Bill Text: TX HB36 | 2023 | 88th Legislature 2nd Special Session | Introduced
Bill Title: Relating to implementation of an express lane option for determining eligibility and enrolling certain individuals in Medicaid or the child health plan program.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2023-06-28 - Filed [HB36 Detail]
Download: Texas-2023-HB36-Introduced.html
| By: Bucy | H.B. No. 36 | |
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| relating to implementation of an express lane option for | ||
| determining eligibility and enrolling certain individuals in | ||
| Medicaid or the child health plan program. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Section 62.1011, Health and Safety Code, is | ||
| amended to read as follows: | ||
| Sec. 62.1011. VERIFICATION OF INCOME. (a) Except as | ||
| provided by Subsection (b) and subject to Subsection (c), the [ |
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| commission shall continue employing methods of verifying the | ||
| individual incomes of the individuals considered in the calculation | ||
| of an applicant's household income. | ||
| (b) The commission shall verify income under this section | ||
| unless the applicant reports a household income that exceeds the | ||
| income eligibility level established under Section 62.101(b). | ||
| (c) The commission may verify income using the verification | ||
| process described in Section 62.1012. | ||
| SECTION 2. Subchapter C, Chapter 62, Health and Safety | ||
| Code, is amended by adding Section 62.1012 to read as follows: | ||
| Sec. 62.1012. EXPRESS LANE OPTION ELIGIBILITY; ENROLLMENT. | ||
| (a) In this section: | ||
| (1) "Express lane agency" means a governmental entity | ||
| that: | ||
| (A) determines eligibility for assistance under | ||
| a public assistance program of this state; and | ||
| (B) is designated by the executive commissioner | ||
| as capable of making determinations of one or more eligibility | ||
| requirements under the child health plan program. | ||
| (2) "Public assistance program" includes: | ||
| (A) the Medicaid program under Chapter 32, Human | ||
| Resources Code; | ||
| (B) the financial assistance program under | ||
| Chapter 31, Human Resources Code; | ||
| (C) the nutritional assistance programs under | ||
| Chapter 33, Human Resources Code, including the supplemental | ||
| nutrition assistance program under that chapter; and | ||
| (D) other programs identified by the commission. | ||
| (b) Notwithstanding any other law and in accordance with | ||
| Sections 1902(e)(13) and 2107(e)(1)(H) of the Social Security Act | ||
| (42 U.S.C. Sections 1396a(e)(13) and 1397gg(e)(1)(H)), the | ||
| commission shall implement an express lane option under which the | ||
| commission may rely on findings made by an express lane agency, | ||
| including a division of an express lane agency, in determining a | ||
| child's eligibility for coverage under the child health plan, | ||
| including a child's eligibility for reenrollment in the plan. The | ||
| commission shall use express lane eligibility by evaluating data | ||
| received from an applicant under other public assistance programs | ||
| to determine the applicant's eligibility for coverage under the | ||
| child health plan. | ||
| (c) In accordance with Section 1902(e)(13)(D) of the Social | ||
| Security Act (42 U.S.C. Section 1396a(e)(13)(D)), the commission | ||
| shall enroll in the child health plan program a child who is | ||
| determined to be eligible for the program under this section, | ||
| except that the child may only be enrolled in the program if the | ||
| child's parent, legal guardian, or custodial relative | ||
| affirmatively consents to the enrollment. The consent: | ||
| (1) must be provided in accordance with identity | ||
| verification standards the commission establishes; and | ||
| (2) may be provided: | ||
| (A) orally; | ||
| (B) by telephone; | ||
| (C) in writing, including: | ||
| (i) by electronic signature; or | ||
| (ii) in an application for coverage or | ||
| benefits under a public assistance program; or | ||
| (D) by any other manner the commission determines | ||
| appropriate. | ||
| (d) The commission and each express lane agency shall | ||
| include in each application for coverage or benefits under a public | ||
| assistance program, including any online application, and on the | ||
| commission's or agency's Internet website a conspicuous notice | ||
| clearly explaining that: | ||
| (1) the information disclosed in the application may | ||
| be used to determine a child's eligibility for coverage under the | ||
| child health plan program using the express lane option implemented | ||
| under this section; | ||
| (2) the child's parent, legal guardian, or custodial | ||
| relative may elect not to have the information disclosed for that | ||
| purpose; and | ||
| (3) the child's parent, legal guardian, or custodial | ||
| relative must provide affirmative consent before the child may be | ||
| enrolled in the child health plan program using the express lane | ||
| option implemented under this section. | ||
| (e) In accordance with 42 C.F.R. Section 457.340(e), the | ||
| commission shall provide to the parent, legal guardian, or | ||
| custodial relative of a child determined eligible for coverage | ||
| under the child health plan program using the express lane option | ||
| implemented under this section notice of that determination. The | ||
| notice may be provided by mail, e-mail, or any other manner the | ||
| commission determines appropriate. | ||
| SECTION 3. Sections 32.026(e) and (g), Human Resources | ||
| Code, are amended to read as follows: | ||
| (e) The executive commissioner shall permit a | ||
| recertification review of the eligibility and need for medical | ||
| assistance of a child under 19 years of age to be conducted by | ||
