Bill Text: TX HB2474 | 2019-2020 | 86th Legislature | Comm Sub
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Relating to the continuation of medical assistance for certain individuals.
Spectrum: Slight Partisan Bill (Republican 2-1)
Status: (Engrossed - Dead) 2019-04-24 - Referred to Health & Human Services [HB2474 Detail]
Download: Texas-2019-HB2474-Comm_Sub.html
Bill Title: Relating to the continuation of medical assistance for certain individuals.
Spectrum: Slight Partisan Bill (Republican 2-1)
Status: (Engrossed - Dead) 2019-04-24 - Referred to Health & Human Services [HB2474 Detail]
Download: Texas-2019-HB2474-Comm_Sub.html
86R21406 KFF-F | |||
By: Guillen | H.B. No. 2474 | ||
Substitute the following for H.B. No. 2474: | |||
By: Hinojosa | C.S.H.B. No. 2474 |
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relating to the continuation of medical assistance for certain | ||
individuals. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 32.0256, Human Resources Code, is | ||
amended to read as follows: | ||
Sec. 32.0256. CONTINUATION OF MEDICAL ASSISTANCE FOR | ||
CERTAIN INDIVIDUALS; ANNUAL REPORT. (a) A recipient [ |
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including a temporary increase in income of a duration of one month | ||
or less or a minor technical or clerical error committed on or with | ||
respect to the recipient's renewal application or other document | ||
required for benefits renewal, that would normally result in the | ||
recipient being determined ineligible for medical assistance | ||
continues to be eligible for that assistance if the individual: | ||
(1) either: | ||
(A) receives services through one of the | ||
following programs that serve [ |
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intellectual or developmental disability [ |
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Section 1915(c), Social Security Act (42 U.S.C. Section 1396n(c)): | ||
(i) the home and community-based services | ||
(HCS) waiver program; or | ||
(ii) the Texas home living (TxHmL) waiver | ||
program; or | ||
(B) resides in an ICF-IID facility; and | ||
(2) continues to meet the functional and diagnostic | ||
criteria for the receipt of services under a program described by | ||
Subdivision (1)(A) or for residency in an ICF-IID facility. | ||
(b) To continue to be eligible for medical assistance, a | ||
recipient described by Subsection (a) who is determined ineligible | ||
for medical assistance because of an event or circumstance caused | ||
wholly by the action or inaction of the recipient or the recipient's | ||
parent or guardian must submit an application for medical | ||
assistance in accordance with Section 32.025(b) not later than the | ||
90th day after the date on which the recipient is determined | ||
ineligible. | ||
(c) The commission may not suspend or terminate the | ||
eligibility of a recipient for medical assistance benefits if the | ||
recipient's ineligibility is caused partly or wholly by a technical | ||
or clerical error committed by the commission or an agent of the | ||
commission. | ||
(d) The commission shall: | ||
(1) coordinate with and inform relevant health care | ||
providers if a recipient described by Subsection (a) is at risk of | ||
being determined ineligible for medical assistance benefits or is | ||
determined ineligible for those benefits; and | ||
(2) make reasonable efforts to ensure the medical | ||
assistance benefits of a recipient described by Subsection (a) are | ||
not suspended or terminated. | ||
(e) Not later than December 31 of each year, the commission | ||
shall prepare and submit a report to the legislature regarding the | ||
suspension or termination of medical assistance benefits of | ||
recipients described by Subsection (a) that occurred during the | ||
preceding state fiscal year. The report must include: | ||
(1) the number of recipients who are living in a | ||
community-based, residential setting whose eligibility for | ||
benefits was suspended or terminated during each month of the | ||
fiscal year; | ||
(2) if the commission reinstated the benefits of a | ||
recipient, the average, median, shortest, and longest length of | ||
time the commission took to reinstate those benefits; | ||
(3) the number of recipients whose benefits were not | ||
reinstated by the commission; | ||
(4) the specific reason for the suspension or | ||
termination of benefits of a recipient, including an analysis of | ||
the percentage of suspensions or terminations related to: | ||
(A) an increase in the recipient's income; | ||
(B) a failure by the recipient or the recipient's | ||
parent or guardian to properly submit a renewal application or | ||
other document required for benefits renewal; | ||
(C) a change in the recipient's condition that | ||
results in the recipient no longer meeting the functional or | ||
diagnostic criteria necessary to establish the recipient's | ||
eligibility for services under a program described by Subsection | ||
(a)(1)(A) or for residency in an ICF-IID facility; | ||
(D) a technical or clerical error committed by | ||
the commission or an agent of the commission; and | ||
(E) any other reason that occurs with enough | ||
frequency to warrant its inclusion in the analysis, as determined | ||
by the commission; and | ||
(5) a statement of the amount of retroactive | ||
reimbursements paid to health care providers for the provision of | ||
services to a recipient during the time the recipient's eligibility | ||
for benefits was suspended or terminated. | ||
SECTION 2. Section 3, Chapter 1072 (H.B. 3292), Acts of the | ||
85th Legislature, Regular Session, 2017, is repealed. | ||
SECTION 3. Notwithstanding Section 32.0256(e), Human | ||
Resources Code, as added by this Act, the Health and Human Services | ||
Commission shall ensure that the initial report required under that | ||
subsection includes a description of the number of recipients | ||
described by Section 32.0256(a), Human Resources Code, as amended | ||
by this Act, who are living in a community-based, residential | ||
setting and whose eligibility for benefits was suspended or | ||
terminated during each month of the state fiscal years ending | ||
August 31, 2016, August 31, 2017, and August 31, 2018. | ||
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 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, 2019. |