Texas 2021 - 87th Regular

Texas Senate Bill SB217 Compare Versions

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

Old	New	Differences
1	1	87R1295 MM-F
2	2	By: West S.B. No. 217
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to expanding eligibility for medical assistance to certain
8	8	persons under the federal Patient Protection and Affordable Care
9	9	Act and ensuring the provision of quality care under and the
10	10	effectiveness of the medical assistance program.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Chapter 32, Human Resources Code, is amended by
13	13	adding Subchapter H to read as follows:
14	14	SUBCHAPTER H. EXPANSION OF ELIGIBILITY FOR MEDICAL ASSISTANCE
15	15	Sec. 32.351. DEFINITIONS. In this subchapter:
16	16	(1) "Medical assistance expansion group" means the
17	17	category of persons who would not be eligible for medical
18	18	assistance under the eligibility criteria in effect on December 31,
19	19	2021, but who are eligible for that assistance because of the
20	20	requirement of Section 32.352(a).
21	21	(2) "Undocumented immigrant" means a person who:
22	22	(A) is not a citizen or other national of the
23	23	United States; and
24	24	(B) is not lawfully authorized to be present in
25	25	the United States under the Immigration and Nationality Act (8
26	26	U.S.C. Section 1101 et seq.) or other federal law.
27	27	Sec. 32.352. EXPANDED ELIGIBILITY FOR MEDICAL ASSISTANCE
28	28	UNDER PATIENT PROTECTION AND AFFORDABLE CARE ACT. (a)
29	29	Notwithstanding any other law and except as provided in Subsection
30	30	(b) and Section 32.353, to the extent money is appropriated to the
31	31	commission for that purpose, beginning January 1, 2022, the
32	32	commission shall provide medical assistance to all persons who
33	33	apply for that assistance and for whom federal matching money is
34	34	available under the Patient Protection and Affordable Care Act
35	35	(Pub. L. No. 111-148) as amended by the Health Care and Education
36	36	Reconciliation Act of 2010 (Pub. L. No. 111-152) to provide that
37	37	assistance.
38	38	(b) Nothing in this section authorizes the commission to
39	39	provide medical assistance to undocumented immigrants.
40	40	(c) The executive commissioner shall adopt rules regarding
41	41	the provision of medical assistance as required by this section.
42	42	Sec. 32.353. RESTRICTED ELIGIBILITY FOR MEDICAL ASSISTANCE
43	43	ON CHANGES IN FEDERAL MATCHING MONEY. (a) Notwithstanding any
44	44	other law, if the federal medical assistance percentage (FMAP) by
45	45	which this state's expenditures under the medical assistance
46	46	program are matched with federal money, and that applies with
47	47	respect to persons in the medical assistance expansion group, is
48	48	less than the percentage provided for in the Patient Protection and
49	49	Affordable Care Act (Pub. L. No. 111-148) as amended by the Health
50	50	Care and Education Reconciliation Act of 2010 (Pub. L. No.
51	51	111-152), excluding subsequent amendments:
52	52	(1) the commission shall alert the Legislative Budget
53	53	Board; and
54	54	(2) beginning on the first day of the month following
55	55	the month in which the new federal medical assistance percentage
56	56	(FMAP) becomes effective, the commission shall:
57	57	(A) cease providing medical assistance to
58	58	persons in the medical assistance expansion group; and
59	59	(B) reinstate the eligibility criteria for
60	60	medical assistance that existed on December 31, 2021.
61	61	(b) The executive commissioner shall adopt any rules
62	62	necessary to implement any changes in the provision of and
63	63	eligibility criteria for medical assistance required by this
64	64	section.
65	65	Sec. 32.354. FEDERAL AUTHORIZATION FOR IMPLEMENTATION OF
66	66	COST-SHARING OBLIGATIONS FOR MEDICAL ASSISTANCE EXPANSION GROUP.
67	67	The executive commissioner shall seek a waiver or other appropriate
68	68	authorization from the appropriate federal agency to develop and
69	69	implement cost-sharing obligations for the medical assistance
70	70	expansion group. Cost-sharing obligations developed by the
71	71	commission under this section:
72	72	(1) must be designed to:
73	73	(A) incentivize persons in the medical
74	74	assistance expansion group to seek preventive or routine health
75	75	care services, rather than emergency health care services, when
76	76	possible and appropriate; and
77	77	(B) guarantee quality health care for persons in
78	78	the medical assistance expansion group;
79	79	(2) may include:
80	80	(A) copayments and deductibles; and
81	81	(B) modifications to the reimbursement
82	82	methodologies for services provided to persons in the medical
83	83	assistance expansion group; and
84	84	(3) may incorporate any other incentives or strategies
85	85	that the commission determines are necessary, including:
86	86	(A) expanded use of managed care;
87	87	(B) increased reliance on private individual or
88	88	employer-based health benefits coverage;
89	89	(C) incentives and rewards for participation in
90	90	evidence-based wellness activities; and
91	91	(D) targeted benefits for chronic illnesses.
92	92	Sec. 32.355. ANNUAL REPORT ON EXPANDED ELIGIBILITY FOR
93	93	MEDICAL ASSISTANCE. Not later than December 1 of each year, the
94	94	commission shall report to the governor, the lieutenant governor,
95	95	the speaker of the house of representatives, and the standing
96	96	committees of the senate and the house of representatives having
97	97	primary jurisdiction over the medical assistance program on the
98	98	effects of expanding eligibility for medical assistance under
99	99	Section 32.352, including the effects on:
100	100	(1) the number of persons in this state who do not have
101	101	health benefits coverage;
102	102	(2) state health care costs, including costs relating
103	103	to programs funded with money appropriated out of the general
104	104	revenue fund;
105	105	(3) local health care costs; and
106	106	(4) charity care and uncompensated care costs for
107	107	hospitals.
108	108	SECTION 2. Section 32.352, Human Resources Code, as added
109	109	by this Act, applies only to an initial determination or
110	110	recertification of eligibility of a person for medical assistance
111	111	under Chapter 32, Human Resources Code, made on or after January 1,
112	112	2022, regardless of the date the person applied for that
113	113	assistance.
114	114	SECTION 3. As soon as possible after the effective date of
115	115	this Act, the executive commissioner of the Health and Human
116	116	Services Commission shall take all necessary actions to expand
117	117	eligibility for medical assistance under Chapter 32, Human
118	118	Resources Code, beginning January 1, 2022, and in accordance with
119	119	Section 32.352, Human Resources Code, as added by this Act,
120	120	including:
121	121	(1) notifying appropriate federal agencies of that
122	122	expanded eligibility; and
123	123	(2) establishing work groups or consulting with
124	124	stakeholder groups.
125	125	SECTION 4. If before implementing any provision of this Act
126	126	a state agency determines that a waiver or authorization from a
127	127	federal agency is necessary for implementation of that provision,
128	128	the agency affected by the provision shall request the waiver or
129	129	authorization and may delay implementing that provision until the
130	130	waiver or authorization is granted.
131	131	SECTION 5. This Act takes effect immediately if it receives
132	132	a vote of two-thirds of all the members elected to each house, as
133	133	provided by Section 39, Article III, Texas Constitution. If this
134	134	Act does not receive the vote necessary for immediate effect, this
135	135	Act takes effect September 1, 2021.