Texas 2019 - 86th Regular

Texas House Bill HB2474 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	By: Guillen, Raymond, Klick H.B. No. 2474
	1	+	86R21406 KFF-F
	2	+	By: Guillen H.B. No. 2474
	3	+	Substitute the following for H.B. No. 2474:
	4	+	By: Hinojosa C.S.H.B. No. 2474
2	5
3	6
4	7		A BILL TO BE ENTITLED
5	8		AN ACT
6	9		relating to the continuation of medical assistance for certain
7	10		individuals.
8	11		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	12		SECTION 1. Section 32.0256, Human Resources Code, is
10	13		amended to read as follows:
11	14		Sec. 32.0256. CONTINUATION OF MEDICAL ASSISTANCE FOR
12	15		CERTAIN INDIVIDUALS; ANNUAL REPORT. (a) A recipient [described by
13	16		Section 32.025(a)] who experiences an event or circumstance,
14	17		including a temporary increase in income of a duration of one month
15	18		or less or a minor technical or clerical error committed on or with
16	19		respect to the recipient's renewal application or other document
17	20		required for benefits renewal, that would normally result in the
18	21		recipient being determined ineligible for medical assistance
19	22		continues to be eligible for that assistance if the individual:
20	23		(1) either:
21	24		(A) receives services through one of the
22	25		following programs that serve [a program for] individuals with an
23	26		intellectual or developmental disability [authorized] under
24	27		Section 1915(c), Social Security Act (42 U.S.C. Section 1396n(c)):
25	28		(i) the home and community-based services
26	29		(HCS) waiver program; or
27	30		(ii) the Texas home living (TxHmL) waiver
28	31		program; or
29	32		(B) resides in an ICF-IID facility; and
30	33		(2) continues to meet the functional and diagnostic
31	34		criteria for the receipt of services under a program described by
32	35		Subdivision (1)(A) or for residency in an ICF-IID facility.
33	36		(b) To continue to be eligible for medical assistance, a
34	37		recipient described by Subsection (a) who is determined ineligible
35	38		for medical assistance because of an event or circumstance caused
36	39		wholly by the action or inaction of the recipient or the recipient's
37	40		parent or guardian must submit an application for medical
38	41		assistance in accordance with Section 32.025(b) not later than the
39	42		90th day after the date on which the recipient is determined
40	43		ineligible.
41	44		(c) The commission may not suspend or terminate the
42	45		eligibility of a recipient for medical assistance benefits if the
43	46		recipient's ineligibility is caused partly or wholly by a technical
44	47		or clerical error committed by the commission or an agent of the
45	48		commission.
46	49		(d) The commission shall:
47	50		(1) coordinate with and inform relevant health care
48	51		providers if a recipient described by Subsection (a) is at risk of
49	52		being determined ineligible for medical assistance benefits or is
50	53		determined ineligible for those benefits; and
51	54		(2) make reasonable efforts to ensure the medical
52	55		assistance benefits of a recipient described by Subsection (a) are
53	56		not suspended or terminated.
54	57		(e) Not later than December 31 of each year, the commission
55	58		shall prepare and submit a report to the legislature regarding the
56	59		suspension or termination of medical assistance benefits of
57	60		recipients described by Subsection (a) that occurred during the
58	61		preceding state fiscal year. The report must include:
59	62		(1) the number of recipients who are living in a
60	63		community-based, residential setting whose eligibility for
61	64		benefits was suspended or terminated during each month of the
62	65		fiscal year;
63	66		(2) if the commission reinstated the benefits of a
64	67		recipient, the average, median, shortest, and longest length of
65	68		time the commission took to reinstate those benefits;
66	69		(3) the number of recipients whose benefits were not
67	70		reinstated by the commission;
68	71		(4) the specific reason for the suspension or
69	72		termination of benefits of a recipient, including an analysis of
70	73		the percentage of suspensions or terminations related to:
71	74		(A) an increase in the recipient's income;
72	75		(B) a failure by the recipient or the recipient's
73	76		parent or guardian to properly submit a renewal application or
74	77		other document required for benefits renewal;
75	78		(C) a change in the recipient's condition that
76	79		results in the recipient no longer meeting the functional or
77	80		diagnostic criteria necessary to establish the recipient's
78	81		eligibility for services under a program described by Subsection
79	82		(a)(1)(A) or for residency in an ICF-IID facility;
80	83		(D) a technical or clerical error committed by
81	84		the commission or an agent of the commission; and
82	85		(E) any other reason that occurs with enough
83	86		frequency to warrant its inclusion in the analysis, as determined
84	87		by the commission; and
85	88		(5) a statement of the amount of retroactive
86	89		reimbursements paid to health care providers for the provision of
87	90		services to a recipient during the time the recipient's eligibility
88	91		for benefits was suspended or terminated.
