Texas 2023 - 88th Regular

Texas House Bill HB3551 Compare Versions

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1	1	88R14024 JG-F
2	2	By: Thierry H.B. No. 3551
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to presumptive eligibility of certain elderly individuals
8	8	for home and community-based services under Medicaid.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subchapter B, Chapter 32, Human Resources Code,
11	11	is amended by adding Section 32.02605 to read as follows:
12	12	Sec. 32.02605. PRESUMPTIVE ELIGIBILITY OF CERTAIN ELDERLY
13	13	INDIVIDUALS FOR HOME AND COMMUNITY-BASED SERVICES. (a) In this
14	14	section, "elderly individual" means an individual who is 65 years
15	15	of age or older.
16	16	(b) The executive commissioner by rule shall adopt a program
17	17	providing for:
18	18	(1) the determination and certification of
19	19	presumptive eligibility for medical assistance of an elderly
20	20	individual who requires a skilled level of nursing care; and
21	21	(2) the provision through the medical assistance
22	22	program to the individual of that care in a home or community-based
23	23	setting instead of in an institutional setting, provided the
24	24	individual applies for and meets the basic eligibility requirements
25	25	for medical assistance.
26	26	(c) The program established under this section must:
27	27	(1) provide medical assistance benefits under a
28	28	presumptive eligibility determination for a period of not more than
29	29	90 days;
30	30	(2) establish eligibility criteria and a process for
31	31	determining the entities authorized to make determinations of
32	32	presumptive eligibility under the program;
33	33	(3) provide a preliminary screening tool to entities
34	34	described by Subdivision (2) that will allow representatives of
35	35	those entities to:
36	36	(A) make a determination as to whether an
37	37	applicant is:
38	38	(i) functionally able to live at home or in
39	39	a community setting; and
40	40	(ii) likely to be financially eligible for
41	41	medical assistance;
42	42	(B) make the determination under Paragraph
43	43	(A)(ii) not later than the fourth day after the date a determination
44	44	is made under Paragraph (A)(i); and
45	45	(C) initiate the provision of medical assistance
46	46	benefits not later than the fifth day after the date an applicant is
47	47	determined eligible under Paragraph (A)(i); and
48	48	(4) require an applicant to sign a written agreement:
49	49	(A) attesting to the accuracy of financial and
50	50	other information the applicant provides and on which presumptive
51	51	eligibility is based; and
52	52	(B) acknowledging that:
53	53	(i) state-funded services are subject to
54	54	the period prescribed by Subdivision (1); and
55	55	(ii) the applicant is required to comply
56	56	with Subsection (d).
57	57	(d) An applicant who is determined presumptively eligible
58	58	for medical assistance under the program established by this
59	59	section must complete an application for medical assistance not
60	60	later than the 10th day after the date the applicant is screened for
61	61	functional eligibility under Subsection (c)(3)(A)(i).
62	62	(e) Not later than the 45th day after the date the
63	63	commission receives an application under Subsection (d), the
64	64	commission shall make a final determination of eligibility for
65	65	medical assistance.
66	66	(f) To the extent permitted by federal law, the commission
67	67	shall retroactively apply a final determination of eligibility for
68	68	medical assistance under Subsection (e) for a period that does not
69	69	precede the 90th day before the date the application was filed under
70	70	Subsection (d).
71	71	(g) The commission shall submit to the standing committees
72	72	of the senate and house of representatives having jurisdiction over
73	73	the medical assistance program an annual report that details:
74	74	(1) the number of individuals determined
75	75	presumptively eligible for medical assistance under the program
76	76	established under this section;
77	77	(2) the savings to the state based on how much
78	78	institutional care would have cost for individuals determined
79	79	presumptively eligible for medical assistance under the program
80	80	established under this section who were later determined eligible
81	81	for medical assistance; and
82	82	(3) the number of individuals determined
83	83	presumptively eligible for medical assistance under the program
84	84	established under this section who were later determined not
85	85	eligible for medical assistance and the cost to the state to provide
86	86	those individuals with home or community-based services before the
87	87	final determination of eligibility for medical assistance.
88	88	(h) The report required under Subsection (g) may be combined
89	89	with any other report required by this chapter or other law.
90	90	SECTION 2. If before implementing any provision of this Act
91	91	a state agency determines that a waiver or authorization from a
92	92	federal agency is necessary for implementation of that provision,
93	93	the agency affected by the provision shall request the waiver or
94	94	authorization and may delay implementing that provision until the
95	95	waiver or authorization is granted.
96	96	SECTION 3. This Act takes effect September 1, 2023.