84R3469 EES-D
By: Naishtat H.B. No. 839
A BILL TO BE ENTITLED
AN ACT
relating to presumptive eligibility for the Medicaid and child
health plan programs for certain children.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 62.101, Health and Safety Code, is
amended by adding Subsections (d) and (e) to read as follows:
(d) As authorized by 42 U.S.C. Section 1397gg, the executive
commissioner of the commission shall adopt rules providing for the
determination and certification of presumptive eligibility for the
child health plan program of a child under 19 years of age who:
(1) has been released from:
(A) confinement in a correctional facility, as
defined by Section 1.07, Penal Code; or
(B) placement, detention, or commitment in a
facility or other setting under Title 3, Family Code; and
(2) applies for and meets the basic eligibility
requirements for the child health plan program.
(e) The rules adopted under Subsection (d) must:
(1) specify the period during which a child may apply
for presumptive eligibility for the child health plan program
following the date of the child's release from a facility or other
setting described in Subsection (d)(1);
(2) require that a qualified entity that is making a
presumptive eligibility determination for a child accept as
verification of the child's release from a facility or other
setting described in Subsection (d)(1) any discharge or release
papers provided to the child on the child's release; and
(3) identify the services and benefits, which must
include mental health and substance abuse services, prescription
drug benefits, and primary care services, that a child who is
presumptively eligible for the child health plan program may
receive under that program.
SECTION 2. Section 62.154(b), Health and Safety Code, is
amended to read as follows:
(b) A child is not subject to a waiting period adopted under
Subsection (a) if:
(1) the family lost coverage for the child as a result
of:
(A) termination of employment because of a layoff
or business closing;
(B) termination of continuation coverage under
the Consolidated Omnibus Budget Reconciliation Act of 1985 (Pub.
L. No. 99-272);
(C) change in marital status of a parent of the
child;
(D) termination of the child's Medicaid
eligibility because:
(i) the child's family's earnings or
resources increased; or
(ii) the child reached an age at which
Medicaid coverage is not available; or
(E) a similar circumstance resulting in the
involuntary loss of coverage;
(2) the family terminated health benefits plan
coverage for the child because the cost to the child's family for
the coverage exceeded 10 percent of the family's net income;
(3) the child has access to group-based health
benefits plan coverage and is required to participate in the health
insurance premium payment reimbursement program administered by
the commission; [or]
(4) the child is certified as presumptively eligible
for the child health plan program under rules adopted under Section
62.101(d); or
(5) the commission has determined that other grounds
exist for a good cause exception.
SECTION 3. Section 32.026, Human Resources Code, is amended
by adding Subsections (h) and (i) to read as follows:
(h) As authorized by 42 U.S.C. Section 1396r-1a, the
executive commissioner of the Health and Human Services Commission
shall adopt rules providing for the determination and certification
of presumptive eligibility for medical assistance for a child under
19 years of age who:
(1) has been released from:
(A) confinement in a correctional facility, as
defined by Section 1.07, Penal Code; or
(B) placement, detention, or commitment in a
facility or other setting under Title 3, Family Code; and
(2) applies for and meets the basic eligibility
requirements for medical assistance.
(i) The rules adopted under Subsection (h) must:
(1) specify the period during which a child may apply
for presumptive eligibility for medical assistance following the
date of the child's release from a facility or other setting
described in Subsection (h)(1);
(2) require that a qualified entity that is making a
presumptive eligibility determination for a child accept as
verification of the child's release from a facility or other
setting described in Subsection (h)(1) any discharge or release
papers provided to the child on the child's release; and
(3) identify the services and benefits, which must
include mental health and substance abuse services, prescription
drug benefits, and primary care services, that a child who is
presumptively eligible for medical assistance may receive under the
medical assistance program.
SECTION 4. The executive commissioner of the Health and
Human Services Commission shall adopt the rules required by Section
62.101(d), Health and Safety Code, as added by this Act, and Section
32.026(h), Human Resources Code, as added by this Act, not later
than January 1, 2016.
SECTION 5. The changes in law made by this Act apply to a
child who is released from a facility or other setting described by
Section 62.101(d)(1), Health and Safety Code, as added by this Act,
or Section 32.026(h)(1), Human Resources Code, as added by this
Act, on or after January 1, 2016, regardless of the date the child
was confined in, placed in, detained in, or committed to the
facility or other setting.
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 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, 2015.