SB225 - Relating to implementation of an express lane option for determining eligibility and enrolling certain individuals in Medicaid or the child health plan program.

  89R570 SCP-D     By: West S.B. No. 225       A BILL TO BE ENTITLED   AN ACT   relating to implementation of an express lane option for   determining eligibility and enrolling certain individuals in   Medicaid or the child health plan program.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 62.1011, Health and Safety Code, is   amended to read as follows:          Sec. 62.1011.  VERIFICATION OF INCOME. (a) Except as   provided by Subsection (b) and subject to Subsection (c), the [ The ]   commission shall continue employing methods of verifying the   individual incomes of the individuals considered in the calculation   of an applicant's household income.           (b)   The commission shall verify income under this section   unless the applicant reports a household income that exceeds the   income eligibility level established under Section 62.101(b).           (c)     The commission may verify income using the verification   process described in Section 62.1012.          SECTION 2.  Subchapter C, Chapter 62, Health and Safety   Code, is amended by adding Section 62.1012 to read as follows:           Sec.   62.1012.     EXPRESS LANE OPTION ELIGIBILITY; AUTOMATIC   ENROLLMENT. (a) In this section:                 (1)     "Express lane agency" means a governmental entity   that:                       (A)     determines eligibility for assistance under   a public assistance program of this state; and                       (B)     the executive commissioner designates as   capable of making determinations of one or more eligibility   requirements under the child health plan program.                   (2)  "Public assistance program" includes:                       (A)     the Medicaid program under Chapter 32, Human   Resources Code;                       (B)     the financial assistance program under   Chapter 31, Human Resources Code;                         (C)     the nutritional assistance programs under   Chapter 33, Human Resources Code, including the supplemental   nutrition assistance program under that chapter;                       (D)     the federal special supplemental nutrition   program for women, infants, and children authorized by 42 U.S.C.   Section 1786;                       (E)     the federal Head Start program established   under 42 U.S.C. Section 9831 et seq.; and                       (F)     the free or reduced-price lunch program   established under 42 U.S.C. Section 1751 et seq.           (b)     Notwithstanding any other law and in accordance with   Sections 1902(e)(13) and 2107(e)(1)(H) of the Social Security Act   (42 U.S.C. Sections 1396a(e)(13) and 1397gg(e)(1)(H)), the   commission shall implement an express lane option under which the   commission may use information obtained by an express lane agency   to determine a child's eligibility for coverage under the child   health plan, including a child's eligibility for reenrollment in   the plan.           (c)     In accordance with Section 1902(e)(13)(D) of the Social   Security Act (42 U.S.C. Section 1396a(e)(13)(D)), the commission   shall automatically enroll in the child health plan program a child   who is determined to be eligible for the program under this section.          SECTION 3.  Sections 32.026(e) and (g), Human Resources   Code, are amended to read as follows:          (e)  The executive commissioner shall permit a   recertification review of the eligibility and need for medical   assistance of a child under 19 years of age to be conducted by   telephone or mail instead of through a personal appearance at an   office, unless the commission determines that the information   needed to verify eligibility cannot be obtained in that manner or   may be obtained in the manner specified by Section 32.026102 . The   executive commissioner by rule may develop procedures to determine   whether there is a need for a recertification review of a child   described by this subsection to be conducted through a personal   interview with a commission representative. Procedures developed   under this subsection shall be based on objective, risk-based   factors and conditions and shall focus on a targeted group of   recertification reviews for which there is a high probability that   eligibility will not be recertified.          (g)  Notwithstanding any other provision of this code, the   commission may use information obtained from a third party to   verify the assets and resources of a person for purposes of   determining the person's eligibility and need for medical   assistance to the extent that verification is applicable under   federal law. Third-party information includes information   obtained from:                (1)  a consumer reporting agency, as defined by Section   20.01, Business & Commerce Code;                (2)  an appraisal district; [ or ]                (3)  the Texas Department of Motor Vehicles vehicle   registration record database ; or                 (4)     an express lane agency described by Section   32.026102 .          SECTION 4.  Subchapter B, Chapter 32, Human Resources Code,   is amended by adding Section 32.026102 to read as follows:           Sec.   32.026102.     EXPRESS LANE OPTION; AUTOMATIC ENROLLMENT.   (a)   In this section:                 (1)     "Express lane agency" means a governmental entity   that:                       (A)     determines eligibility for assistance under   a public assistance program of this state; and                       (B)     the executive commissioner designates as   capable of making determinations of one or more eligibility   requirements under the medical assistance program.                   (2)  "Public assistance program" includes:                       (A)     the child health plan program under Chapters   62 and 63, Health and Safety Code;                       (B)     the financial assistance program under   Chapter 31;                         (C)     the nutritional assistance programs under   Chapter 33, including the supplemental nutrition assistance   program under that chapter;                       (D)     the federal special supplemental nutrition   program for women, infants, and children authorized by 42 U.S.C.   Section 1786;                       (E)     the federal Head Start program established   under 42 U.S.C. Section 9831 et seq.; and                       (F)     the free or reduced-price lunch program   established under 42 U.S.C. Section 1751 et seq.           (b)     Notwithstanding any other law and in accordance with   Section 1902(e)(13) of the Social Security Act (42 U.S.C. Section   1396a(e)(13)), the commission shall implement an express lane   option under which the commission may use information obtained by   an express lane agency to determine an individual's eligibility for   medical assistance, including the recertification of an   individual's eligibility for medical assistance benefits.           (c)     In accordance with Section 1902(e)(13)(D) of the Social   Security Act (42 U.S.C. Section 1396a(e)(13)(D)), the commission   shall automatically enroll in the medical assistance program an   individual who is determined to be eligible for the program under   this section.          SECTION 5.  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 6.  This Act takes effect September 1, 2025.