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.