Bill Text: TX HB1016 | 2019-2020 | 86th Legislature | Introduced
Bill Title: Relating to eligibility determinations for the STAR+PLUS home and community based services (HCBS) program.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2019-04-23 - Left pending in committee [HB1016 Detail]
Download: Texas-2019-HB1016-Introduced.html
| 86R3390 LED-D | ||
| By: Martinez | H.B. No. 1016 | |
|
|
||
|
|
||
| relating to eligibility determinations for the STAR+PLUS home and | ||
| community based services (HCBS) program. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Subchapter A, Chapter 533, Government Code, is | ||
| amended by adding Section 533.00282 to read as follows: | ||
| Sec. 533.00282. ELIGIBILITY DETERMINATIONS FOR STAR+PLUS | ||
| HOME AND COMMUNITY BASED SERVICES (HCBS) PROGRAM. (a) The | ||
| commission shall determine Medicaid eligibility for an applicant | ||
| for the STAR+PLUS home and community based services (HCBS) program | ||
| not later than: | ||
| (1) the 20th day after the date the applicant submits | ||
| the application; or | ||
| (2) the 45th day after the date the applicant submits | ||
| the application, if the applicant is applying on the basis of a | ||
| disability. | ||
| (b) A managed care organization with which the commission | ||
| contracts to provide health care services to recipients shall, not | ||
| later than the 30th day after the date an applicant for the | ||
| STAR+PLUS home and community based services (HCBS) program submits | ||
| the application, complete and submit to the entity serving as this | ||
| state's Medicaid claims administrator the applicant's: | ||
| (1) individual service plan; and | ||
| (2) medical necessity and level of care assessment. | ||
| SECTION 2. Section 533.00282(a), Government Code, as added | ||
| by this Act, applies only to an application for a determination of | ||
| Medicaid eligibility submitted on or after the effective date of | ||
| this Act. An application for a determination of Medicaid | ||
| eligibility submitted before the effective date of this Act is | ||
| governed by the law in effect immediately before the effective date | ||
| of this Act, and that law is continued in effect for that purpose. | ||
| SECTION 3. (a) The Health and Human Services Commission | ||
| shall, in a contract between the commission and a managed care | ||
| organization under Chapter 533, Government Code, that is entered | ||
| into or renewed on or after the effective date of this Act, require | ||
| that the managed care organization comply with Section | ||
| 533.00282(b), Government Code, as added by this Act. | ||
| (b) The Health and Human Services Commission shall seek to | ||
| amend contracts entered into with managed care organizations under | ||
| Chapter 533, Government Code, before the effective date of this Act | ||
| to require those managed care organizations to comply with Section | ||
| 533.00282(b), Government Code, as added by this Act. To the extent | ||
| of a conflict between Section 533.00282(b), Government Code, as | ||
| added by this Act, and a provision of a contract with a managed care | ||
| organization entered into before the effective date of this Act, | ||
| the contract provision prevails. | ||
| SECTION 4. 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 5. This Act takes effect September 1, 2019. | ||
