Bill Text: TX SB1496 | 2023-2024 | 88th Legislature | Introduced


Bill Title: Relating to authorizing certain health benefit exchanges to make eligibility determinations under Medicaid and the child health plan program.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2023-03-16 - Referred to Health & Human Services [SB1496 Detail]

Download: Texas-2023-SB1496-Introduced.html
  88R7613 JG-D
 
  By: Johnson S.B. No. 1496
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to authorizing certain health benefit exchanges to make
  eligibility determinations under Medicaid and 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), the [The] commission shall continue
  employing methods of verifying the individual incomes of the
  individuals considered in the calculation of an applicant's
  household income. 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).
         (b)  The commission may not verify the income of a child
  determined eligible for coverage under the child health plan by a
  health benefit exchange in accordance with 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.  DETERMINATION OF ELIGIBILITY BY HEALTH
  BENEFIT EXCHANGE; ENROLLMENT. (a) In this section, "health
  benefit exchange" means an American Health Benefit Exchange
  administered by the federal government or an exchange created under
  Section 1311(b) of the Patient Protection and Affordable Care Act
  (42 U.S.C. Section 18031(b)).
         (b)  Notwithstanding any other law and in accordance with an
  agreement entered into under 42 C.F.R. Section 457.348, the
  commission shall accept eligibility determinations for coverage
  under the child health plan made by a health benefit exchange.
         (c)  The commission shall automatically enroll in the child
  health plan program a child who is determined eligible for coverage
  by a health benefit exchange. This subsection does not require the
  commission to enroll a child in the child health plan program whose
  eligibility for the program was not fully verified by the exchange.
  The commission shall take any further action necessary to verify
  and resolve an incomplete eligibility determination referred to the
  commission by the exchange.
         (d)  In entering into an agreement with a health benefit
  exchange under 42 C.F.R. Section 457.348, the commission shall
  ensure that the exchange makes determinations of eligibility for
  the child health plan based on eligibility criteria in accordance
  with applicable state law.
         (e)  The commission shall seek any federal money available
  for implementing this section, including enhanced federal
  financial participation made available under federal law.
         SECTION 3.  Section 32.026(g), Human Resources Code, is
  amended to read as follows:
         (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; [or]
               (3)  the Texas Department of Motor Vehicles vehicle
  registration record database; or
               (4)  a health benefit exchange, 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.  DETERMINATION OF ELIGIBILITY BY HEALTH
  BENEFIT EXCHANGE; ENROLLMENT. (a) In this section, "health
  benefit exchange" means an American Health Benefit Exchange
  administered by the federal government or an exchange created under
  Section 1311(b) of the Patient Protection and Affordable Care Act
  (42 U.S.C. Section 18031(b)).
         (b)  Notwithstanding any other law and in accordance with an
  agreement entered into under 42 C.F.R. Section 431.10, the
  commission shall accept eligibility determinations for medical
  assistance made by a health benefit exchange.
         (c)  The commission shall automatically enroll in the
  medical assistance program an individual whose eligibility for
  medical assistance benefits is determined by a health benefit
  exchange. This subsection does not require the commission to
  enroll an individual in the medical assistance program whose
  eligibility for the program was not fully verified by the exchange.
  The commission shall take any further action that is necessary to
  verify and resolve an incomplete eligibility determination
  referred to the commission by the exchange.
         (d)  In entering into an agreement with a health benefit
  exchange under 42 C.F.R. Section 431.10, the commission shall
  ensure that the exchange makes determinations of eligibility for
  the medical assistance program based on eligibility criteria in
  accordance with applicable state law.
         (e)  The commission shall seek any federal money available
  for implementing this section, including enhanced federal
  financial participation made available under 42 C.F.R. Part 433,
  Subpart C.
         SECTION 5.  Section 32.026101, Human Resources Code, is
  repealed.
         SECTION 6.  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 7.  This Act takes effect September 1, 2023.
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