Bill Text: TX SB1995 | 2015-2016 | 84th Legislature | Introduced
Bill Title: Relating to the establishment of a health care pilot program for low-income individuals.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2015-03-25 - Referred to Business & Commerce [SB1995 Detail]
Download: Texas-2015-SB1995-Introduced.html
84R13265 SCL-D | ||
By: Menéndez | S.B. No. 1995 |
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relating to the establishment of a health care pilot program for | ||
low-income individuals. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subtitle C, Title 2, Health and Safety Code, is | ||
amended by adding Chapter 65 to read as follows: | ||
CHAPTER 65. HEALTH CARE PILOT PROGRAM FOR LOW-INCOME INDIVIDUALS | ||
Sec. 65.001. DEFINITIONS. In this chapter: | ||
(1) "Commissioner" means the commissioner of | ||
insurance. | ||
(2) "Department" means the Texas Department of | ||
Insurance. | ||
(3) "Pilot program" means the health care pilot | ||
program for low-income individuals established under this chapter. | ||
Sec. 65.002. ESTABLISHMENT OF PILOT PROGRAM; RULEMAKING | ||
AUTHORITY. (a) The department shall establish and maintain in | ||
accordance with this chapter a pilot program for health benefits | ||
coverage for certain low-income individuals residing in an area | ||
designated by the department under Section 65.003. | ||
(b) The commissioner may adopt rules as necessary to | ||
implement this chapter. | ||
Sec. 65.003. DESIGNATION OF AREAS UNDER PILOT PROGRAM. (a) | ||
The commissioner by rule shall adopt standards in accordance with | ||
this subsection for the designation of an area to be served under | ||
the pilot program. To be eligible for the pilot program: | ||
(1) the percentage of adults in the area who do not | ||
have coverage or benefits for health care services under a public or | ||
private plan or program must be higher than the state average; | ||
(2) the area must be designated as a health | ||
professional shortage area by the United States Department of | ||
Health and Human Services; and | ||
(3) the area must be served on or before January 1, | ||
2015, by one or more promotoras trained under Chapter 48. | ||
(b) The department shall designate 10 areas in this state | ||
for inclusion in the pilot program in accordance with the standards | ||
under Subsection (a) and rules adopted under this chapter. | ||
(c) The department may establish an application process to | ||
allow an area to apply for inclusion in the pilot program. | ||
Sec. 65.004. PROMOTORA DUTIES. A promotora serving an area | ||
designated for the pilot program may assist the department in | ||
coordination of health care under the pilot program, in monitoring | ||
the compliance of individuals enrolled in the pilot program, and in | ||
establishing an application process. | ||
Sec. 65.005. INDIVIDUAL ELIGIBILITY. To be eligible to | ||
receive services under the pilot program, an individual must have | ||
an income of less than 138 percent of the federal poverty level and | ||
be a parent of a child currently enrolled in the state health plan | ||
or health benefits plan for children under Chapter 62 or 63 or the | ||
state Medicaid program operated under Chapter 32, Human Resources | ||
Code. | ||
Sec. 65.006. HEALTH COVERAGE UNDER PILOT PROGRAM. The | ||
commissioner by rule shall develop the health benefits coverage | ||
under the pilot program, including the benefits offered under the | ||
pilot program and the method of providing benefits. | ||
Sec. 65.007. FUNDING. Notwithstanding Section 6(e)(2), | ||
Chapter 615 (S.B. 1367), Acts of the 83rd Legislature, Regular | ||
Session, 2013, the department shall fund the pilot program with | ||
available funds transferred to the department under that Act. The | ||
commissioner may adopt rules necessary to facilitate the funding of | ||
the pilot program under this section. | ||
Sec. 65.008. REPORT. (a) The department shall contract | ||
with an independent third party to evaluate the pilot program and | ||
develop a report under this section. | ||
(b) Not later than December 1, 2016, the third party | ||
contracting with the department under Subsection (a) shall | ||
distribute a report that evaluates the pilot program to the | ||
governor, lieutenant governor, speaker of the house of | ||
representatives, and chairs of the standing committees of the | ||
senate and house of representatives with primary jurisdiction | ||
regarding health care or insurance. | ||
Sec. 65.009. ADVISORY COMMITTEE. The commissioner shall | ||
appoint an advisory committee composed of five members to advise | ||
the department on the implementation of this chapter. The | ||
committee must include: | ||
(1) two individuals eligible to obtain coverage under | ||
the pilot program; | ||
(2) a representative of the insurance industry; | ||
(3) a representative of a university hospital system; | ||
and | ||
(4) a health care provider providing services in an | ||
area included in the pilot program. | ||
Sec. 65.010. EXPIRATION OF CHAPTER. This chapter expires | ||
August 31, 2019. | ||
SECTION 2. Not later than January 1, 2016, the Texas | ||
Department of Insurance shall establish the indigent health care | ||
pilot program described by Chapter 65, Health and Safety Code, as | ||
added by this Act. | ||
SECTION 3. This Act takes effect September 1, 2015. |