HBA-NRS H.B. 2069 77(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 2069 By: Kitchen Public Health 5/15/2001 Introduced BACKGROUND AND PURPOSE The federal Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) allows states the option of providing Medicaid benefits for children with severe disabilities who do not qualify for their state's Medicaid program based on their family's income level. The TEFRA option provides care to disabled children in their homes, which relieves the financial and emotional stress of parents of such children and can prevent more costly institutional care. Texas has not added the TEFRA option to its medical assistance program. House Bill 2069 requires the commissioner of health and human services to execute a study regarding the feasibility of incorporating the TEFRA option into the medical assistance program. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that this bill does not expressly delegate any additional rulemaking authority to a state officer, department, agency, or institution. ANALYSIS House Bill 2069 requires the commissioner of health and human services (commissioner) to conduct a study regarding the feasibility of expanding the medical assistance program to provide assistance to disabled children in accordance with the Medicaid eligibility option under the federal Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA). In conducting the study, the bill requires the commissioner to evaluate the number of children who would be eligible for medical assistance under TEFRA based on the severity of each child's disabilities, as determined by childhood disability standards and evidence requirements established for Supplemental Security Income, and a determination of whether each disabled child requires the level of care provided in a hospital, skilled nursing facility, or intermediate care facility. The bill requires the commissioner, in conducting the study, to evaluate the effect of other health insurance coverage provided for children who would be eligible for medical assistance under TEFRA on the cost of expanding the medical assistance program. In conducting the study, the commissioner is also required to evaluate utilization patterns of similar populations of disabled children under similar programs in this state and other states, the cost to the state of inappropriate institutionalization of disabled children in hospitals, nursing facilities, intermediate care facilities that results from unavailability of health insurance coverage for those children, and options for gradual implementation of the medical assistance program expansion. Not later than December 1, 2002, the bill requires the commissioner to submit a report to the legislature regarding the results of the study, which must include a recommendation regarding expanding the medical assistance program. EFFECTIVE DATE September 1, 2001.