87R30257 KKR-F     By: Kolkhorst S.R. No. 542     R E S O L U T I O N            BE IT RESOLVED by the Senate of the State of Texas, 87th   Legislature, Regular Session, 2021, That Senate Rule 12.03 be   suspended in part as provided by Senate Rule 12.08 to enable the   conference committee appointed to resolve the differences on House   Bill 2658 (the Medicaid program, including the administration and   operation of the Medicaid managed care program) to consider and   take action on the following matter:          Senate Rule 12.03(4) is suspended to permit the committee to   add text on a matter not included in either the house or senate   version of the bill by adding the following new SECTION to the bill:          SECTION 8.  Section 32.0261, Human Resources Code, is   amended to read as follows:          Sec. 32.0261.  CONTINUOUS ELIGIBILITY.  (a) This section   applies only to a child younger than 19 years of age who is   determined eligible for medical assistance under this chapter.          (b)  The executive commissioner shall adopt rules in   accordance with 42 U.S.C. Section 1396a(e)(12), as amended, to   provide for two consecutive periods of [a period of continuous]   eligibility for a child between each certification and   recertification of the child's eligibility, subject to Subsections   (f) and (h) [under 19 years of age who is determined to be eligible   for medical assistance under this chapter].          (c)  The first of the two consecutive periods of eligibility   described by Subsection (b) must be continuous in accordance with   Subsection (d). The second of the two consecutive periods of   eligibility is not continuous and may be affected by changes in a   child's household income, regardless of whether those changes   occurred or whether the commission became aware of the changes   during the first or second of the two consecutive periods of   eligibility.          (d)  A [The rules shall provide that the] child remains   eligible for medical assistance during the first of the two   consecutive periods of eligibility, without additional review by   the commission and regardless of changes in the child's household   [resources or] income, until [the earlier of:                [(1)]  the end of the six-month period following the   date on which the child's eligibility was determined, except as   provided by Subsections (f)(1) and (h) [; or                [(2)  the child's 19th birthday].          (e)  During the sixth month following the date on which a   child's eligibility for medical assistance is certified or   recertified, the commission shall, in a manner that complies with   federal law, including verification plan requirements under 42   C.F.R. Section 435.945(j), review the child's household income   using electronic income data available to the commission. The   commission may conduct this review only once during the child's two   consecutive periods of eligibility.  Based on the review:                (1)  the commission shall, if the review indicates that   the child's household income does not exceed the maximum income for   eligibility for the medical assistance program, provide for a   second consecutive period of eligibility for the child until the   child's required annual recertification, except as provided by   Subsection (h) and subject to Subsection (c); or                (2)  the commission may, if the review indicates that   the child's household income exceeds the maximum income for   eligibility for the medical assistance program, request additional   documentation to verify the child's household income in a manner   that complies with federal law.          (f)  If, after reviewing a child's household income under   Subsection (e), the commission determines that the household income   exceeds the maximum income for eligibility for the medical   assistance program, the commission shall continue to provide   medical assistance to the child until:                (1)  the commission provides the child's parent or   guardian with a period of not less than 30 days to provide   documentation demonstrating that the child's household income does   not exceed the maximum income for eligibility; and                (2)  the child's parent or guardian fails to provide the   documentation during the period described by Subdivision (1).          (g)  If a child's parent or guardian provides to the   commission within the period described by Subsection (f)   documentation demonstrating that the child's household income does   not exceed the maximum income for eligibility for the medical   assistance program, the commission shall provide for a second   consecutive period of eligibility for the child until the child's   required annual recertification, except as provided by Subsection   (h) and subject to Subsection (c).          (h)  Notwithstanding any other period prescribed by this   section, a child's eligibility for medical assistance ends on the   child's 19th birthday.          (i)  The commission may not recertify a child's eligibility   for medical assistance more frequently than every 12 months as   required by federal law.          (j)  If a child's parent or guardian fails to provide to the   commission within the period described by Subsection (f)   documentation demonstrating that the child's household income does   not exceed the maximum income for eligibility for the medical   assistance program, the commission shall provide the child's parent   or guardian with written notice of termination following that   period. The notice must include a statement that the child may be   eligible for enrollment in the child health plan under Chapter 62,   Health and Safety Code.          (k)  In developing the notice, the commission shall consult   with health care providers, children's health care advocates,   family members of children enrolled in the medical assistance   program, and other stakeholders to determine the most user-friendly   method to provide the notice to a child's parent or guardian.          (l)  The executive commissioner may adopt rules as necessary   to implement this section.          Explanation: This addition is necessary to provide for   continuous eligibility and a periodic eligibility review for a   child for Medicaid.