88R11332 BDP-F
 
  By: Blanco S.B. No. 1695
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the establishment of the case assistance affiliate
  program to provide certain assistance to Medicaid recipients and
  child health plan program enrollees.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Chapter 531, Government Code, is amended by
  adding Subchapter T to read as follows:
  SUBCHAPTER T.  CASE ASSISTANCE AFFILIATE PROGRAM
         Sec. 531.801.  DEFINITIONS. In this subchapter:
               (1)  "Case assistance affiliate" means a managed care
  organization or dental maintenance organization that participates
  in the program by assisting Medicaid recipients and child health
  plan program enrollees by providing application and renewal
  assistance and benefit case management services.
               (2)  "Case assistant" means an employee of a case
  assistance affiliate who directly provides application and renewal
  assistance and benefit case management services to a recipient or
  enrollee.
               (3)  "Enrollee" means an individual enrolled in the
  child health plan program.
               (4)  "Program" means the case assistance affiliate
  program established under this subchapter.
               (5)  "Program manager" means the employee of a case
  assistance affiliate who is designated by the affiliate to oversee:
                     (A)  case assistants; and
                     (B)  the application and renewal assistance
  activities and benefit case management services provided by the
  affiliate under the program.
               (6)  "Recipient" means a Medicaid recipient.
               (7)  "Virtual case assistance website" means an
  Internet website described by Section 531.803.
         Sec. 531.802.  ESTABLISHMENT OF CASE ASSISTANCE AFFILIATE
  PROGRAM. (a)  The commission shall:
               (1)  establish a statewide case assistance affiliate
  program under which managed care organizations and dental
  maintenance organizations that participate in Medicaid or the child
  health plan program are allowed to operate as case assistance
  affiliates by maintaining virtual case assistance websites; and
               (2)  provide a training and certification process for
  program managers and case assistants providing services under the
  program.
         (b)  In establishing the program, the commission:
               (1)  shall consult with:
                     (A)  experts, as determined by the commission; and
                     (B)  other interested persons, including managed
  care organizations and dental maintenance organizations
  participating in Medicaid or the child health plan program; and
               (2)  may establish a work group or advisory committee
  that includes interested persons to advise the commission on the
  establishment of the program.
         Sec. 531.803.  VIRTUAL CASE ASSISTANCE WEBSITES. (a)  A case
  assistance affiliate shall establish and maintain Internet
  websites for purposes of providing virtual application and renewal
  assistance and benefit case management services to the recipients
  and enrollees served by those organizations.
         (b)  In providing benefit case management services, a case
  assistance affiliate may use its virtual case assistance website to
  assist a recipient or enrollee with applying for and managing the
  recipient's or enrollee's benefits under other public assistance
  programs, including nutritional and financial assistance benefits.
         (c)  The commission shall ensure that a virtual case
  assistance website allows a recipient or enrollee to access the
  website from any electronic device that provides Internet access.
         Sec. 531.804.  ADMINISTRATIVE EXPENSE.  The commission shall
  allow a case assistance affiliate to categorize the services the
  affiliate provides under the program as administrative expenses.
         Sec. 531.805.  RULES: PROGRAM REQUIREMENTS AND STANDARDS.
  The executive commissioner shall adopt rules necessary to implement
  the program, including rules:
               (1)  establishing requirements for a managed care
  organization or dental maintenance organization to participate in
  the program;
               (2)  establishing the training and certification
  process required by Section 531.802(a)(2);
               (3)  providing for the suspension, revocation, and, as
  appropriate, periodic renewal of a case assistant's or program
  manager's certification;
               (4)  protecting the confidentiality of recipients' and
  enrollees' information; and
               (5)  establishing any other standards or requirements
  the executive commissioner determines necessary.
         SECTION 2.  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 3.  This Act takes effect immediately if it receives
  a vote of two-thirds of all the members elected to each house, as
  provided by Section 39, Article III, Texas Constitution.  If this
  Act does not receive the vote necessary for immediate effect, this
  Act takes effect September 1, 2023.