89	92		SECTION 2. Section 3, Chapter 1072 (H.B. 3292), Acts of the
90	93		85th Legislature, Regular Session, 2017, is repealed.
91	94		SECTION 3. Notwithstanding Section 32.0256(e), Human
92	95		Resources Code, as added by this Act, the Health and Human Services
93	96		Commission shall ensure that the initial report required under that
94	97		subsection includes a description of the number of recipients
95	98		described by Section 32.0256(a), Human Resources Code, as amended
96	99		by this Act, who are living in a community-based, residential
97	100		setting and whose eligibility for benefits was suspended or
98	101		terminated during each month of the state fiscal years ending
99	102		August 31, 2016, August 31, 2017, and August 31, 2018.
100		-	SECTION 4. (a) As soon as practicable after the effective
101		-	date of this Act, the Health and Human Services Commission shall
102		-	conduct a review of the commission's policies and processes
103		-	relating to the renewal of Medicaid benefits for the following
104		-	Medicaid recipients:
105		-	(1) persons receiving services through one of the
106		-	following Medicaid programs authorized under Section 1915(c) of the
107		-	federal Social Security Act (42 U.S.C. Section 1396n(c)) that
108		-	provide services to persons with an intellectual or developmental
109		-	disability:
110		-	(A) the home and community-based services (HCS)
111		-	waiver program; or
112		-	(B) the Texas home living (TxHmL) waiver program;
113		-	and
114		-	(2) persons residing in an ICF-IID facility.
115		-	(b) In conducting the review under this section, the Health
116		-	and Human Services Commission shall:
117		-	(1) analyze existing data relating to:
118		-	(A) the number of Medicaid recipients who lost
119		-	eligibility for Medicaid benefits during each month of the state
120		-	fiscal years ending August 31, 2016, August 31, 2017, and August 31,
121		-	2018; and
122		-	(B) the reasons for those recipients' loss of
123		-	eligibility, including because of minor technical or clerical
124		-	errors made on or with respect to a renewal application or other
125		-	document required to renew eligibility for the benefits;
126		-	(2) evaluate the impact recipients' temporary loss of
127		-	benefits has on the recipients and health care providers; and
128		-	(3) identify best practices for the commission,
129		-	recipients and their legally authorized representatives, and
130		-	health care providers to minimize recipients' loss of eligibility
131		-	for the benefits because of:
132		-	(A) minor technical or clerical errors made on or
133		-	with respect to a renewal application or other document required to
134		-	renew eligibility for the benefits; or
135		-	(B) the recipient's failure to provide
136		-	information necessary to renew eligibility for the benefits.
137		-	(c) Based on the findings of the review conducted under this
138		-	section, the Health and Human Services Commission shall, in
139		-	consultation with relevant stakeholders, develop a plan to
140		-	implement best practices and address barriers to timely renewal of
141		-	eligibility for Medicaid benefits and continuation of services for
142		-	Medicaid recipients described by Subsection (a) of this section.
143		-	The plan must specifically identify best practices for avoiding
144		-	loss of eligibility for Medicaid benefits by those recipients
145		-	because of minor technical or clerical errors made on or with
146		-	respect to a renewal application or other document required to
147		-	renew eligibility for the benefits.
148		-	(d) Not later than November 1, 2020, the Health and Human
149		-	Services Commission shall submit to the legislature the plan
150		-	developed under Subsection (c) of this section. The plan must
151		-	include:
152		-	(1) a summary of issues identified by the commission's
153		-	review of policies and processes under this section;
154		-	(2) a timeline for the commission's implementation of
155		-	the best practices identified for implementation in the review; and
156		-	(3) recommendations for potential legislation if the
157		-	commission determines that changes in statute are required to
158		-	address issues identified in the review.
159		-	(e) This section expires September 1, 2021.
160		-	SECTION 5. If before implementing any provision of this Act
	103	+	SECTION 4. If before implementing any provision of this Act
161	104		a state agency determines that a waiver or authorization from a
162	105		federal agency is necessary for implementation of that provision,
163	106		the agency affected by the provision shall request the waiver or
164	107		authorization and may delay implementing that provision until the
165	108		waiver or authorization is granted.
166		-	SECTION 6. This Act takes effect immediately if it receives
	109	+	SECTION 5. This Act takes effect immediately if it receives
167	110		a vote of two-thirds of all the members elected to each house, as
168	111		provided by Section 39, Article III, Texas Constitution. If this
169	112		Act does not receive the vote necessary for immediate effect, this
170	113		Act takes effect September 1, 2019.