81R13149 KLA-F
By: Coleman H.B. No. 3470
A BILL TO BE ENTITLED
AN ACT
relating to the administration and funding of and eligibility for
the child health plan, medical assistance, and other programs.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 531.021(e), Government Code, is amended
to read as follows:
(e) Notwithstanding any other provision of Chapter 32,
Human Resources Code, Chapter 533, or this chapter, the commission:
(1) may adjust the fees, charges, and rates paid to
Medicaid providers as necessary to achieve the objectives of the
Medicaid program in a manner consistent with the considerations
described by Subsection (d); and
(2) shall adjust the fees, charges, and rates paid for
primary care and nursing home services annually to, at a minimum,
account for inflation.
SECTION 2. Subchapter B, Chapter 531, Government Code, is
amended by adding Sections 531.02417, 531.02418, 531.02419, and
531.02420 to read as follows:
Sec. 531.02417. ENROLLMENT AND RETENTION MODIFICATIONS FOR
RECEIPT OF FEDERAL BONUS PAYMENTS. (a) Notwithstanding any other
provision of this chapter, Chapter 62, Health and Safety Code,
Chapter 32, Human Resources Code, or any other law, the commission
shall take all necessary actions to modify enrollment and retention
processes employed in the child health plan and Medicaid programs
to ensure that this state receives federal performance bonus
payments made available under Section 2105(a)(3), Social Security
Act (42 U.S.C. Section 1397ee(a)(3)), or, if an enrollment and
retention process employed in those programs does not require a
modification, maintain the process to ensure receipt of those
payments.
(b) Actions the commission is required to take under
Subsection (a) include implementing or maintaining the following
with respect to children younger than 19 years of age:
(1) a 12-month period of continuous eligibility for
the child health plan and Medicaid programs, as required by Section
62.102, Health and Safety Code, and Section 32.0261, Human
Resources Code, respectively;
(2) liberalizing asset test requirements for
eligibility determinations for the child health plan and Medicaid
programs, which may include:
(A) eliminating the asset test regardless of
whether the test is specifically authorized by statute; or
(B) permitting an applicant, or the applicant's
parent or guardian, to certify under penalty of perjury information
relating to assets or using an asset verification process that does
not require an applicant, or the applicant's parent or guardian, to
provide documentation except when discrepancies are discovered or
under other circumstances that justify requiring documentation, as
determined by the executive commissioner in accordance with federal
law;
(3) eliminating any personal interview requirements
for determining eligibility for the child health plan or Medicaid
programs, notwithstanding any other law;
(4) using the same application, set of supplemental
forms, if applicable, and information verification process for
determining eligibility for the child health plan and Medicaid
programs; and
(5) using automatic, administrative processes for
recertifying eligibility for the child health plan and Medicaid
programs that comply with the requirements specified by Section
2105(a)(4)(E), Social Security Act (42 U.S.C. Section
1397ee(a)(4)(E)), including:
(A) providing a preprinted form completed by the
commission or a person contracting with the commission to perform
eligibility and enrollment functions that is based on available
information, unless other information is provided or obtained
through verification; and
(B) using an ex parte process under which no
personal interview is required unless the commission, or the person
contracting with the commission to perform eligibility and
enrollment functions, does not have sufficient information to
recertify eligibility and that information cannot be acquired from
other sources without the participation of an applicant or the
applicant's parent or guardian.
Sec. 531.02418. RECEIPT OF TEMPORARY INCREASED MEDICAID
FMAP AND DSH ALLOTMENT. (a) In this section:
(1) "DSH allotment" means the federal funding
allotment provided under the disproportionate share hospital
supplemental payment program.
(2) "Medicaid FMAP" means the federal medical
assistance percentage by which state Medicaid expenditures are
matched with federal funds.
(b) The commission shall take all actions necessary to
qualify this state for the temporary increase in the Medicaid FMAP
authorized by Section 5001, American Recovery and Reinvestment Act
of 2009 (Pub. L. No. 111-5), and for the temporary increase in this
state's DSH allotment authorized by Section 5002, American Recovery
and Reinvestment Act of 2009 (Pub. L. No. 111-5). If necessary, the
commission shall, with assistance from the Texas Workforce
Commission, monitor the state unemployment increase percentage as
defined by Section 5001(c)(4), American Recovery and Reinvestment
Act of 2009 (Pub. L. No. 111-5), and assist in providing accurate
data regarding that percentage to the federal government for
purposes of ensuring receipt of the additional Medicaid FMAP
increase authorized by Section 5001(c) of that Act, if applicable.
(c) This section expires September 2, 2011.
Sec. 531.02419. MAINTENANCE OF ELIGIBILITY; PROMPT PAYMENT
REQUIREMENTS. (a) In this section, "Medicaid FMAP" has the meaning
assigned by Section 531.02418.
