CHAPTER 41. HEMOPHILIA - Texas Statutes

HEALTH AND SAFETY CODE

TITLE 2. HEALTH

SUBTITLE B. TEXAS DEPARTMENT OF HEALTH PROGRAMS

CHAPTER 41. HEMOPHILIA

Sec. 41.001. DEFINITIONS. In this chapter:

(1) "Hemophilia" means a human physical condition characterized

by bleeding resulting from a genetically determined deficiency of

a blood coagulation factor or hereditarily resulting in an

abnormal or deficient plasma procoagulant.

(2) "Other benefit" means a benefit, other than a benefit under

this chapter, to which a person is entitled for payment of the

costs of blood, blood derivatives and concentrates, and other

substances provided under this chapter, including benefits

available from:

(A) an insurance policy, group health plan, or prepaid medical

or dental care plan;

(B) Title XVIII or Title XIX of the Social Security Act (42

U.S.C. Sec. 1395 et seq. or 42 U.S.C. Sec. 1396 et seq.);

(C) the Veterans Administration;

(D) the Civilian Health and Medical Program of the Uniformed

Services;

(E) workers' compensation or any compulsory employers' insurance

program;

(F) a public program created by federal law, state law, or the

ordinances or rules of a municipality or political subdivision of

the state, excluding benefits created by the establishment of a

municipal or county hospital, a joint municipal-county hospital,

a county hospital authority, a hospital district, or the

facilities of a publicly supported medical school; or

(G) a cause of action for medical or dental expenses to a person

applying for or receiving services from the department, or a

settlement or judgment based on the cause of action, if the

expenses are related to the need for services provided under this

chapter.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 41.002. HEMOPHILIA ASSISTANCE PROGRAM. (a) The hemophilia

assistance program is in the department to assist persons who

have hemophilia and who require continuing treatment with blood,

blood derivatives, or manufactured pharmaceutical products, but

who are unable to pay the entire cost of the treatment.

(b) The department shall establish standards of eligibility for

assistance under this chapter in accordance with Section 41.004.

(c) The department shall provide, through approved providers,

financial assistance for medically eligible persons in obtaining

blood, blood derivatives and concentrates, and other substances

for use in medical or dental facilities or in the home.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 41.003. ADMINISTRATION. (a) The commissioner may employ

or appoint an administrator who shall carry out the hemophilia

assistance program and report to the commissioner.

(b) The administrator may employ two persons to help carry out

the program.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 41.004. FINANCIAL ELIGIBILITY. (a) A person is not

eligible to receive services provided by this chapter:

(1) to the extent that another person with a legal obligation to

provide for the person's care and treatment is financially able

to pay for all or part of the services provided by this chapter;

or

(2) to the extent that the person or a person with a legal

obligation to support the person is eligible for some other

benefit that would pay for all or part of the services provided

by this chapter.

(b) When the application is made under this chapter or when the

services are received, the person applying for or receiving

services shall inform the department of any other benefit to

which the person or any other person with a legal obligation to

support the person may be entitled.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 41.005. REIMBURSEMENT. (a) The department shall require a

person receiving services under this chapter who is financially

able to bear part of the expense, or a person who has a legal

obligation to provide for the person's care and treatment and who

is financially able to bear part of the expense, to pay for or

reimburse the department for that part of the cost of the

services provided to the person by the department.

(b) A person who has received services that are covered by some

other benefit, or any other person with a legal obligation to

support that person, shall reimburse the department to the extent

of the services provided when the other benefit is received.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 41.006. RECOVERY OF COSTS. (a) The department may recover

the cost of services provided under this chapter from a person

who does not reimburse the department as required by Section

41.005 or from any third party who has a legal obligation to pay

other benefits and to whom notice of the department's interest

has been given.

(b) At the request of the commissioner, the attorney general may

bring suit in the appropriate court of Travis County on behalf of

the department.

(c) In a judgment in favor of the department, the court may

award attorney's fees, court costs, and interest accruing from

the date on which the department provides the service to the date

on which the department is reimbursed.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 41.007. FUNDING. (a) The department may accept gifts and

grants from individuals, private or public organizations, or

federal or local funds to support the hemophilia assistance

program.

(b) The department shall investigate any potential sources of

funding from federal grants or programs.

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.