By: Bonnen of Galveston H.B. No. 3634
A BILL TO BE ENTITLED
AN ACT
relating to the amendment of the Texas Health Care Transformation
and Quality Improvement Program waiver.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Chapter 531, Government Code, is amended by
adding Subchapter N-1 to read as follows:
SUBCHAPTER N-1. TEXAS HEALTH CARE TRANSFORMATION AND QUALITY
IMPROVEMENT PROGRAM WAIVER
Sec. 531.521. AMENDMENT OF TEXAS HEALTH CARE TRANSFORMATION
AND QUALITY IMPROVEMENT PROGRAM WAIVER. Notwithstanding any other
law, the commission shall seek to amend the Texas Health Care
Transformation and Quality Improvement Program waiver issued under
Section 1115 of the federal Social Security Act (42 U.S.C. Section
1315) to:
(1) reinstate the eligibility criteria for Medicaid
that existed on December 31, 2013, including by reinstating income
limits and asset test requirements that existed on that date,
eliminating income disregards that have been implemented since that
date, and discontinuing the use of the modified adjusted gross
income (MAGI) income eligibility methodology;
(2) ensure that the eligibility certification period
for Medicaid is six months;
(3) prohibit recipients enrolled in a Medicaid managed
care plan from enrolling in a different Medicaid managed care plan
at any time during the 6-month period after the date of enrollment
in the plan without cause, to the extent not prohibited by federal
law;
(4) reinstate the eligibility criteria for the child
health plan program that existed immediately before the effective
date of Chapter 1353 (H.B. 109), Acts of the 80th Legislature,
Regular Session, 2007, including by reinstating asset test
requirements that existed immediately before that date,
eliminating income disregards that have been implemented since that
date, and discontinuing the use of the modified adjusted gross
income (MAGI) income eligibility methodology;
(5) ensure that the eligibility certification period
for the child health plan program is six months;
(6) require Medicaid recipients and child health plan
program enrollees to participate in a health insurance premium
payment reimbursement program if the employer-sponsored coverage
available to the recipient or enrollee meets benchmarks established
by the commission;
(7) authorize the commission to establish a system in
which employers may pay all or part of the share of a premium
required to be paid by a recipient or enrollee described by
Subdivision (6);
(8) require Medicaid recipients to pay copayments for
services provided under Medicaid to the same extent copayments
for
the same or similar services are required under the child health
plan program;
(9) authorize the imposition of fees on Medicaid
recipients and child health plan program enrollees for missed
health care appointments that are more comparable to those imposed
in the private market;
(10) require adult Medicaid recipients to sign a
personal responsibility agreement similar to the agreement
required for adult recipients of financial assistance benefits
under Section 31.0031, Human Resources Code;
(11) ensure that the commission has broad authority to
evaluate new and innovative payment and service delivery models for
Medicaid by implementing pilot programs to test those models,
including pilot programs to evaluate the direct primary care
payment model, bundled payment models, and the delivery of services
through accountable care organizations, without the need to seek
additional waivers or authorizations for implementation of those
pilot programs; and
(12) operate Medicaid under a block grant funding
system based on population and cost growth trends.
SECTION 2. Chapter 537, Government Code, is repealed.
SECTION 3. Not later than October 1, 2017, the Health and
Human Services Commission shall apply to the federal Centers for
Medicare and Medicaid Services to amend the Texas Health Care
Transformation and Quality Improvement Program waiver issued under
Section 1115 of the federal Social Security Act (42 U.S.C. Section
1315), as required by Subchapter N-1, Government Code, as added by
this Act.
SECTION 4. This Act takes effect September 1, 2017.