Tex. Hum. Res. Code § 32.064

Current with legislation from the 2023 Regular and Special Sessions signed by the Governor as of November 21, 2023.

Section 32.064 - [Effective 4/1/2025] Cost Sharing

(a) To the extent permitted under Title XIX, Social Security Act (42 U.S.C. Section 1396 et seq.), as amended, and any other applicable law or regulations, the executive commissioner shall adopt provisions requiring recipients of medical assistance to share the cost of medical assistance, including provisions requiring recipients to pay:

(1) an enrollment fee;

(2) a deductible; or

(3) coinsurance or a portion of the plan premium, if the recipients receive medical assistance under the Medicaid managed care program under Chapter 540 or 540A , Government Code, as applicable.

(b) Subject to Subsection (d), cost-sharing provisions adopted under this section shall ensure that families with higher levels of income are required to pay progressively higher percentages of the cost of the medical assistance.

(c) If cost-sharing provisions imposed under Subsection (a) include requirements that recipients pay a portion of the plan premium, the commission shall specify the manner in which the premium is paid. The commission may require that the premium be paid to the commission, an agency operating part of the medical assistance program, or the Medicaid managed care plan.

(d) Cost-sharing provisions adopted under this section may be determined based on the maximum level authorized under federal law and applied to income levels in a manner that minimizes administrative costs.

Tex. Hum. Res. Code § 32.064

Amended by Acts 2023, Texas Acts of the 88th Leg.- Regular Session, ch. 769,Sec. 2.87, eff. 4/1/2025.

Amended by Acts 2015, Texas Acts of the 84th Leg. - Regular Session, ch. 1,Sec. 4.138, eff. 4/2/2015.

Added by Acts 2003, 78th Leg., ch. 198, Sec. 2.112(a), eff. 9/1/2003.

This section is set out more than once due to postponed, multiple, or conflicting amendments.