Bill Text: TX HB290 | 2021-2022 | 87th Legislature | Comm Sub
Bill Title: Relating to the period of continuous eligibility and a periodic eligibility review for a child for Medicaid.
Spectrum: Slight Partisan Bill (Democrat 39-15)
Status: (Engrossed - Dead) 2021-05-26 - Not again placed on intent calendar [HB290 Detail]
Download: Texas-2021-HB290-Comm_Sub.html
By: Cortez, et al. | H.B. No. 290 | |
(Senate Sponsor - Kolkhorst, et al.) | ||
(In the Senate - Received from the House April 19, 2021; | ||
May 18, 2021, read first time and referred to Committee on Health & | ||
Human Services; May 22, 2021, reported adversely, with favorable | ||
Committee Substitute by the following vote: Yeas 9, Nays 0; | ||
May 22, 2021, sent to printer.) | ||
COMMITTEE SUBSTITUTE FOR H.B. No. 290 | By: Blanco |
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relating to the period of continuous eligibility and a periodic | ||
eligibility review for a child for Medicaid. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 32.0261, Human Resources Code, is | ||
amended to read as follows: | ||
Sec. 32.0261. CONTINUOUS ELIGIBILITY. (a) This section | ||
applies only to a child younger than 19 years of age who is | ||
determined eligible for medical assistance under this chapter. | ||
(b) The executive commissioner shall adopt rules in | ||
accordance with 42 U.S.C. Section 1396a(e)(12), as amended, to | ||
provide for two consecutive periods of [ |
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eligibility for a child between each certification and | ||
recertification of the child's eligibility, subject to Subsections | ||
(f) and (h) [ |
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(c) The first of the two consecutive periods of eligibility | ||
described by Subsection (b) must be continuous in accordance with | ||
Subsection (d). The second of the two consecutive periods of | ||
eligibility is not continuous and may be affected by changes in a | ||
child's household income, regardless of whether those changes | ||
occurred or whether the commission became aware of the changes | ||
during the first or second of the two consecutive periods of | ||
eligibility. | ||
(d) A [ |
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eligible for medical assistance during the first of the two | ||
consecutive periods of eligibility, without additional review by | ||
the commission and regardless of changes in the child's household | ||
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date on which the child's eligibility was determined, except as | ||
provided by Subsections (f)(1) and (h) [ |
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(e) During the sixth month following the date on which a | ||
child's eligibility for medical assistance is certified or | ||
recertified, the commission shall, in a manner that complies with | ||
federal law, including verification plan requirements under 42 | ||
C.F.R. Section 435.945(j), review the child's household income | ||
using electronic income data available to the commission. The | ||
commission may conduct this review only once during the child's two | ||
consecutive periods of eligibility. Based on the review: | ||
(1) the commission shall, if the review indicates that | ||
the child's household income does not exceed the maximum income for | ||
eligibility for the medical assistance program, provide for a | ||
second consecutive period of eligibility for the child until the | ||
child's required annual recertification, except as provided by | ||
Subsection (h) and subject to Subsection (c); or | ||
(2) the commission may, if the review indicates that | ||
the child's household income exceeds the maximum income for | ||
eligibility for the medical assistance program, request additional | ||
documentation to verify the child's household income in a manner | ||
that complies with federal law. | ||
(f) If, after reviewing a child's household income under | ||
Subsection (e), the commission determines that the household income | ||
exceeds the maximum income for eligibility for the medical | ||
assistance program, the commission shall continue to provide | ||
medical assistance to the child until: | ||
(1) the commission provides the child's parent or | ||
guardian with a period of not less than 30 days to provide | ||
documentation demonstrating that the child's household income does | ||
not exceed the maximum income for eligibility; and | ||
(2) the child's parent or guardian fails to provide the | ||
documentation during the period described by Subdivision (1). | ||
(g) If a child's parent or guardian provides to the | ||
commission within the period described by Subsection (f) | ||
documentation demonstrating that the child's household income does | ||
not exceed the maximum income for eligibility for the medical | ||
assistance program, the commission shall provide for a second | ||
consecutive period of eligibility for the child until the child's | ||
required annual recertification, except as provided by Subsection | ||
(h) and subject to Subsection (c). | ||
(h) Notwithstanding any other period prescribed by this | ||
section, a child's eligibility for medical assistance ends on the | ||
child's 19th birthday. | ||
(i) The commission may not recertify a child's eligibility | ||
for medical assistance more frequently than every 12 months as | ||
required by federal law. | ||
(j) If a child's parent or guardian fails to provide to the | ||
commission within the period described by Subsection (f) | ||
documentation demonstrating that the child's household income does | ||
not exceed the maximum income for eligibility for the medical | ||
assistance program, the commission shall provide the child's parent | ||
or guardian with written notice of termination following that | ||
period. The notice must include a statement that the child may be | ||
eligible for enrollment in the child health plan under Chapter 62, | ||
Health and Safety Code. | ||
(k) In developing the notice, the commission shall consult | ||
with health care providers, children's health care advocates, | ||
family members of children enrolled in the medical assistance | ||
program, and other stakeholders to determine the most user-friendly | ||
method to provide the notice to a child's parent or guardian. | ||
(l) The executive commissioner may adopt rules as necessary | ||
to implement this section. | ||
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 September 1, 2021. | ||
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