| 1 | 1 | | 87R1123 KFF-F |
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| 2 | 2 | | By: Bernal H.B. No. 165 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to a supporting medically fragile children program for the |
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| 8 | 8 | | provision of certain necessary health care services to those |
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| 9 | 9 | | children. |
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| 10 | 10 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 11 | 11 | | SECTION 1. Chapter 32, Human Resources Code, is amended by |
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| 12 | 12 | | adding Subchapter G to read as follows: |
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| 13 | 13 | | SUBCHAPTER G. SUPPORTING MEDICALLY FRAGILE CHILDREN PROGRAM |
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| 14 | 14 | | Sec. 32.301. DEFINITIONS. In this subchapter: |
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| 15 | 15 | | (1) "Program" means the supporting medically fragile |
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| 16 | 16 | | children program established under this subchapter. |
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| 17 | 17 | | (2) "Section 1915(c) waiver program" has the meaning |
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| 18 | 18 | | assigned by Section 531.001, Government Code. |
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| 19 | 19 | | (3) "STAR Kids managed care program" means the STAR |
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| 20 | 20 | | Kids managed care program operated under Section 533.00253, |
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| 21 | 21 | | Government Code. |
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| 22 | 22 | | Sec. 32.302. SUPPORTING MEDICALLY FRAGILE CHILDREN |
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| 23 | 23 | | PROGRAM. (a) The commission shall develop and implement a program |
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| 24 | 24 | | to provide financial assistance to eligible Medicaid recipients who |
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| 25 | 25 | | are in need of the assistance for purposes of receiving or |
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| 26 | 26 | | continuing necessary health care services that have been delayed or |
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| 27 | 27 | | denied under Medicaid, including care that has been denied pending |
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| 28 | 28 | | appeal. Financial assistance under the program must be provided in |
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| 29 | 29 | | the form of direct reimbursements to health care providers. |
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| 30 | 30 | | (b) In establishing the program, the commission shall: |
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| 31 | 31 | | (1) consult with appropriate stakeholders to |
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| 32 | 32 | | determine: |
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| 33 | 33 | | (A) application and eligibility requirements for |
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| 34 | 34 | | receiving financial assistance under the program; and |
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| 35 | 35 | | (B) how providers will be reimbursed with |
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| 36 | 36 | | financial assistance granted through the program; and |
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| 37 | 37 | | (2) designate a person within the commission to act as |
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| 38 | 38 | | an ombudsman for the program and as a point of contact for Medicaid |
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| 39 | 39 | | recipients, recipients' families, and health care providers. |
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| 40 | 40 | | Sec. 32.303. ELIGIBLE MEDICAID RECIPIENTS. To be eligible |
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| 41 | 41 | | for assistance under the program, a Medicaid recipient must be |
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| 42 | 42 | | receiving benefits under: |
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| 43 | 43 | | (1) a Section 1915(c) waiver program, including: |
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| 44 | 44 | | (A) the Medically Dependent Children Program |
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| 45 | 45 | | (MDCP); |
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| 46 | 46 | | (B) the Community Living Assistance and Support |
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| 47 | 47 | | Services (CLASS) waiver program; |
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| 48 | 48 | | (C) the Home and Community-based Services (HCS) |
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| 49 | 49 | | waiver program; and |
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| 50 | 50 | | (D) the Deaf-Blind with Multiple Disabilities |
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| 51 | 51 | | (DBMD) waiver program; or |
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| 52 | 52 | | (2) the STAR Kids managed care program. |
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| 53 | 53 | | Sec. 32.304. SUPPORTING MEDICALLY FRAGILE CHILDREN |
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| 54 | 54 | | ACCOUNT. (a) The supporting medically fragile children account is |
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| 55 | 55 | | an account in the general revenue fund. |
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| 56 | 56 | | (b) The account consists of: |
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| 57 | 57 | | (1) appropriations of money to the account by the |
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| 58 | 58 | | legislature; |
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| 59 | 59 | | (2) gifts, grants, including federal grants, and other |
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| 60 | 60 | | donations received under Section 32.305; and |
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| 61 | 61 | | (3) interest earned on the investment of money in the |
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| 62 | 62 | | account. |
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| 63 | 63 | | (c) Money in the account may be appropriated only to the |
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| 64 | 64 | | commission for purposes of the program. |
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| 65 | 65 | | (d) The account is exempt from the application of Section |
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| 66 | 66 | | 404.071, Government Code. |
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| 67 | 67 | | Sec. 32.305. GIFTS, GRANTS, AND DONATIONS. The commission |
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| 68 | 68 | | may accept gifts, grants, and donations from any source that are |
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| 69 | 69 | | made for the purposes of the program. The commission shall deposit |
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| 70 | 70 | | money received under this section to the credit of the supporting |
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| 71 | 71 | | medically fragile children account. |
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| 72 | 72 | | Sec. 32.306. RULES. The executive commissioner shall adopt |
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| 73 | 73 | | rules necessary to implement this subchapter. |
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| 74 | 74 | | SECTION 2. If before implementing any provision of this Act |
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| 75 | 75 | | a state agency determines that a waiver or authorization from a |
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| 76 | 76 | | federal agency is necessary for implementation of that provision, |
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| 77 | 77 | | the agency affected by the provision shall request the waiver or |
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| 78 | 78 | | authorization and may delay implementing that provision until the |
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| 79 | 79 | | waiver or authorization is granted. |
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| 80 | 80 | | SECTION 3. This Act takes effect September 1, 2021. |
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