HBA-DMH S.B. 43 77(R) BILL ANALYSIS Office of House Bill AnalysisS.B. 43 By: Zaffirini Public Health 5/1/2001 Engrossed BACKGROUND AND PURPOSE Under current law, the application process for children that are eligible for Medicaid can be complex and confusing for those required to go through the process. The state child health plan (CHIP) application process is much less complex. Simplifying the Medicaid enrollment process for children could increase the number of enrolled children, which could benefit the state by reducing the number of children absent from school and the number of parents unexpectedly missing work to care for a sick child. Senate Bill 43 modifies the application requirements for Medicaid to streamline the application and renewal process. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the Health and Human Services Commission in SECTION 3 (Section 32.0261, Human Resources Code) and SECTION 5 of this bill. ANALYSIS Senate Bill 43 amends the Human Resources Code to require the Health and Human Services Commission (HHSC) to adopt application forms and procedures for a request for medical assistance provided to children under 19 years of age (child) that are similar to application forms and procedures adopted under the state child health plan (CHIP). The bill requires HHSC to permit an application requesting medical assistance for a child to be conducted by mail instead of through a personal appearance at an HHSC office. In adopting rules, HHSC is required to ensure that documentation and verification procedures used in determining and certifying a child's eligibility and need for medical assistance, including the procedures used to evaluate the assets and resources of the child, the child's parents, or the child's other caretaker are the same as those used to determine and certify a child's eligibility for CHIP coverage. The bill provides the exception that the procedure adopted may not be more stringent than the procedures under CHIP existing on January 1, 2001. The bill also requires HHSC to permit a recertification review of the child's eligibility and need for medical assistance to be conducted by telephone or mail instead of in person. The bill requires HHSC to adopt rules, in accordance with federal law, not later than February 1, 2002, to provide for a period of continuous eligibility for a child under five years of age who is determined to be eligible for the medical assistance program. The bill requires that the rules provide that such a child remains eligible for medical assistance, without additional review by HHSC and regardless of changes in the child's resources or income, until the earlier of either the first anniversary of the date on which the child's eligibility was determined or the child's fifth birthday. To the extent funds are available for that purpose, the bill authorizes HHSC by rule to provide for an expansion of the continuous eligibility provisions to apply to older children who are determined to be eligible for medical assistance. In adopting rules, HHSC is required to specify the age groups to which the expansion applies and to ensure that the children are under 19 years of age. EFFECTIVE DATE January 1, 2002.