Texas 2019 - 86th Regular

Texas House Bill HB1016 Compare Versions

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

Old	New	Differences
1	1	86R3390 LED-D
2	2	By: Martinez H.B. No. 1016
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to eligibility determinations for the STAR+PLUS home and
8	8	community based services (HCBS) program.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subchapter A, Chapter 533, Government Code, is
11	11	amended by adding Section 533.00282 to read as follows:
12	12	Sec. 533.00282. ELIGIBILITY DETERMINATIONS FOR STAR+PLUS
13	13	HOME AND COMMUNITY BASED SERVICES (HCBS) PROGRAM. (a) The
14	14	commission shall determine Medicaid eligibility for an applicant
15	15	for the STAR+PLUS home and community based services (HCBS) program
16	16	not later than:
17	17	(1) the 20th day after the date the applicant submits
18	18	the application; or
19	19	(2) the 45th day after the date the applicant submits
20	20	the application, if the applicant is applying on the basis of a
21	21	disability.
22	22	(b) A managed care organization with which the commission
23	23	contracts to provide health care services to recipients shall, not
24	24	later than the 30th day after the date an applicant for the
25	25	STAR+PLUS home and community based services (HCBS) program submits
26	26	the application, complete and submit to the entity serving as this
27	27	state's Medicaid claims administrator the applicant's:
28	28	(1) individual service plan; and
29	29	(2) medical necessity and level of care assessment.
30	30	SECTION 2. Section 533.00282(a), Government Code, as added
31	31	by this Act, applies only to an application for a determination of
32	32	Medicaid eligibility submitted on or after the effective date of
33	33	this Act. An application for a determination of Medicaid
34	34	eligibility submitted before the effective date of this Act is
35	35	governed by the law in effect immediately before the effective date
36	36	of this Act, and that law is continued in effect for that purpose.
37	37	SECTION 3. (a) The Health and Human Services Commission
38	38	shall, in a contract between the commission and a managed care
39	39	organization under Chapter 533, Government Code, that is entered
40	40	into or renewed on or after the effective date of this Act, require
41	41	that the managed care organization comply with Section
42	42	533.00282(b), Government Code, as added by this Act.
43	43	(b) The Health and Human Services Commission shall seek to
44	44	amend contracts entered into with managed care organizations under
45	45	Chapter 533, Government Code, before the effective date of this Act
46	46	to require those managed care organizations to comply with Section
47	47	533.00282(b), Government Code, as added by this Act. To the extent
48	48	of a conflict between Section 533.00282(b), Government Code, as
49	49	added by this Act, and a provision of a contract with a managed care
50	50	organization entered into before the effective date of this Act,
51	51	the contract provision prevails.
52	52	SECTION 4. If before implementing any provision of this Act
53	53	a state agency determines that a waiver or authorization from a
54	54	federal agency is necessary for implementation of that provision,
55	55	the agency affected by the provision shall request the waiver or
56	56	authorization and may delay implementing that provision until the
57	57	waiver or authorization is granted.
58	58	SECTION 5. This Act takes effect September 1, 2019.