2023 Texas Statutes › Human Resources Code › Title 2 - Human Services and Protective Services in General › Subtitle C - Assistance Programs › Chapter 32 - Medical Assistance Program › Subchapter B. Administrative Provisions › Section 32.0246. Medical Assistance Reimbursement for Certain Behavioral Health and Physical Health Services

Text of section effective on April 01, 2025
Sec. 32.0246.  MEDICAL ASSISTANCE REIMBURSEMENT FOR CERTAIN BEHAVIORAL HEALTH AND PHYSICAL HEALTH SERVICES.  (a)  In this section, "behavioral health services" has the meaning assigned by Section 540.0703(a), Government Code, and includes targeted case management and psychiatric rehabilitation services.
(b)  The commission shall provide to a public or private provider of behavioral health services medical assistance reimbursement through a fee-for-service delivery model for behavioral health or physical health services provided to a recipient before that recipient's enrollment with and receipt of medical assistance services through a managed care organization under Chapter 540 or 540A, Government Code, as applicable.
(c)  The commission shall ensure that a public or private provider of behavioral health services who is reimbursed under Subsection (b) through a fee-for-service delivery model is provided medical assistance reimbursement through a managed care model for behavioral health or physical health services provided to a recipient after that recipient's enrollment with and receipt of medical assistance services through a managed care organization under Chapter 540 or 540A, Government Code, as applicable.
Added by Acts 2021, 87th Leg., R.S., Ch. 966 (S.B. 1921), Sec. 1, eff. September 1, 2022.
Amended by:
Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 2.80, eff. April 1, 2025.
Sec. 32.0247.  MEDICAL ASSISTANCE FOR CERTAIN PERSONS MAKING TRANSITION FROM FOSTER CARE TO INDEPENDENT LIVING.  (a)  In this section, "independent foster care adolescent" has the meaning assigned by 42 U.S.C. Section 1396d(w)(1), as amended.
(b)  The commission shall provide medical assistance, in accordance with commission rules, to an independent foster care adolescent who:
(1)  is not otherwise eligible for medical assistance; and
(2)  is not covered by a health benefits plan offering adequate benefits, as determined by the commission.
(c)  To the extent allowed by federal law, the executive commissioner shall by rule establish a specific set of income, assets, or resources allowable for recipients under this section.  The income level shall not be less than 200 percent or more than 400 percent of the federal poverty level.  Allowable asset or resource levels shall not be less than:
(1)  the levels allowed for individuals who are in foster care; and
(2)  the levels allowed for a person under 19 years of age who is eligible for the medical assistance program.
(d)  In setting allowable income, asset, or resource levels, the executive commissioner shall, to the extent allowed by federal law, exclude:
(1)  any financial benefit used for the purpose of educational or vocational training, such as scholarships, student loans, or grants;
(2)  any financial benefit used for the purpose of housing; and
(3)  any grants or subsidies obtained as a result of the Foster Care Independence Act of 1999 (Pub.  L. No. 106-169).
(e)  The Department of Family and Protective Services shall certify the income, assets, or resources of each individual on the date the individual exits substitute care.  An individual qualifying for medical assistance as established by this section shall remain eligible for the maximum period permitted under federal law before any recertification is required.
(f)  If recertification is required, the recertification process for individuals who are eligible for medical assistance under this section must:
(1)  comply with Section 32.024715; and
(2)  include the option of recertifying online or by mail or phone.
Added by Acts 2001, 77th Leg., ch. 1218, Sec. 1, eff. Sept. 1, 2001.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.087, eff. April 2, 2015.
Acts 2021, 87th Leg., R.S., Ch. 432 (S.B. 1059), Sec. 1, eff. September 1, 2021.