Relating to implementing an express lane option under Medicaid and the child health plan program.

89(R) HB 321 - Engrossed version - Bill Text

89R21121 SCF-F

By: Bucy, Oliverson, Rose, Bonnen, Walle,

H.B. No. 321

et al.

A BILL TO BE ENTITLED

AN ACT

relating to implementing an express lane option under Medicaid and

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; ENROLLMENT.

(a) In this section, "supplemental nutrition assistance program"

has the meaning assigned by Section 33.0005, Human Resources Code.

(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 evaluates data received from an applicant under the

supplemental nutrition assistance program in determining a child's

eligibility for coverage under the child health plan program.

(c)

In determining a child's eligibility for coverage under

the child health plan program using the express lane option

implemented under this section, the commission shall open a new

case to ensure there is no delay in providing benefits to the child

under the supplemental nutrition assistance program.

(d)

On determining that a child is eligible for coverage

under the child health plan program under this section, the

commission shall enroll the child in the program in accordance with

Section 1902(e)(13)(D) of the Social Security Act (42 U.S.C.

Section 1396a(e)(13)(D)) if the commission:

(1)

provides notice of the determination to the

child's parent, legal guardian, or custodial relative in the manner

indicated under Subsection (e); and

(2)

obtains the affirmative consent of the child's

parent, legal guardian, or custodial relative in accordance with

Subsection (f) to enroll the child.

(e)

The commission shall provide the notice required by

Subsection (d) in the manner a child's parent, legal guardian, or

custodial relative indicates as the preferred method of contact

when applying for supplemental nutrition assistance program

benefits. If a preferred method of contact is not indicated, the

commission may provide the notice:

(1) orally;

(2) by telephone;

(3) in writing, including by electronic signature; or

(4)

by any other manner the commission determines

appropriate.

(f)

In obtaining the affirmative consent of a child's

parent, legal guardian, or custodial relative required by

Subsection (d), the commission:

(1) shall ensure the consent is provided:

(A)

within a reasonable amount of time, as

determined by the commission; and

(B)

in accordance with identity verification

standards the commission establishes; and

(2) may obtain the consent:

(A) orally;

(B) by telephone;

(C) in writing, including by:

(i) electronic signature; or

(ii) fax; or

(D)

during an initial eligibility or

recertification interview for the supplemental nutrition

assistance program.

SECTION 3. Section 32.026(e), Human Resources Code, is

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.

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 ELIGIBILITY;

ENROLLMENT. (a) In this section, "supplemental nutrition

assistance program"

has the meaning assigned by Section 33.0005.

(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 evaluates data received from an

applicant under the supplemental nutrition assistance program in

determining a child's eligibility for medical assistance benefits.

(c)

In determining a child's eligibility for medical

assistance benefits using the express lane option implemented under

this section, the commission shall open a new case to ensure there

is no delay in providing benefits to the child under the

supplemental nutrition assistance program.

(d)

On determining that a child is eligible for medical

assistance benefits under this section, the commission shall enroll

the child in the medical assistance program in accordance with

Section 1902(e)(13)(D) of the Social Security Act (42 U.S.C.

Section 1396a(e)(13)(D)) if the commission:

(1)

provides notice of the determination to the

child's parent, legal guardian, or custodial relative in the manner

indicated under Subsection (e); and

(2)

obtains the affirmative consent of the child's

parent, legal guardian, or custodial relative in accordance with

Subsection (f) to enroll the child.

(e)

The commission shall provide the notice required by

Subsection (d) in the manner a child's parent, legal guardian, or

custodial relative indicates as the preferred method of contact

when applying for supplemental nutrition assistance program

benefits. If a preferred method of contact is not indicated, the

commission may provide the notice:

(1) orally;

(2) by telephone;

(3) in writing, including:

(A) by electronic signature; or

(B)

in an application for benefits under the

supplemental nutrition assistance program; or

(4)

by any other manner the commission determines

appropriate.

(f)

In obtaining the affirmative consent of a child's

parent, legal guardian, or custodial relative required by

Subsection (d), the commission:

(1) shall ensure the consent is provided:

(A)

within a reasonable amount of time, as

determined by the commission; and

(B)

in accordance with identity verification

standards the commission establishes; and

(2) may obtain the consent:

(A) orally;

(B) by telephone;

(C) in writing, including by:

(i) electronic signature; or

(ii) fax; or

(D)

during an initial eligibility or

recertification interview for the supplemental nutrition

assistance program.

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.