88R7613 JG-D
By: Johnson S.B. No. 1496
A BILL TO BE ENTITLED
AN ACT
relating to authorizing certain health benefit exchanges to make
eligibility determinations under Medicaid and the child health plan
program.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 62.1011, Health and Safety Code, is
amended to read as follows:
Sec. 62.1011. VERIFICATION OF INCOME. (a) Except as
provided by Subsection (b), the [The] commission shall continue
employing methods of verifying the individual incomes of the
individuals considered in the calculation of an applicant's
household income. The commission shall verify income under this
section unless the applicant reports a household income that
exceeds the income eligibility level established under Section
62.101(b).
(b) The commission may not verify the income of a child
determined eligible for coverage under the child health plan by a
health benefit exchange in accordance with Section 62.1012.
SECTION 2. Subchapter C, Chapter 62, Health and Safety
Code, is amended by adding Section 62.1012 to read as follows:
Sec. 62.1012. DETERMINATION OF ELIGIBILITY BY HEALTH
BENEFIT EXCHANGE; ENROLLMENT. (a) In this section, "health
benefit exchange" means an American Health Benefit Exchange
administered by the federal government or an exchange created under
Section 1311(b) of the Patient Protection and Affordable Care Act
(42 U.S.C. Section 18031(b)).
(b) Notwithstanding any other law and in accordance with an
agreement entered into under 42 C.F.R. Section 457.348, the
commission shall accept eligibility determinations for coverage
under the child health plan made by a health benefit exchange.
(c) The commission shall automatically enroll in the child
health plan program a child who is determined eligible for coverage
by a health benefit exchange. This subsection does not require the
commission to enroll a child in the child health plan program whose
eligibility for the program was not fully verified by the exchange.
The commission shall take any further action necessary to verify
and resolve an incomplete eligibility determination referred to the
commission by the exchange.
(d) In entering into an agreement with a health benefit
exchange under 42 C.F.R. Section 457.348, the commission shall
ensure that the exchange makes determinations of eligibility for
the child health plan based on eligibility criteria in accordance
with applicable state law.
(e) The commission shall seek any federal money available
for implementing this section, including enhanced federal
financial participation made available under federal law.
SECTION 3. Section 32.026(g), Human Resources Code, is
amended to read as follows:
(g) Notwithstanding any other provision of this code, the
commission may use information obtained from a third party to
verify the assets and resources of a person for purposes of
determining the person's eligibility and need for medical
assistance to the extent that verification is applicable under
federal law. Third-party information includes information
obtained from:
(1) a consumer reporting agency, as defined by Section
20.01, Business & Commerce Code;
(2) an appraisal district; [or]
(3) the Texas Department of Motor Vehicles vehicle
registration record database; or
(4) a health benefit exchange, as defined by Section
32.026102.
SECTION 4. Subchapter B, Chapter 32, Human Resources Code,
is amended by adding Section 32.026102 to read as follows:
Sec. 32.026102. DETERMINATION OF ELIGIBILITY BY HEALTH
BENEFIT EXCHANGE; ENROLLMENT. (a) In this section, "health
benefit exchange" means an American Health Benefit Exchange
administered by the federal government or an exchange created under
Section 1311(b) of the Patient Protection and Affordable Care Act
(42 U.S.C. Section 18031(b)).
(b) Notwithstanding any other law and in accordance with an
agreement entered into under 42 C.F.R. Section 431.10, the
commission shall accept eligibility determinations for medical
assistance made by a health benefit exchange.
(c) The commission shall automatically enroll in the
medical assistance program an individual whose eligibility for
medical assistance benefits is determined by a health benefit
exchange. This subsection does not require the commission to
enroll an individual in the medical assistance program whose
eligibility for the program was not fully verified by the exchange.
The commission shall take any further action that is necessary to
verify and resolve an incomplete eligibility determination
referred to the commission by the exchange.
(d) In entering into an agreement with a health benefit
exchange under 42 C.F.R. Section 431.10, the commission shall
ensure that the exchange makes determinations of eligibility for
the medical assistance program based on eligibility criteria in
accordance with applicable state law.
(e) The commission shall seek any federal money available
for implementing this section, including enhanced federal
financial participation made available under 42 C.F.R. Part 433,
Subpart C.
SECTION 5. Section 32.026101, Human Resources Code, is
repealed.
SECTION 6. If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
SECTION 7. This Act takes effect September 1, 2023.