Bill Text: TX HB1016 | 2019-2020 | 86th Legislature | Introduced


Bill Title: Relating to eligibility determinations for the STAR+PLUS home and community based services (HCBS) program.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2019-04-23 - Left pending in committee [HB1016 Detail]

Download: Texas-2019-HB1016-Introduced.html
  86R3390 LED-D
 
  By: Martinez H.B. No. 1016
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to eligibility determinations for the STAR+PLUS home and
  community based services (HCBS) program.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter A, Chapter 533, Government Code, is
  amended by adding Section 533.00282 to read as follows:
         Sec. 533.00282.  ELIGIBILITY DETERMINATIONS FOR STAR+PLUS
  HOME AND COMMUNITY BASED SERVICES (HCBS) PROGRAM.  (a)  The
  commission shall determine Medicaid eligibility for an applicant
  for the STAR+PLUS home and community based services (HCBS) program
  not later than:
               (1)  the 20th day after the date the applicant submits
  the application; or
               (2)  the 45th day after the date the applicant submits
  the application, if the applicant is applying on the basis of a
  disability.
         (b)  A managed care organization with which the commission
  contracts to provide health care services to recipients shall, not
  later than the 30th day after the date an applicant for the
  STAR+PLUS home and community based services (HCBS) program submits
  the application, complete and submit to the entity serving as this
  state's Medicaid claims administrator the applicant's:
               (1)  individual service plan; and
               (2)  medical necessity and level of care assessment.
         SECTION 2.  Section 533.00282(a), Government Code, as added
  by this Act, applies only to an application for a determination of
  Medicaid eligibility submitted on or after the effective date of
  this Act. An application for a determination of Medicaid
  eligibility submitted before the effective date of this Act is
  governed by the law in effect immediately before the effective date
  of this Act, and that law is continued in effect for that purpose.
         SECTION 3.  (a) The Health and Human Services Commission
  shall, in a contract between the commission and a managed care
  organization under Chapter 533, Government Code, that is entered
  into or renewed on or after the effective date of this Act, require
  that the managed care organization comply with Section
  533.00282(b), Government Code, as added by this Act.
         (b)  The Health and Human Services Commission shall seek to
  amend contracts entered into with managed care organizations under
  Chapter 533, Government Code, before the effective date of this Act
  to require those managed care organizations to comply with Section
  533.00282(b), Government Code, as added by this Act. To the extent
  of a conflict between Section 533.00282(b), Government Code, as
  added by this Act, and a provision of a contract with a managed care
  organization entered into before the effective date of this Act,
  the contract provision prevails.
         SECTION 4.  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 5.  This Act takes effect September 1, 2019.
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