
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Section 1311(b) of the Patient Protection and Affordable Care Act |
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(42 U.S.C. Section 18031(b)). |
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(b) Notwithstanding any other law and in accordance with an |
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agreement entered into under 42 C.F.R. Section 457.348, the |
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commission shall accept eligibility determinations for coverage |
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under the child health plan made by a health benefit exchange. |
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(c) The commission shall automatically enroll in the child |
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health plan program a child who is determined eligible for coverage |
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by a health benefit exchange. This subsection does not require the |
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commission to enroll a child in the child health plan program whose |
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eligibility for the program was not fully verified by the exchange. |
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The commission shall take any further action necessary to verify |
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and resolve an incomplete eligibility determination referred to the |
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commission by the exchange. |
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(d) In entering into an agreement with a health benefit |
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exchange under 42 C.F.R. Section 457.348, the commission shall |
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ensure that the exchange makes determinations of eligibility for |
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the child health plan based on eligibility criteria in accordance |
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with applicable state law. |
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(e) The commission shall seek any federal money available |
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for implementing this section, including enhanced federal |
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financial participation made available under federal law. |
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SECTION 3. Section 32.026(g), Human Resources Code, is |
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amended to read as follows: |
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(g) Notwithstanding any other provision of this code, the |
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commission may use information obtained from a third party to |
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verify the assets and resources of a person for purposes of |
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determining the person's eligibility and need for medical |
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assistance to the extent that verification is applicable under |
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federal law. Third-party information includes information |
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obtained from: |
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(1) a consumer reporting agency, as defined by Section |
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20.01, Business & Commerce Code; |
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(2) an appraisal district; [or] |
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(3) the Texas Department of Motor Vehicles vehicle |
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registration record database; or |
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(4) a health benefit exchange, as defined by Section |
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32.026102. |
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SECTION 4. Subchapter B, Chapter 32, Human Resources Code, |
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is amended by adding Section 32.026102 to read as follows: |
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Sec. 32.026102. DETERMINATION OF ELIGIBILITY BY HEALTH |
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BENEFIT EXCHANGE; ENROLLMENT. (a) In this section, "health |
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benefit exchange" means an American Health Benefit Exchange |
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administered by the federal government or an exchange created under |
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Section 1311(b) of the Patient Protection and Affordable Care Act |
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(42 U.S.C. Section 18031(b)). |
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(b) Notwithstanding any other law and in accordance with an |
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agreement entered into under 42 C.F.R. Section 431.10, the |
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commission shall accept eligibility determinations for medical |
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assistance made by a health benefit exchange. |
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(c) The commission shall automatically enroll in the |
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medical assistance program an individual whose eligibility for |
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medical assistance benefits is determined by a health benefit |
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exchange. This subsection does not require the commission to |
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enroll an individual in the medical assistance program whose |
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eligibility for the program was not fully verified by the exchange. |
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The commission shall take any further action that is necessary to |
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verify and resolve an incomplete eligibility determination |
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referred to the commission by the exchange. |
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(d) In entering into an agreement with a health benefit |
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exchange under 42 C.F.R. Section 431.10, the commission shall |
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ensure that the exchange makes determinations of eligibility for |
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the medical assistance program based on eligibility criteria in |
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accordance with applicable state law. |
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(e) The commission shall seek any federal money available |
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for implementing this section, including enhanced federal |
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financial participation made available under 42 C.F.R. Part 433, |
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Subpart C. |
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SECTION 5. Section 32.026101, Human Resources Code, is |
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repealed. |
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SECTION 6. 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 7. This Act takes effect September 1, 2023. |