By: Johnson S.B. No. 238
A BILL TO BE ENTITLED
AN ACT
relating to implementing an express lane option 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) and subject to Subsection (c), 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.
(b) 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).
(c) The commission may verify income using the verification
process described in 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. EXPRESS LANE OPTION ELIGIBILITY; ENROLLMENT.
(a) In this section, "supplemental nutrition assistance program"
has the meaning assigned by Section 33.0005, Human Resources Code.
(b) Notwithstanding any other law and in accordance with
Sections 1902(e)(13) and 2107(e)(1)(H) of the Social Security Act
(42 U.S.C. Sections 1396a(e)(13) and 1397gg(e)(1)(H)), the
commission shall implement an express lane option under which the
commission evaluates data received from an applicant under the
supplemental nutrition assistance program in determining a child's
eligibility for coverage under the child health plan program.
(c) In determining a child's eligibility for coverage under
the child health plan program using the express lane option
implemented under this section, the commission shall open a new
case to ensure there is no delay in providing benefits to the child
under the supplemental nutrition assistance program.
(d) On determining that a child is eligible for coverage
under the child health plan program under this section, the
commission shall enroll the child in the program in accordance with
Section 1902(e)(13)(D) of the Social Security Act (42 U.S.C.
Section 1396a(e)(13)(D)) if the commission:
(1) provides notice of the determination to the
child's parent, legal guardian, or custodial relative in the manner
indicated under Subsection (e); and
(2) obtains the affirmative consent of the child's
parent, legal guardian, or custodial relative in accordance with
Subsection (f) to enroll the child.
(e) The commission shall provide the notice required by
Subsection (d) in the manner a child's parent, legal guardian, or
custodial relative indicates as the preferred method of contact
when applying for supplemental nutrition assistance program
benefits. If a preferred method of contact is not indicated, the
commission may provide the notice:
(1) orally;
(2) by telephone;
(3) in writing, including by electronic signature; or
(4) by any other manner the commission determines
appropriate.
(f) In obtaining the affirmative consent of a child's
parent, legal guardian, or custodial relative required by
Subsection (d), the commission:
(1) shall ensure the consent is provided:
(A) within a reasonable amount of time, as
determined by the commission; and
(B) in accordance with identity verification
standards the commission establishes; and
(2) may obtain the consent:
(A) orally;
(B) by telephone;
(C) in writing, including by:
(i) electronic signature; or
(ii) fax; or
(D) during an initial eligibility or
recertification interview for the supplemental nutrition
assistance program.
SECTION 3. Section 32.026(e), Human Resources Code, is
amended to read as follows:
(e) The executive commissioner shall permit a
recertification review of the eligibility and need for medical
assistance of a child under 19 years of age to be conducted by
telephone or mail instead of through a personal appearance at an
office, unless the commission determines that the information
needed to verify eligibility cannot be obtained in that manner or
may be obtained in the manner specified by Section 32.026102. The
executive commissioner by rule may develop procedures to determine
whether there is a need for a recertification review of a child
described by this subsection to be conducted through a personal
interview with a commission representative. Procedures developed
under this subsection shall be based on objective, risk-based
factors and conditions and shall focus on a targeted group of
recertification reviews for which there is a high probability that
eligibility will not be recertified.
SECTION 4. Subchapter B, Chapter 32, Human Resources Code,
is amended by adding Section 32.026102 to read as follows:
Sec. 32.026102. EXPRESS LANE OPTION ELIGIBILITY;
ENROLLMENT. (a) In this section, "supplemental nutrition
assistance program" has the meaning assigned by Section 33.0005.
(b) Notwithstanding any other law and in accordance with
Section 1902(e)(13) of the Social Security Act (42 U.S.C. Section
1396a(e)(13)), the commission shall implement an express lane
option under which the commission evaluates data received from an
applicant under the supplemental nutrition assistance program in
determining a child's eligibility for medical assistance benefits.
(c) In determining a child's eligibility for medical
assistance benefits using the express lane option implemented under
this section, the commission shall open a new case to ensure there
is no delay in providing benefits to the child under the
supplemental nutrition assistance program.
(d) On determining that a child is eligible for medical
assistance benefits under this section, the commission shall enroll
the child in the medical assistance program in accordance with
Section 1902(e)(13)(D) of the Social Security Act (42 U.S.C.
Section 1396a(e)(13)(D)) if the commission:
(1) provides notice of the determination to the
child's parent, legal guardian, or custodial relative in the manner
indicated under Subsection (e); and
(2) obtains the affirmative consent of the child's
parent, legal guardian, or custodial relative in accordance with
Subsection (f) to enroll the child.
(e) The commission shall provide the notice required by
Subsection (d) in the manner a child's parent, legal guardian, or
custodial relative indicates as the preferred method of contact
when applying for supplemental nutrition assistance program
benefits. If a preferred method of contact is not indicated, the
commission may provide the notice:
(1) orally;
(2) by telephone;
(3) in writing, including:
(A) by electronic signature; or
(B) in an application for benefits under the
supplemental nutrition assistance program; or
(4) by any other manner the commission determines
appropriate.
(f) In obtaining the affirmative consent of a child's
parent, legal guardian, or custodial relative required by
Subsection (d), the commission:
(1) shall ensure the consent is provided:
(A) within a reasonable amount of time, as
determined by the commission; and
(B) in accordance with identity verification
standards the commission establishes; and
(2) may obtain the consent:
(A) orally;
(B) by telephone;
(C) in writing, including by:
(i) electronic signature; or
(ii) fax; or
(D) during an initial eligibility or
recertification interview for the supplemental nutrition
assistance program.
SECTION 5. 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 6. This Act takes effect September 1, 2025.