| telephone or mail instead of through a personal appearance at an | ||
| office, unless the commission determines that the information | ||
| needed to verify eligibility cannot be obtained in that manner or | ||
| may be obtained in the manner specified by Section 32.026102. The | ||
| executive commissioner by rule may develop procedures to determine | ||
| whether there is a need for a recertification review of a child | ||
| described by this subsection to be conducted through a personal | ||
| interview with a commission representative. Procedures developed | ||
| under this subsection shall be based on objective, risk-based | ||
| factors and conditions and shall focus on a targeted group of | ||
| recertification reviews for which there is a high probability that | ||
| eligibility will not be recertified. | ||
| (g) Notwithstanding any other provision of this code, the | ||
| commission may use information obtained from a third party to | ||
| verify the assets and resources of a person for purposes of | ||
| determining the person's eligibility and need for medical | ||
| assistance to the extent that verification is applicable under | ||
| federal law. Third-party information includes information | ||
| obtained from: | ||
| (1) a consumer reporting agency, as defined by Section | ||
| 20.01, Business & Commerce Code; | ||
| (2) an appraisal district; [ |
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| (3) the Texas Department of Motor Vehicles vehicle | ||
| registration record database; or | ||
| (4) an express lane agency as defined by Section | ||
| 32.026102. | ||
| SECTION 4. Subchapter B, Chapter 32, Human Resources Code, | ||
| is amended by adding Section 32.026102 to read as follows: | ||
| Sec. 32.026102. EXPRESS LANE OPTION ELIGIBILITY; | ||
| ENROLLMENT. (a) In this section: | ||
| (1) "Express lane agency" means a governmental entity | ||
| that: | ||
| (A) determines eligibility for assistance under | ||
| a public assistance program of this state; and | ||
| (B) is designated by the executive commissioner | ||
| as capable of making determinations of one or more eligibility | ||
| requirements under the medical assistance program. | ||
| (2) "Public assistance program" includes: | ||
| (A) the child health plan program under Chapters | ||
| 62 and 63, Health and Safety Code; | ||
| (B) the financial assistance program under | ||
| Chapter 31; | ||
| (C) the nutritional assistance programs under | ||
| Chapter 33, including the supplemental nutrition assistance | ||
| program under that chapter; and | ||
| (D) other programs identified by the commission. | ||
| (b) Notwithstanding any other law and in accordance with | ||
| Section 1902(e)(13) of the Social Security Act (42 U.S.C. Section | ||
| 1396a(e)(13)), the commission shall implement an express lane | ||
| option under which the commission may rely on findings made by an | ||
| express lane agency, including a division of an express lane | ||
| agency, in determining a child's eligibility for medical | ||
| assistance, including the recertification of a child's eligibility | ||
| for medical assistance benefits. The commission shall use express | ||
| lane eligibility by evaluating data received from an applicant | ||
| under other public assistance programs to determine the applicant's | ||
| eligibility for benefits under the medical assistance program. | ||
| (c) In accordance with Section 1902(e)(13)(D) of the Social | ||
| Security Act (42 U.S.C. Section 1396a(e)(13)(D)), the commission | ||
| shall enroll in the medical assistance program a child who is | ||
| determined to be eligible for the program under this section, | ||
| except that the child may only be enrolled in the program if the | ||
| child's parent, legal guardian, or custodial relative | ||
| affirmatively consents to the enrollment. The consent: | ||
| (1) must be provided in accordance with identity | ||
| verification standards the commission establishes; and | ||
| (2) may be provided: | ||
| (A) orally; | ||
| (B) by telephone; | ||
| (C) in writing, including: | ||
| (i) by electronic signature; or | ||
| (ii) in an application for coverage or | ||
| benefits under a public assistance program; or | ||
| (D) by any other manner the commission determines | ||
| appropriate. | ||
| (d) The commission and each express lane agency shall | ||
| include in each application for coverage or benefits under a public | ||
| assistance program, including any online application, and on the | ||
| commission's or agency's Internet website a conspicuous notice | ||
| clearly explaining that: | ||
| (1) the information disclosed in the application may | ||
| be used to determine a child's eligibility for medical assistance | ||
| benefits using the express lane option implemented under this | ||
| section; | ||
| (2) the child's parent, legal guardian, or custodial | ||
| relative may elect not to have the information disclosed for that | ||
| purpose; and | ||
| (3) the child's parent, legal guardian, or custodial | ||
| relative must provide affirmative consent before the child may be | ||
| enrolled in the medical assistance program using the express lane | ||
| option implemented under this section. | ||
| (e) In accordance with 42 C.F.R. Section 435.917, the | ||
| commission shall provide to the parent, legal guardian, or | ||
| custodial relative of a child determined eligible for benefits | ||
| under the medical assistance program using the express lane option | ||
| implemented under this section notice of that determination. The | ||
| notice may be provided by mail, e-mail, or any other manner the | ||
| commission determines appropriate. | ||
| SECTION 5. 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 6. 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 on the 91st day after the last day of the | ||
| legislative session. | ||
