Texas 2009 - 81st Regular

Texas Senate Bill SB66 Compare Versions

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1	1	81R1148 KKA-F
2	2	By: Nelson S.B. No. 66
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to health care coverage for children in Title IV-D cases.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. Section 154.182(b), Family Code, is amended to
10	10	read as follows:
11	11	(b) In determining the manner in which health care coverage
12	12	for the child is to be ordered, the court shall render its order in
13	13	accordance with the following priorities, unless a party shows good
14	14	cause why a particular order would not be in the best interest of
15	15	the child:
16	16	(1) if health insurance is available for the child
17	17	through a parent's employment or membership in a union, trade
18	18	association, or other organization at reasonable cost [to the
19	19	parent], the court shall order that parent to include the child in
20	20	the parent's health insurance;
21	21	(2) if health insurance is not available for the child
22	22	under Subdivision (1) but is available to a parent at reasonable
23	23	cost from another source, including the program under Section
24	24	154.1826 to provide health insurance in Title IV-D cases [and at a
25	25	reasonable cost], the court may order that parent to provide health
26	26	insurance for the child; or
27	27	(3) if health insurance coverage is not available for
28	28	the child under Subdivision (1) or (2), the court shall order the
29	29	obligor to pay the obligee, in addition to any amount ordered under
30	30	the guidelines for child support, an amount, not to exceed nine
31	31	percent of the obligor's annual [monthly] resources, as described
32	32	by Section 154.062(b), as cash medical support for the child.
33	33	SECTION 2. Subchapter D, Chapter 154, Family Code, is
34	34	amended by adding Sections 154.1826 and 154.1827 to read as
35	35	follows:
36	36	Sec. 154.1826. HEALTH CARE PROGRAM FOR CERTAIN CHILDREN IN
37	37	TITLE IV-D CASES. (a) In this section:
38	38	(1) "Health benefit plan issuer" means an insurer,
39	39	health maintenance organization, or other entity authorized to
40	40	provide health benefits coverage under this section, including a
41	41	primary care case management provider network.
42	42	(2) "Health care provider" means a physician or other
43	43	person who is licensed, certified, or otherwise authorized to
44	44	provide a health care service in this state.
45	45	(3) "Program" means the child health care program
46	46	developed under this section.
47	47	(4) "Reasonable cost" has the meaning assigned by
48	48	Section 154.181(e).
49	49	(b) In consultation with the Texas Department of Insurance,
50	50	the Health and Human Services Commission, and representatives of
51	51	the insurance industry in this state, the Title IV-D agency shall
52	52	develop and implement a statewide program to address the health
53	53	care needs of children in Title IV-D cases for whom health insurance
54	54	is not available to either parent at reasonable cost in the manner
55	55	described by Section 154.182(b)(1).
56	56	(c) The principal objective of the program is to provide
57	57	basic health care services, including usual physician services,
58	58	office visits, hospitalization, and laboratory, x-ray, and
59	59	emergency services, to eligible children in Title IV-D cases at
60	60	reasonable cost to the parents obligated by court order to provide
61	61	medical support for the children. The health care services
62	62	provided are intended to be commensurate in range of services with
63	63	the premium reimbursement available to a health benefit plan
64	64	issuer.
65	65	(d) It is the intent of the legislature that the Title IV-D
66	66	agency maximize the use of private resources in administering the
67	67	program, including the use of gifts and grants. To the extent
68	68	federal money is available for that purpose, the Title IV-D agency
69	69	may contract with a third-party administrator to provide enrollment
70	70	and related services under the program.
71	71	(e) The Title IV-D agency shall adopt rules as necessary to
72	72	implement the program. The Title IV-D agency shall consult with the
73	73	Health and Human Services Commission and other public and private
74	74	health care authorities in establishing policies regarding
75	75	benefits provided by the program.
76	76	(f) The program may not deny health care coverage to
77	77	eligible children because of preexisting conditions or chronic
78	78	illnesses, and must provide a uniform schedule of benefits for all
79	79	children enrolled in the program. A child who is determined to be
80	80	eligible for coverage under the program continues to be eligible
81	81	until the termination of the parent's duty to pay child support as
82	82	specified by Section 154.006.
83	83	(g) The Title IV-D agency shall solicit applications for
84	84	participation in the program from health benefit plan issuers who
85	85	meet requirements specified by the agency. The Title IV-D agency
86	86	shall consult with the Texas Department of Insurance in the
87	87	appropriate rating of health benefit plan issuers who apply for
88	88	participation in the program. Each health benefit plan issuer who
89	89	participates in the program must hold a certificate of authority
90	90	issued by the Texas Department of Insurance.
91	91	(h) The Title IV-D agency shall promptly notify the courts
92	92	of this state when the program has been implemented and is available
93	93	to provide for the health care needs of children described by
94	94	Subsection (b). The notification must specify a date beginning on
95	95	which children may be enrolled in the program.
96	96	(i) On or after the date specified in the notification
97	97	required by Subsection (h), a court that orders health care
98	98	coverage for a child in a Title IV-D case shall order that the child
99	99	be enrolled in the program authorized by this section unless other
100	100	private health insurance is available for the child at reasonable
101	101	cost.
102	102	(j) Payment of premium costs for the enrollment of a child
103	103	in the program may be enforced against the obligor by any means
104	104	available for the enforcement of a child support obligation,
105	105	including income withholding under Chapter 158.
106	106	(k) To provide the flexibility necessary to provide
107	107	services at a reasonable cost to an obligor, and notwithstanding
108	108	any provision in the Insurance Code, the program authorized by this
109	109	section is not subject to a law that requires:
110	110	(1) coverage or the offer of coverage of a particular
111	111	health care service or benefit;
112	112	(2) coverage or the offer of coverage for the
113	113	provision of services by a particular health care provider, other
114	114	than a provider selected for participation in the program; or
115	115	(3) the use of a particular insurance policy or
116	116	contract form or of particular language in a policy or contract
117	117	form.
118	118	Sec. 154.1827. ADMINISTRATIVE ADJUSTMENT OF MEDICAL
119	119	SUPPORT ORDER. (a) In a Title IV-D case in which a medical support
120	120	order requires that a child be enrolled in a health care program
121	121	under Section 154.1826, the Title IV-D agency may administratively
122	122	adjust the order as necessary to reflect changes in the amount of
123	123	premium costs associated with the child's enrollment.
124	124	(b) The Title IV-D agency shall provide notice of the
125	125	administrative adjustment to the obligor and the clerk of the court
126	126	that rendered the order.
127	127	SECTION 3. This Act takes effect September 1, 2009, except
128	128	that Section 2 of this Act takes effect immediately if this Act
129	129	receives a vote of two-thirds of all the members elected to each
130	130	house, as provided by Section 39, Article III, Texas Constitution.
131	131	If this Act does not receive the vote necessary for immediate
132	132	effect, Section 2 takes effect September 1, 2009.