Bill Text: TX HB3551 | 2023-2024 | 88th Legislature | Introduced
Bill Title: Relating to presumptive eligibility of certain elderly individuals for home and community-based services under Medicaid.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2023-03-16 - Referred to Human Services [HB3551 Detail]
Download: Texas-2023-HB3551-Introduced.html
88R14024 JG-F | ||
By: Thierry | H.B. No. 3551 |
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relating to presumptive eligibility of certain elderly individuals | ||
for home and community-based services under Medicaid. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subchapter B, Chapter 32, Human Resources Code, | ||
is amended by adding Section 32.02605 to read as follows: | ||
Sec. 32.02605. PRESUMPTIVE ELIGIBILITY OF CERTAIN ELDERLY | ||
INDIVIDUALS FOR HOME AND COMMUNITY-BASED SERVICES. (a) In this | ||
section, "elderly individual" means an individual who is 65 years | ||
of age or older. | ||
(b) The executive commissioner by rule shall adopt a program | ||
providing for: | ||
(1) the determination and certification of | ||
presumptive eligibility for medical assistance of an elderly | ||
individual who requires a skilled level of nursing care; and | ||
(2) the provision through the medical assistance | ||
program to the individual of that care in a home or community-based | ||
setting instead of in an institutional setting, provided the | ||
individual applies for and meets the basic eligibility requirements | ||
for medical assistance. | ||
(c) The program established under this section must: | ||
(1) provide medical assistance benefits under a | ||
presumptive eligibility determination for a period of not more than | ||
90 days; | ||
(2) establish eligibility criteria and a process for | ||
determining the entities authorized to make determinations of | ||
presumptive eligibility under the program; | ||
(3) provide a preliminary screening tool to entities | ||
described by Subdivision (2) that will allow representatives of | ||
those entities to: | ||
(A) make a determination as to whether an | ||
applicant is: | ||
(i) functionally able to live at home or in | ||
a community setting; and | ||
(ii) likely to be financially eligible for | ||
medical assistance; | ||
(B) make the determination under Paragraph | ||
(A)(ii) not later than the fourth day after the date a determination | ||
is made under Paragraph (A)(i); and | ||
(C) initiate the provision of medical assistance | ||
benefits not later than the fifth day after the date an applicant is | ||
determined eligible under Paragraph (A)(i); and | ||
(4) require an applicant to sign a written agreement: | ||
(A) attesting to the accuracy of financial and | ||
other information the applicant provides and on which presumptive | ||
eligibility is based; and | ||
(B) acknowledging that: | ||
(i) state-funded services are subject to | ||
the period prescribed by Subdivision (1); and | ||
(ii) the applicant is required to comply | ||
with Subsection (d). | ||
(d) An applicant who is determined presumptively eligible | ||
for medical assistance under the program established by this | ||
section must complete an application for medical assistance not | ||
later than the 10th day after the date the applicant is screened for | ||
functional eligibility under Subsection (c)(3)(A)(i). | ||
(e) Not later than the 45th day after the date the | ||
commission receives an application under Subsection (d), the | ||
commission shall make a final determination of eligibility for | ||
medical assistance. | ||
(f) To the extent permitted by federal law, the commission | ||
shall retroactively apply a final determination of eligibility for | ||
medical assistance under Subsection (e) for a period that does not | ||
precede the 90th day before the date the application was filed under | ||
Subsection (d). | ||
(g) The commission shall submit to the standing committees | ||
of the senate and house of representatives having jurisdiction over | ||
the medical assistance program an annual report that details: | ||
(1) the number of individuals determined | ||
presumptively eligible for medical assistance under the program | ||
established under this section; | ||
(2) the savings to the state based on how much | ||
institutional care would have cost for individuals determined | ||
presumptively eligible for medical assistance under the program | ||
established under this section who were later determined eligible | ||
for medical assistance; and | ||
(3) the number of individuals determined | ||
presumptively eligible for medical assistance under the program | ||
established under this section who were later determined not | ||
eligible for medical assistance and the cost to the state to provide | ||
those individuals with home or community-based services before the | ||
final determination of eligibility for medical assistance. | ||
(h) The report required under Subsection (g) may be combined | ||
with any other report required by this chapter or other law. | ||
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 September 1, 2023. |