CHAPTER 63. HEALTH BENEFITS PLAN FOR CERTAIN CHILDREN - Texas Statutes

HEALTH AND SAFETY CODE

TITLE 2. HEALTH

SUBTITLE C. PROGRAMS PROVIDING HEALTH CARE BENEFITS AND SERVICES

CHAPTER 63. HEALTH BENEFITS PLAN FOR CERTAIN CHILDREN

Sec. 63.001. DEFINITION. In this chapter, "commission" means

the Health and Human Services Commission.

Added by Acts 1999, 76th Leg., ch. 235, Sec. 1, eff. Aug. 30,

1999.

Sec. 63.002. NOT AN ENTITLEMENT. This chapter does not

establish an entitlement to assistance in obtaining health

benefits for a child.

Added by Acts 1999, 76th Leg., ch. 235, Sec. 1, eff. Aug. 30,

1999.

Sec. 63.003. HEALTH BENEFITS PLAN COVERAGE FOR CERTAIN CHILDREN.

The commission shall develop and implement a program to provide

health benefits plan coverage for a child who:

(1) is a qualified alien, as that term is defined by 8 U.S.C.

Section 1641(b);

(2) is younger than 19 years of age;

(3) entered the United States after August 22, 1996;

(4) has resided in the United States for less than five years;

and

(5) meets the income eligibility requirement of, but is not

eligible for assistance under:

(A) the child health plan program under Chapter 62; or

(B) the medical assistance program under Chapter 32, Human

Resources Code.

Added by Acts 1999, 76th Leg., ch. 235, Sec. 1, eff. Aug. 30,

1999.

Sec. 63.004. BENEFITS COVERAGE REQUIRED. To the extent

possible, the program required by Section 63.003 must provide

benefits comparable to the benefits provided under the child

health plan program under Chapter 62.

Added by Acts 1999, 76th Leg., ch. 235, Sec. 1, eff. Aug. 30,

1999.

Sec. 63.005. HEALTH BENEFITS PLAN PROVIDER. (a) A health

benefits plan provider under this chapter must:

(1) hold a certificate of authority or other appropriate license

issued by the Texas Department of Insurance that authorizes the

health benefits plan provider to provide the type of coverage to

be offered through the program required by Section 63.003; and

(2) satisfy, except as provided by Subsection (b), any other

applicable requirement of the Insurance Code or another insurance

law of this state.

(b) Except as required by the commission, a health benefits plan

provider under this chapter is not subject to a law that requires

coverage or the offer of coverage of a health care service or

benefit.

Added by Acts 1999, 76th Leg., ch. 235, Sec. 1, eff. Aug. 30,

1999.

Sec. 63.006. COST-SHARING PAYMENTS. (a) Except as provided by

Subsection (b), the commission may not require a child who is

provided health benefits plan coverage under Section 63.003 and

who meets the income eligibility requirement of the medical

assistance program under Chapter 32, Human Resources Code, to pay

a premium, deductible, coinsurance, or other cost-sharing payment

as a condition of health benefits plan coverage under this

chapter.

(b) The commission may require a child described by Subsection

(a) to pay a copayment as a condition of health benefits plan

coverage under this chapter that is equal to any copayment

required under the child health plan program under Chapter 62.

(c) The commission may require a child who is provided health

benefits plan coverage under Section 63.003 and who meets the

income eligibility requirement of the child health plan program

under Chapter 62 to pay a premium, deductible, coinsurance, or

other cost-sharing payment as a condition of health benefits plan

coverage under this chapter. The payment must be equal to any

premium, deductible, coinsurance, or other cost-sharing payment

required under the child health plan program under Chapter 62.

Added by Acts 1999, 76th Leg., ch. 235, Sec. 1, eff. Aug. 30,

1999.

Sec. 63.007. DISALLOWANCE OF MATCHING FUNDS FROM FEDERAL

GOVERNMENT. Expenditures made to provide health benefits plan

coverage under this chapter may not be included for the purpose

of determining the state children's health insurance

expenditures, as that term is defined by 42 U.S.C. Section

1397ee(d)(2)(B), as amended.

Added by Acts 1999, 76th Leg., ch. 235, Sec. 1, eff. Aug. 30,

1999.