84R13265 SCL-D
By: Bernal H.B. No. 3195
A BILL TO BE ENTITLED
AN ACT
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.