Texas 2025 - 89th Regular

Texas Senate Bill SB999 Compare Versions

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

Old	New	Differences
1	1	89R11174 AND-F
2	2	By: Blanco S.B. No. 999
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7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to the establishment of the case assistance affiliate
10	10	program to provide certain assistance to Medicaid recipients and
11	11	child health plan program enrollees.
12	12	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
13	13	SECTION 1. Chapter 545, Government Code, as effective April
14	14	1, 2025, is amended by adding Subchapter F to read as follows:
15	15	SUBCHAPTER F. CASE ASSISTANCE AFFILIATE PROGRAM
16	16	Sec. 545.0251. DEFINITIONS. In this subchapter:
17	17	(1) "Benefit case management services" means
18	18	assisting a client or member of the client's household to apply for
19	19	and manage other benefits for which the client may be eligible.
20	20	(2) "Case assistance" means providing a client:
21	21	(A) application and renewal assistance under
22	22	Medicaid or the child health plan program, as appropriate; and
23	23	(B) benefit case management services under
24	24	public benefits programs, including the financial and nutritional
25	25	assistance programs.
26	26	(3) "Case assistance affiliate" means a managed care
27	27	organization or dental maintenance organization that provides case
28	28	assistance to clients and members of the clients' households.
29	29	(4) "Case assistant" means an employee of a case
30	30	assistance affiliate who directly provides case assistance to a
31	31	client or a member of the client's household.
32	32	(5) "Client" means, with respect to a managed care
33	33	organization or dental maintenance organization, a recipient or
34	34	enrollee who is enrolled in the organization's managed care plan.
35	35	(6) "Enrollee" means an individual enrolled in the
36	36	child health plan program.
37	37	(7) "Program" means the case assistance affiliate
38	38	program established under this subchapter.
39	39	(8) "Program manager" means the employee of a case
40	40	assistance affiliate who is designated by the affiliate to oversee:
41	41	(A) case assistants; and
42	42	(B) the provision of case assistance services
43	43	under the program.
44	44	(9) "Recipient" means a Medicaid recipient.
45	45	Sec. 545.0252. ESTABLISHMENT OF CASE ASSISTANCE AFFILIATE
46	46	PROGRAM. (a) The commission shall:
47	47	(1) establish a statewide case assistance affiliate
48	48	program under which managed care organizations and dental
49	49	maintenance organizations that participate in Medicaid or the child
50	50	health plan program are authorized to operate as case assistance
51	51	affiliates by providing, to the extent permitted by federal law,
52	52	case assistance to their clients and members of their clients'
53	53	households; and
54	54	(2) provide a training and certification process for
55	55	program managers and case assistants providing services under the
56	56	program.
57	57	(b) In establishing the program, the commission:
58	58	(1) shall consult with:
59	59	(A) experts, as determined by the commission; and
60	60	(B) other interested persons, including managed
61	61	care organizations and dental maintenance organizations
62	62	participating in Medicaid or the child health plan program; and
63	63	(2) may establish a work group or advisory committee
64	64	that includes interested persons to advise the commission on the
65	65	establishment of the program.
66	66	Sec. 545.0253. AUTHORIZED SERVICES. Under the program, a
67	67	case assistance affiliate may:
68	68	(1) provide case assistance by any appropriate means,
69	69	including in person or virtually using a computer, tablet, or other
70	70	electronic device; and
71	71	(2) with the consent of the client, submit to the
72	72	commission an application for benefits on behalf of the client
73	73	using the client's captured electronic signature.
74	74	Sec. 545.0254. PROHIBITED SERVICES. Under the program, a
75	75	case assistance affiliate may not:
76	76	(1) provide counseling to a client on choosing a
77	77	managed care plan in which to enroll; or
78	78	(2) assist a client in completing fields on benefit
79	79	forms associated with managed care plan selection.
80	80	Sec. 545.0255. RULES: PROGRAM REQUIREMENTS AND STANDARDS.
81	81	The executive commissioner shall adopt rules necessary to implement
82	82	the program, including rules:
83	83	(1) establishing requirements for a managed care
84	84	organization or dental maintenance organization to participate in
85	85	the program;
86	86	(2) establishing the training and certification
87	87	process required by Section 545.0252(a)(2);
88	88	(3) providing for the suspension, revocation, and, as
89	89	appropriate, periodic renewal of a case assistant's or program
90	90	manager's certification;
91	91	(4) protecting the confidentiality of clients'
92	92	information; and
93	93	(5) establishing any other standards or requirements
94	94	the executive commissioner determines necessary.
95	95	SECTION 2. If before implementing any provision of this Act
96	96	a state agency determines that a waiver or authorization from a
97	97	federal agency is necessary for implementation of that provision,
98	98	the agency affected by the provision shall request the waiver or
99	99	authorization and may delay implementing that provision until the
100	100	waiver or authorization is granted.
101	101	SECTION 3. This Act takes effect immediately if it receives
102	102	a vote of two-thirds of all the members elected to each house, as
103	103	provided by Section 39, Article III, Texas Constitution. If this
104	104	Act does not receive the vote necessary for immediate effect, this
105	105	Act takes effect September 1, 2025.