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A BILL TO BE ENTITLED
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AN ACT
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relating to implementing an express lane option under Medicaid and |
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the child health plan 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) and subject to Subsection (c), the [The] |
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commission shall continue employing methods of verifying the |
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individual incomes of the individuals considered in the calculation |
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of an applicant's household income. |
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(b) The commission shall verify income under this section |
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unless the applicant reports a household income that exceeds the |
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income eligibility level established under Section 62.101(b). |
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(c) The commission may verify income using the verification |
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process described in 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. EXPRESS LANE OPTION ELIGIBILITY; ENROLLMENT. |
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(a) In this section, "supplemental nutrition assistance program" |
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has the meaning assigned by Section 33.0005, Human Resources Code. |
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(b) Notwithstanding any other law and in accordance with |
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Sections 1902(e)(13) and 2107(e)(1)(H) of the Social Security Act |
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(42 U.S.C. Sections 1396a(e)(13) and 1397gg(e)(1)(H)), the |
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commission shall implement an express lane option under which the |
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commission evaluates data received from an applicant under the |
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supplemental nutrition assistance program in determining a child's |
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eligibility for coverage under the child health plan program. |
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(c) In determining a child's eligibility for coverage under |
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the child health plan program using the express lane option |
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implemented under this section, the commission shall open a new |
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case to ensure there is no delay in providing benefits to the child |
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under the supplemental nutrition assistance program. |
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(d) On determining that a child is eligible for coverage |
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under the child health plan program under this section, the |
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commission shall enroll the child in the program in accordance with |
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Section 1902(e)(13)(D) of the Social Security Act (42 U.S.C. |
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Section 1396a(e)(13)(D)) if the commission: |
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(1) provides notice of the determination to the |
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child's parent, legal guardian, or custodial relative in the manner |
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indicated under Subsection (e); and |
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(2) obtains the affirmative consent of the child's |
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parent, legal guardian, or custodial relative in accordance with |
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Subsection (f) to enroll the child. |
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(e) The commission shall provide the notice required by |
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Subsection (d) in the manner a child's parent, legal guardian, or |
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custodial relative indicates as the preferred method of contact |
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when applying for supplemental nutrition assistance program |
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benefits. If a preferred method of contact is not indicated, the |
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commission may provide the notice: |
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(1) orally; |
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(2) by telephone; |
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(3) in writing, including by electronic signature; or |
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(4) by any other manner the commission determines |
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appropriate. |
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(f) In obtaining the affirmative consent of a child's |
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parent, legal guardian, or custodial relative required by |
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Subsection (d), the commission: |
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(1) shall ensure the consent is provided: |
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(A) within a reasonable amount of time, as |
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determined by the commission; and |
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(B) in accordance with identity verification |
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standards the commission establishes; and |
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(2) may obtain the consent: |
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(A) orally; |
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(B) by telephone; |
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(C) in writing, including by: |
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(i) electronic signature; or |
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(ii) fax; or |
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(D) during an initial eligibility or |
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recertification interview for the supplemental nutrition |
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assistance program. |
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SECTION 3. Section 32.026(e), Human Resources Code, is |
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amended to read as follows: |
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(e) The executive commissioner shall permit a |
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recertification review of the eligibility and need for medical |
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assistance of a child under 19 years of age to be conducted by |
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telephone or mail instead of through a personal appearance at an |
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office, unless the commission determines that the information |
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needed to verify eligibility cannot be obtained in that manner or |
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may be obtained in the manner specified by Section 32.026102. The |
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executive commissioner by rule may develop procedures to determine |
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whether there is a need for a recertification review of a child |
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described by this subsection to be conducted through a personal |
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interview with a commission representative. Procedures developed |
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under this subsection shall be based on objective, risk-based |
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factors and conditions and shall focus on a targeted group of |
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recertification reviews for which there is a high probability that |
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eligibility will not be recertified. |
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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. EXPRESS LANE OPTION ELIGIBILITY; |
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ENROLLMENT. (a) In this section, "supplemental nutrition |
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assistance program" has the meaning assigned by Section 33.0005. |
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(b) Notwithstanding any other law and in accordance with |
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Section 1902(e)(13) of the Social Security Act (42 U.S.C. Section |
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1396a(e)(13)), the commission shall implement an express lane |
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option under which the commission evaluates data received from an |
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applicant under the supplemental nutrition assistance program in |
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determining a child's eligibility for medical assistance benefits. |
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(c) In determining a child's eligibility for medical |
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assistance benefits using the express lane option implemented under |
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this section, the commission shall open a new case to ensure there |
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is no delay in providing benefits to the child under the |
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supplemental nutrition assistance program. |
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(d) On determining that a child is eligible for medical |
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assistance benefits under this section, the commission shall enroll |
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the child in the medical assistance program in accordance with |
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Section 1902(e)(13)(D) of the Social Security Act (42 U.S.C. |
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Section 1396a(e)(13)(D)) if the commission: |
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(1) provides notice of the determination to the |
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child's parent, legal guardian, or custodial relative in the manner |
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indicated under Subsection (e); and |
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(2) obtains the affirmative consent of the child's |
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parent, legal guardian, or custodial relative in accordance with |
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Subsection (f) to enroll the child. |
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(e) The commission shall provide the notice required by |
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Subsection (d) in the manner a child's parent, legal guardian, or |
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custodial relative indicates as the preferred method of contact |
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when applying for supplemental nutrition assistance program |
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benefits. If a preferred method of contact is not indicated, the |
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commission may provide the notice: |
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(1) orally; |
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(2) by telephone; |
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(3) in writing, including: |
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(A) by electronic signature; or |
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(B) in an application for benefits under the |
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supplemental nutrition assistance program; or |
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(4) by any other manner the commission determines |
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appropriate. |
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(f) In obtaining the affirmative consent of a child's |
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parent, legal guardian, or custodial relative required by |
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Subsection (d), the commission: |
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(1) shall ensure the consent is provided: |
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(A) within a reasonable amount of time, as |
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determined by the commission; and |
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(B) in accordance with identity verification |
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standards the commission establishes; and |
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(2) may obtain the consent: |
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(A) orally; |
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(B) by telephone; |
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(C) in writing, including by: |
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(i) electronic signature; or |
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(ii) fax; or |
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(D) during an initial eligibility or |
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recertification interview for the supplemental nutrition |
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assistance program. |
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SECTION 5. 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 6. This Act takes effect September 1, 2025. |