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AN ACT
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relating to information about private health care insurance |
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coverage and the health insurance exchange for individuals applying |
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for certain Department of State Health Services health or mental |
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health benefits, services, and assistance. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter D, Chapter 1001, Health and Safety |
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Code, is amended by adding Sections 1001.080 and 1001.081 to read as |
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follows: |
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Sec. 1001.080. HEALTH INSURANCE COVERAGE INFORMATION. |
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(a) In this section, "individual's legally authorized |
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representative" means: |
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(1) a parent, managing conservator, or guardian of an |
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individual, if the individual is a minor; |
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(2) a guardian of an individual, if the individual has |
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been adjudicated incompetent to manage the individual's personal |
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affairs; or |
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(3) an agent of the individual authorized under a |
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durable power of attorney for health care. |
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(b) This section applies to health or mental health |
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benefits, services, or assistance provided by the department that |
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the department anticipates will be impacted by a health insurance |
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exchange as defined by Section 1001.081(a), including: |
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(1) community primary health care services provided |
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under Chapter 31; |
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(2) women's and children's health services provided |
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under Chapter 32; |
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(3) services for children with special health care |
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needs provided under Chapter 35; |
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(4) epilepsy program assistance provided under |
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Chapter 40; |
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(5) hemophilia program assistance provided under |
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Chapter 41; |
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(6) kidney health care services provided under Chapter |
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42; |
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(7) human immunodeficiency virus infection and |
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sexually transmitted disease prevention programs and services |
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provided under Chapter 85; |
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(8) immunization programs provided under Chapter 161; |
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(9) programs and services provided by the Rio Grande |
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State Center under Chapter 252; |
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(10) mental health services for adults provided under |
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Chapter 534; |
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(11) mental health services for children provided |
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under Chapter 534; |
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(12) the NorthSTAR Behavioral Health Program provided |
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under Chapter 534; |
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(13) programs and services provided by community |
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mental health hospitals under Chapter 552; |
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(14) programs and services provided by state mental |
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health hospitals under Chapter 552; and |
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(15) any other health or mental health program or |
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service designated by the department. |
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(c) Subject to Subsection (d), the department may not |
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provide health or mental health benefits, services, or assistance |
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described in Subsection (b) unless the individual applying to |
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receive the benefits, services, or assistance submits to the |
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department on the form prescribed by the department: |
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(1) a statement by the individual or the individual's |
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legally authorized representative attesting that the individual |
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does not have access to private health care insurance that provides |
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coverage for the benefit, service, or assistance; or |
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(2) if the individual has access to private health |
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care insurance that provides coverage for the benefit, service, or |
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assistance, the information and authorization necessary for the |
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department to submit a claim for reimbursement from the insurer for |
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the benefit, service, or assistance. |
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(d) The department may waive the prohibition under |
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Subsection (c) for an individual or for health or mental health |
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benefits, services, or assistance described in Subsection (b) if |
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the department determines that a benefit, service, or assistance is |
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necessary during a crisis or emergency. |
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(e) The executive commissioner shall adopt rules necessary |
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to implement this section. |
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Sec. 1001.081. HEALTH INSURANCE EXCHANGE INFORMATION. |
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(a) In this section: |
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(1) "Health insurance exchange" means an American |
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Health Benefit Exchange administered by the federal government |
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under 42 U.S.C. Section 18041 or created under 42 U.S.C. Section |
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18031. |
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(2) "Individual's legally authorized representative" |
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has the meaning assigned by Section 1001.080(a). |
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(b) The department may develop informational materials |
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regarding health care insurance coverage and subsidies available |
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under a health insurance exchange. |
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(c) The department shall provide the informational |
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materials regarding health care insurance coverage and subsidies |
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available under a health insurance exchange to an individual or the |
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individual's legally authorized representative who: |
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(1) applies to receive health or mental health |
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benefits, services, or assistance described in Section |
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1001.080(b); and |
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(2) has an income above 100 percent of the federal |
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poverty level. |
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(d) The executive commissioner shall adopt rules necessary |
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to implement this section. |
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SECTION 2. As soon as practicable after the effective date |
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of this Act, the Department of State Health Services shall |
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prescribe the form required by Section 1001.080, Health and Safety |
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Code, as added by this Act. |
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SECTION 3. As soon as possible after the effective date of |
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this Act, the Health and Human Services Commission shall apply for |
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any waiver or other authorization necessary to implement this Act. |
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The commission may delay implementing this Act until the waiver or |
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authorization is granted. |
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SECTION 4. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2013. |
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______________________________ |
______________________________ |
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President of the Senate |
Speaker of the House |
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I hereby certify that S.B. No. 1057 passed the Senate on |
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April 11, 2013, by the following vote: Yeas 31, Nays 0. |
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______________________________ |
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Secretary of the Senate |
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I hereby certify that S.B. No. 1057 passed the House on |
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May 20, 2013, by the following vote: Yeas 143, Nays 2, two |
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present not voting. |
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______________________________ |
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Chief Clerk of the House |
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Approved: |
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______________________________ |
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Date |
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______________________________ |
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Governor |