Texas 2015 - 84th Regular

Texas Senate Bill SB423 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	By: West S.B. No. 423
2	2
3	3
4	4	A BILL TO BE ENTITLED
5	5	AN ACT
6	6	relating to expanding eligibility for medical assistance to certain
7	7	persons under the federal Patient Protection and Affordable Care
8	8	Act and ensuring the provision of quality care under and the
9	9	effectiveness of the medical assistance program.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. Chapter 32, Human Resources Code, is amended by
12	12	adding Subchapter H to read as follows:
13	13	SUBCHAPTER H. EXPANSION OF ELIGIBILITY FOR MEDICAL ASSISTANCE
14	14	Sec. 32.351. DEFINITIONS. In this subchapter:
15	15	(1) "Commission" means the Health and Human Services
16	16	Commission.
17	17	(2) "Executive commissioner" means the executive
18	18	commissioner of the Health and Human Services Commission.
19	19	(3) "Medical assistance expansion group" means the
20	20	category of persons who would not be eligible for medical
21	21	assistance under the eligibility criteria in effect on December 31,
22	22	2013, but who are eligible for that assistance because of the
23	23	requirement of Section 32.352(a).
24	24	(4) "Undocumented immigrant" means a person who:
25	25	(A) is not a citizen or other national of the
26	26	United States; and
27	27	(B) is not lawfully authorized to be present in
28	28	the United States under the Immigration and Nationality Act (8
29	29	U.S.C. Section 1101 et seq.) or other federal law.
30	30	Sec. 32.352. EXPANDED ELIGIBILITY FOR MEDICAL ASSISTANCE
31	31	UNDER PATIENT PROTECTION AND AFFORDABLE CARE ACT.
32	32	(a) Notwithstanding any other law and except as provided in
33	33	Subsection (b) and Section 32.353, to the extent funds are
34	34	appropriated to the commission for that purpose, the commission
35	35	shall provide medical assistance to all persons who apply for that
36	36	assistance and for whom federal matching funds are available under
37	37	the Patient Protection and Affordable Care Act (Pub. L.
38	38	No. 111-148) as amended by the Health Care and Education
39	39	Reconciliation Act of 2010 (Pub. L. No. 111-152) to provide that
40	40	assistance.
41	41	(b) Nothing in this section authorizes the commission to
42	42	provide medical assistance to undocumented immigrants.
43	43	(c) The executive commissioner shall adopt rules regarding
44	44	the provision of medical assistance as required by this section.
45	45	Sec. 32.353. RESTRICTED ELIGIBILITY FOR MEDICAL ASSISTANCE
46	46	UPON CHANGES IN FEDERAL MATCHING FUNDS. (a) Notwithstanding any
47	47	other law, if the federal medical assistance percentage (FMAP) by
48	48	which this state's expenditures under the medical assistance
49	49	program are matched with federal funds and that applies with
50	50	respect to persons in the medical assistance expansion group is
51	51	less than the percentage provided for in the Patient Protection and
52	52	Affordable Care Act (Pub. L. No. 111-148) as amended by the Health
53	53	Care and Education Reconciliation Act of 2010 (Pub. L.
54	54	No. 111-152), and excluding subsequent amendments:
55	55	(1) the commission shall alert the Legislative Budget
56	56	Board; and
57	57	(2) beginning on the first day of the month following
58	58	the month in which the new federal medical assistance percentage
59	59	(FMAP) becomes effective, the commission shall:
60	60	(A) cease providing medical assistance to
61	61	persons in the medical assistance expansion group; and
62	62	(B) reinstate the eligibility criteria for
63	63	medical assistance that existed on December 31, 2015.
64	64	(b) The executive commissioner shall adopt any rules
65	65	necessary to implement any changes in the provision of and
66	66	eligibility criteria for medical assistance required by this
67	67	section.
68	68	Sec. 32.354. FEDERAL AUTHORIZATION FOR IMPLEMENTATION OF
69	69	COST-SHARING OBLIGATIONS FOR MEDICAL ASSISTANCE EXPANSION GROUP.
70	70	The executive commissioner shall seek a waiver or other appropriate
71	71	authorization from the appropriate federal agency to develop and
72	72	implement cost-sharing obligations for the medical assistance
73	73	expansion group. Cost-sharing obligations developed by the
74	74	commission under this section:
75	75	(1) must be designed to:
76	76	(A) incentivize persons in the medical
77	77	assistance expansion group to seek preventive or routine health
78	78	care services, rather than emergency health care services, when
79	79	possible and appropriate; and
80	80	(B) guarantee quality health care for persons in
81	81	the medical assistance expansion group;
82	82	(2) may include:
83	83	(A) copayments and deductibles; and
84	84	(B) modifications to the reimbursement
85	85	methodologies for services provided to persons in the medical
86	86	assistance expansion group; and
87	87	(3) may incorporate any other incentives or strategies
88	88	that the commission determines are necessary, including:
89	89	(A) expanded use of managed care;
90	90	(B) increased reliance on private individual or
91	91	employer-based insurance;
92	92	(C) incentives and rewards for participation in
93	93	evidence-based wellness activities; and
94	94	(D) targeted benefits for chronic illnesses.
95	95	Sec. 32.355. ANNUAL REPORT ON EXPANDED ELIGIBILITY FOR
96	96	MEDICAL ASSISTANCE. Not later than December 1 of each year, the
97	97	commission shall report to the governor, the lieutenant governor,
98	98	the speaker of the house of representatives, and the standing
99	99	committees of the senate and the house of representatives having
100	100	primary jurisdiction over the medical assistance program on the
101	101	effects of expanding eligibility for medical assistance under
102	102	Section 32.352, including the effects on:
103	103	(1) the number of persons in this state who do not have
104	104	health benefits coverage;
105	105	(2) state health care costs, including costs relating
106	106	to programs funded with money appropriated out of the general
107	107	revenue fund;
108	108	(3) local health care costs; and
109	109	(4) charity care and uncompensated care costs for
110	110	hospitals.
111	111	SECTION 2. Section 32.352, Human Resources Code, as added
112	112	by this Act, applies only to an initial determination or
113	113	recertification of eligibility of a person for medical assistance
114	114	under Chapter 32, Human Resources Code, made on or after January 1,
115	115	2016, regardless of the date the person applied for that
116	116	assistance.
117	117	SECTION 3. As soon as possible after the effective date of
118	118	this Act, the executive commissioner of the Health and Human
119	119	Services Commission shall take all necessary actions to expand
120	120	eligibility for medical assistance under Chapter 32, Human
121	121	Resources Code, beginning January 1, 2016, and in accordance with
122	122	Section 32.352, Human Resources Code, as added by this Act,
123	123	including:
124	124	(1) notifying appropriate federal agencies of that
125	125	expanded eligibility; and
126	126	(2) establishing work groups or consulting with
127	127	stakeholder groups.
128	128	SECTION 4. If before implementing any provision of this Act
129	129	a state agency determines that a waiver or authorization from a
130	130	federal agency is necessary for implementation of that provision,
131	131	the agency affected by the provision shall request the waiver or
132	132	authorization and may delay implementing that provision until the
133	133	waiver or authorization is granted.
134	134	SECTION 5. This Act takes effect immediately if it receives
135	135	a vote of two-thirds of all the members elected to each house, as
136	136	provided by Section 39, Article III, Texas Constitution. If this
137	137	Act does not receive the vote necessary for immediate effect, this
138	138	Act takes effect September 1, 2015.