Bill Text: TX SB1093 | 2019-2020 | 86th Legislature | Introduced
Bill Title: Relating to the eligibility of children and prioritization of persons on waiting lists for certain Medicaid long-term care services waiver programs.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2019-03-07 - Referred to Health & Human Services [SB1093 Detail]
Download: Texas-2019-SB1093-Introduced.html
86R5769 KKR-D | ||
By: Perry | S.B. No. 1093 |
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relating to the eligibility of children and prioritization of | ||
persons on waiting lists for certain Medicaid long-term care | ||
services waiver programs. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subchapter B, Chapter 531, Government Code, is | ||
amended by adding Sections 531.0601 and 531.0602 to read as | ||
follows: | ||
Sec. 531.0601. LONG-TERM CARE SERVICES WAIVER PROGRAM | ||
INTEREST LISTS. (a) This section applies only to a child who | ||
becomes ineligible for services under the medically dependent | ||
children (MDCP) waiver program because the child no longer meets: | ||
(1) the level of care criteria for medical necessity | ||
for nursing facility care; or | ||
(2) the age requirement for the program. | ||
(b) A legally authorized representative of a child who is | ||
notified by the commission that the child is no longer eligible for | ||
the medically dependent children (MDCP) waiver program may request | ||
that the commission: | ||
(1) return the child to the interest list for the | ||
program unless the child is ineligible due to the child's age; or | ||
(2) place the child on the interest list for another | ||
Section 1915(c) waiver program. | ||
(c) At the time a child's legally authorized representative | ||
makes a request under Subsection (b), the commission shall: | ||
(1) for a child who becomes ineligible for the reason | ||
described by Subsection (a)(1), place the child: | ||
(A) on the interest list for the medically | ||
dependent children (MDCP) waiver program in the first position on | ||
the list; or | ||
(B) except as provided by Subdivision (3), on the | ||
interest list for another Section 1915(c) waiver program in a | ||
position relative to other persons on the list that is based on the | ||
date the child was initially placed on the interest list for the | ||
medically dependent children (MDCP) waiver program; | ||
(2) except as provided by Subdivision (3), for a child | ||
who becomes ineligible for the reason described by Subsection | ||
(a)(2), place the child on the interest list for another Section | ||
1915(c) waiver program in a position relative to other persons on | ||
the list that is based on the date the child was initially placed on | ||
the interest list for the medically dependent children (MDCP) | ||
waiver program; or | ||
(3) for a child who becomes ineligible for a reason | ||
described by Subsection (a) and who is already on an interest list | ||
for another Section 1915(c) waiver program, move the child to a | ||
position on the interest list relative to other persons on the list | ||
that is based on the date the child was initially placed on the | ||
interest list for the medically dependent children (MDCP) waiver | ||
program, if that date is earlier than the date the child was | ||
initially placed on the interest list for the other waiver program. | ||
(d) At the time the commission provides notice to a legally | ||
authorized representative that a child is no longer eligible for | ||
the medically dependent children (MDCP) waiver program, the | ||
commission shall inform the representative in writing about the | ||
options under this section for placing the child on an interest | ||
list. | ||
Sec. 531.0602. MEDICALLY DEPENDENT CHILDREN (MDCP) WAIVER | ||
PROGRAM REASSESSMENTS. (a) To the extent allowed by federal law, | ||
the commission shall require that a child participating in the | ||
medically dependent children (MDCP) waiver program be reassessed to | ||
determine whether the child meets the level of care criteria for | ||
medical necessity for nursing facility care only if the child has a | ||
significant change in function that may affect the medical | ||
necessity for that level of care instead of requiring that the | ||
reassessment be made annually. | ||
(b) If federal law requires that a reassessment of a child | ||
participating in the medically dependent children (MDCP) waiver | ||
program to determine whether the child meets the level of care | ||
criteria for medical necessity for nursing facility care be made | ||
annually, the commission shall allow the reassessment to be made on | ||
an expedited basis. | ||
SECTION 2. As soon as possible after the effective date of | ||
this Act, the Health and Human Services Commission shall identify | ||
each child who became ineligible for services under the medically | ||
dependent children (MDCP) waiver program on or after July 1, 2016, | ||
and before January 1, 2019, based on the child's level of care | ||
assessment. The commission shall, on request of the parent or | ||
legally authorized representative of an identified child, reassess | ||
the child to determine whether the child meets the level of care | ||
criteria for medical necessity for nursing facility care required | ||
to participate in the medically dependent children (MDCP) waiver | ||
program. | ||
SECTION 3. Not later than December 1, 2019, the executive | ||
commissioner of the Health and Human Services Commission shall | ||
adopt rules necessary to implement Sections 531.0601 and 531.0602, | ||
Government Code, as added by this Act. | ||
SECTION 4. Section 531.0601, Government Code, as added by | ||
this Act, applies only to a child who becomes ineligible for the | ||
medically dependent children (MDCP) waiver program on or after | ||
December 1, 2019. | ||
SECTION 5. Section 531.0602, Government Code, as added by | ||
this Act, applies only to a reassessment of a child's eligibility | ||
for the medically dependent children (MDCP) waiver program made on | ||
or after December 1, 2019. | ||
SECTION 6. 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 7. This Act takes effect September 1, 2019. |