(b) Notwithstanding any other law, including any Act of the
81st Legislature that is enacted and becomes law, the commission
may not implement any eligibility standard, methodology, or
procedure under the Medicaid program, including a Medicaid waiver
program, that is more restrictive than the corresponding
eligibility standard, methodology, or procedure in effect on July
1, 2008, if the implementation of the standard, methodology, or
procedure would result in this state's ineligibility under Section
5001(f), American Recovery and Reinvestment Act of 2009 (Pub. L.
No. 111-5), for an increase in the Medicaid FMAP.
(c) The commission and any person under contract with the
commission shall comply with the prompt payment requirements with
respect to claims subject to Section 1902(a)(37)(A), Social
Security Act (42 U.S.C. Section 1396a(a)(37)(A)), to ensure this
state's eligibility for an increased Medicaid FMAP. The commission
shall report to the United States secretary of health and human
services on a quarterly basis as required by Section
5001(f)(2)(A)(ii), American Recovery and Reinvestment Act of 2009
(Pub. L. No. 111-5), regarding compliance with those requirements
by the commission and persons under contract with the commission.
(d) This section expires September 2, 2011.
Sec. 531.02420. USE OF ADDITIONAL FEDERAL FUNDS; REPORT TO
FEDERAL GOVERNMENT. (a) Notwithstanding any other law, funds
received as a result of the increased Medicaid FMAP, as defined by
Section 531.02418, and any other federal funds received for
purposes of the Medicaid program as a result of the enactment of the
American Recovery and Reinvestment Act of 2009 (Pub. L. No. 111-5),
shall be credited to the general revenue fund and may not be
credited to the economic stabilization fund established under
Section 3.49-g, Article III, Texas Constitution, or another similar
fund established as a reserve fund for the future needs of this
state.
(b) Not later than September 30, 2011, the commission shall
submit a report to the United States secretary of health and human
services in the form and manner required by the secretary regarding
the use of additional Medicaid FMAP funds received by this state
resulting from the American Recovery and Reinvestment Act of 2009
(Pub. L. No. 111-5).
(c) This section expires December 1, 2011.
SECTION 3. Section 531.02444(a), Government Code, is
amended to read as follows:
(a) The executive commissioner shall develop and implement
a Medicaid buy-in program for persons with disabilities as
authorized by the Ticket to Work and Work Incentives Improvement
Act of 1999 (Pub. L. No. 106-170) or the Balanced Budget Act of 1997
(Pub. L. No. 105-33). The commission may conduct a community
outreach campaign to provide information relating to the
availability of Medicaid coverage through the buy-in program and to
promote enrollment of eligible persons in the program.
SECTION 4. Section 32.0261, Human Resources Code, is
amended to read as follows:
Sec. 32.0261. CONTINUOUS ELIGIBILITY. The department
shall adopt rules in accordance with 42 U.S.C. Section
1396a(e)(12), as amended, to provide for a period of continuous
eligibility for a child under 19 years of age who is determined to
be eligible for medical assistance under this chapter. The rules
shall provide that the child remains eligible for medical
assistance, without additional review by the department and
regardless of changes in the child's resources or income, until the
earlier of:
(1) the first anniversary of [end of the six-month
period following] the date on which the child's eligibility was
determined; or
(2) the child's 19th birthday.
SECTION 5. (a) In this section:
(1) "Benefits program" means any program operated by
the Health and Human Services Commission or a health and human
services agency, as defined by Section 531.001, Government Code,
that provides benefits to persons whose eligibility for the program
is determined using TIERS, including:
(A) the child health plan program under Chapter
62, Health and Safety Code;
(B) the financial assistance program under
Chapter 31, Human Resources Code;
(C) the medical assistance program under Chapter
32, Human Resources Code; and
(D) the food stamp program under Chapter 33,
Human Resources Code.
(2) "TIERS" means the Texas Integrated Eligibility
Redesign System.
(b) The Health and Human Services Commission shall develop
and implement reforms to:
(1) improve the operation of TIERS and the accuracy of
eligibility determinations for benefits programs made through
TIERS; and
(2) ensure that eligibility determinations for
benefits programs made through TIERS are made within the timelines
required under state and federal law.
(c) Reforms the commission may consider implementing
include establishing minimum staffing levels for the operation of
TIERS, qualifications and training for TIERS staff, and maximum
caseloads per staff person.
SECTION 6. The changes in law made by this Act apply to an
initial determination of eligibility or a recertification of
eligibility for the child health plan program under Chapter 62,
Health and Safety Code, or the medical assistance program under
Chapter 32, Human Resources Code, made on or after September 1,
2009.
SECTION 7. 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 8. In the event of a conflict between a provision of
this Act and another Act passed by the 81st Legislature, Regular
Session, 2009, that becomes law, this Act prevails regardless of
the relative dates of enactment.
SECTION 9. 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 September 1, 2009.