88R11332 BDP-F
By: Blanco S.B. No. 1695
A BILL TO BE ENTITLED
AN ACT
relating to the establishment of the case assistance affiliate
program to provide certain assistance to Medicaid recipients and
child health plan program enrollees.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Chapter 531, Government Code, is amended by
adding Subchapter T to read as follows:
SUBCHAPTER T. CASE ASSISTANCE AFFILIATE PROGRAM
Sec. 531.801. DEFINITIONS. In this subchapter:
(1) "Case assistance affiliate" means a managed care
organization or dental maintenance organization that participates
in the program by assisting Medicaid recipients and child health
plan program enrollees by providing application and renewal
assistance and benefit case management services.
(2) "Case assistant" means an employee of a case
assistance affiliate who directly provides application and renewal
assistance and benefit case management services to a recipient or
enrollee.
(3) "Enrollee" means an individual enrolled in the
child health plan program.
(4) "Program" means the case assistance affiliate
program established under this subchapter.
(5) "Program manager" means the employee of a case
assistance affiliate who is designated by the affiliate to oversee:
(A) case assistants; and
(B) the application and renewal assistance
activities and benefit case management services provided by the
affiliate under the program.
(6) "Recipient" means a Medicaid recipient.
(7) "Virtual case assistance website" means an
Internet website described by Section 531.803.
Sec. 531.802. ESTABLISHMENT OF CASE ASSISTANCE AFFILIATE
PROGRAM. (a) The commission shall:
(1) establish a statewide case assistance affiliate
program under which managed care organizations and dental
maintenance organizations that participate in Medicaid or the child
health plan program are allowed to operate as case assistance
affiliates by maintaining virtual case assistance websites; and
(2) provide a training and certification process for
program managers and case assistants providing services under the
program.
(b) In establishing the program, the commission:
(1) shall consult with:
(A) experts, as determined by the commission; and
(B) other interested persons, including managed
care organizations and dental maintenance organizations
participating in Medicaid or the child health plan program; and
(2) may establish a work group or advisory committee
that includes interested persons to advise the commission on the
establishment of the program.
Sec. 531.803. VIRTUAL CASE ASSISTANCE WEBSITES. (a) A case
assistance affiliate shall establish and maintain Internet
websites for purposes of providing virtual application and renewal
assistance and benefit case management services to the recipients
and enrollees served by those organizations.
(b) In providing benefit case management services, a case
assistance affiliate may use its virtual case assistance website to
assist a recipient or enrollee with applying for and managing the
recipient's or enrollee's benefits under other public assistance
programs, including nutritional and financial assistance benefits.
(c) The commission shall ensure that a virtual case
assistance website allows a recipient or enrollee to access the
website from any electronic device that provides Internet access.
Sec. 531.804. ADMINISTRATIVE EXPENSE. The commission shall
allow a case assistance affiliate to categorize the services the
affiliate provides under the program as administrative expenses.
Sec. 531.805. RULES: PROGRAM REQUIREMENTS AND STANDARDS.
The executive commissioner shall adopt rules necessary to implement
the program, including rules:
(1) establishing requirements for a managed care
organization or dental maintenance organization to participate in
the program;
(2) establishing the training and certification
process required by Section 531.802(a)(2);
(3) providing for the suspension, revocation, and, as
appropriate, periodic renewal of a case assistant's or program
manager's certification;
(4) protecting the confidentiality of recipients' and
enrollees' information; and
(5) establishing any other standards or requirements
the executive commissioner determines necessary.
SECTION 2. 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 3. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2023.