Bill Text: TX SB1995 | 2015-2016 | 84th Legislature | Introduced


Bill Title: Relating to the establishment of a health care pilot program for low-income individuals.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2015-03-25 - Referred to Business & Commerce [SB1995 Detail]

Download: Texas-2015-SB1995-Introduced.html
  84R13265 SCL-D
 
  By: Menéndez S.B. No. 1995
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the establishment of a health care pilot program for
  low-income individuals.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subtitle C, Title 2, Health and Safety Code, is
  amended by adding Chapter 65 to read as follows:
  CHAPTER 65. HEALTH CARE PILOT PROGRAM FOR LOW-INCOME INDIVIDUALS
         Sec. 65.001.  DEFINITIONS. In this chapter:
               (1)  "Commissioner" means the commissioner of
  insurance.
               (2)  "Department" means the Texas Department of
  Insurance.
               (3)  "Pilot program" means the health care pilot
  program for low-income individuals established under this chapter.
         Sec. 65.002.  ESTABLISHMENT OF PILOT PROGRAM; RULEMAKING
  AUTHORITY. (a) The department shall establish and maintain in
  accordance with this chapter a pilot program for health benefits
  coverage for certain low-income individuals residing in an area
  designated by the department under Section 65.003.
         (b)  The commissioner may adopt rules as necessary to
  implement this chapter.
         Sec. 65.003.  DESIGNATION OF AREAS UNDER PILOT PROGRAM. (a)
  The commissioner by rule shall adopt standards in accordance with
  this subsection for the designation of an area to be served under
  the pilot program. To be eligible for the pilot program:
               (1)  the percentage of adults in the area who do not
  have coverage or benefits for health care services under a public or
  private plan or program must be higher than the state average;
               (2)  the area must be designated as a health
  professional shortage area by the United States Department of
  Health and Human Services; and
               (3)  the area must be served on or before January 1,
  2015, by one or more promotoras trained under Chapter 48.
         (b)  The department shall designate 10 areas in this state
  for inclusion in the pilot program in accordance with the standards
  under Subsection (a) and rules adopted under this chapter.
         (c)  The department may establish an application process to
  allow an area to apply for inclusion in the pilot program.
         Sec. 65.004.  PROMOTORA DUTIES. A promotora serving an area
  designated for the pilot program may assist the department in
  coordination of health care under the pilot program, in monitoring
  the compliance of individuals enrolled in the pilot program, and in
  establishing an application process.
         Sec. 65.005.  INDIVIDUAL ELIGIBILITY. To be eligible to
  receive services under the pilot program, an individual must have
  an income of less than 138 percent of the federal poverty level and
  be a parent of a child currently enrolled in the state health plan
  or health benefits plan for children under Chapter 62 or 63 or the
  state Medicaid program operated under Chapter 32, Human Resources
  Code.
         Sec. 65.006.  HEALTH COVERAGE UNDER PILOT PROGRAM. The
  commissioner by rule shall develop the health benefits coverage
  under the pilot program, including the benefits offered under the
  pilot program and the method of providing benefits.
         Sec. 65.007.  FUNDING. Notwithstanding Section 6(e)(2),
  Chapter 615 (S.B. 1367), Acts of the 83rd Legislature, Regular
  Session, 2013, the department shall fund the pilot program with
  available funds transferred to the department under that Act.  The
  commissioner may adopt rules necessary to facilitate the funding of
  the pilot program under this section.
         Sec. 65.008.  REPORT. (a) The department shall contract
  with an independent third party to evaluate the pilot program and
  develop a report under this section.
         (b)  Not later than December 1, 2016, the third party
  contracting with the department under Subsection (a) shall
  distribute a report that evaluates the pilot program to the
  governor, lieutenant governor, speaker of the house of
  representatives, and chairs of the standing committees of the
  senate and house of representatives with primary jurisdiction
  regarding health care or insurance.
         Sec. 65.009.  ADVISORY COMMITTEE. The commissioner shall
  appoint an advisory committee composed of five members to advise
  the department on the implementation of this chapter. The
  committee must include:
               (1)  two individuals eligible to obtain coverage under
  the pilot program;
               (2)  a representative of the insurance industry;
               (3)  a representative of a university hospital system;
  and
               (4)  a health care provider providing services in an
  area included in the pilot program.
         Sec. 65.010.  EXPIRATION OF CHAPTER. This chapter expires
  August 31, 2019.
         SECTION 2.  Not later than January 1, 2016, the Texas
  Department of Insurance shall establish the indigent health care
  pilot program described by Chapter 65, Health and Safety Code, as
  added by this Act.
         SECTION 3.  This Act takes effect September 1, 2015.
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