Texas 2017 - 85th Regular

Texas House Bill HB1871 Compare Versions

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

Old	New	Differences
1	1	85R2309 KFF-F
2	2	By: Tinderholt H.B. No. 1871
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to a person's eligibility for Medicaid.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. Section 32.026, Human Resources Code, is amended
10	10	by adding Subsection (a-1) to read as follows:
11	11	(a-1) Rules adopted under Subsection (a) must require that:
12	12	(1) a person applying for medical assistance or having
13	13	the person's eligibility for medical assistance recertified
14	14	provide the commission with proof of:
15	15	(A) at least one month's income from all sources
16	16	received; and
17	17	(B) residency in this state;
18	18	(2) the commission provide a recipient notice of the
19	19	requirements for continued eligibility at least 60 days before the
20	20	date the recipient's eligibility for medical assistance will expire
21	21	with a warning that if the recipient fails to fulfill the
22	22	requirements, the recipient's eligibility for medical assistance
23	23	will cease on the last day of the eligibility period;
24	24	(3) a recipient's eligibility may be reinstated
25	25	without requiring a new application if the recipient fulfills the
26	26	requirements for continued eligibility before the last day of the
27	27	month following the last day of the eligibility period; and
28	28	(4) a recipient whose medical assistance has expired
29	29	may reapply for medical assistance at any time.
30	30	SECTION 2. Subchapter B, Chapter 32, Human Resources Code,
31	31	is amended by adding Section 32.02615 to read as follows:
32	32	Sec. 32.02615. ELIGIBILITY VERIFICATION VENDOR. (a) The
33	33	executive commissioner shall contract with a private vendor to,
34	34	using random sampling procedures, conduct an annual audit of
35	35	recipients enrolled in the medical assistance program to verify
36	36	that recipients are eligible for assistance under the program. In
37	37	conducting an audit under this section, the private vendor shall:
38	38	(1) perform data matches using the name, date of
39	39	birth, address, and social security number of each recipient
40	40	against public records to verify recipient eligibility; and
41	41	(2) make and submit to the commission a preliminary
42	42	determination regarding whether a recipient is eligible or is not
43	43	eligible for benefits under the medical assistance program.
44	44	(b) Not later than the 20th day after the date the
45	45	commission receives a preliminary determination under Subsection
46	46	(a)(2), the commission shall accept or reject the private vendor's
47	47	determination and provide the private vendor with notice of the
48	48	commission's decision respecting the private vendor's
49	49	determination together with the commission's stated reason for any
50	50	rejection of the private vendor's determination.
51	51	(c) The private vendor shall keep a record of all
52	52	preliminary determinations of ineligibility for medical assistance
53	53	communicated to the commission under this section.
54	54	(d) Not later than the 30th day following the end of each
55	55	calendar quarter, the commission and the private vendor shall
56	56	submit a joint report on audits conducted and actions taken during
57	57	the preceding calendar quarter under this section to the governor,
58	58	lieutenant governor, and speaker of the house of representatives.
59	59	The report must include:
60	60	(1) the number of preliminary determinations of
61	61	eligibility or ineligibility submitted to the commission by the
62	62	private vendor under Subsection (a)(2), reported on a monthly
63	63	basis; and
64	64	(2) the commission's actions taken with respect to the
65	65	determinations made by the private vendor and the commission's
66	66	stated reasons for rejecting any determination of ineligibility
67	67	made by the private vendor.
68	68	(e) Information shared with a private vendor under this
69	69	section is confidential. The private vendor may use the
70	70	information only for the purposes authorized under this section.
71	71	The contract between the commission and the private vendor may
72	72	include penalties for the unauthorized use of the information.
73	73	(f) The executive commissioner shall adopt rules necessary
74	74	to implement this section, including rules:
75	75	(1) establishing minimum qualifications for a private
76	76	vendor selected to perform audits under this section; and
77	77	(2) exempting appropriate categories of recipients
78	78	from audit which may include recipients whose eligibility for
79	79	medical assistance benefits was verified within the three-month
80	80	period preceding an audit.
81	81	(g) This section does not affect the commission's authority
82	82	to finally determine a recipient's eligibility for benefits under
83	83	the medical assistance program.
84	84	SECTION 3. As soon as practicable after the effective date
85	85	of this Act but not later than December 31, 2017, the executive
86	86	commissioner of the Health and Human Services Commission shall
87	87	adopt the rules required by Section 32.026, Human Resources Code,
88	88	as amended by this Act.
89	89	SECTION 4. Section 32.026, Human Resources Code, as amended
90	90	by this Act, applies to an initial determination or redetermination
91	91	of eligibility of a person for medical assistance under Chapter 32,
92	92	Human Resources Code, that is made on or after January 1, 2018.
93	93	SECTION 5. The initial contract entered into under Section
94	94	32.02615, Human Resources Code, as added by this Act, may not exceed
95	95	a term of two years and may only be renewed or extended for two
96	96	successive one-year periods.
97	97	SECTION 6. If before implementing any provision of this Act
98	98	a state agency determines that a waiver or authorization from a
99	99	federal agency is necessary for implementation of that provision,
100	100	the agency affected by the provision shall request the waiver or
101	101	authorization and may delay implementing that provision until the
102	102	waiver or authorization is granted.
103	103	SECTION 7. This Act takes effect September 1, 2017.