Bill > HB3910

This bill establishes a new process for presumptive eligibility for Medicaid medical assistance for individuals needing nursing facility care in Texas. Under the proposed law, nursing facilities can use a preliminary screening tool to make a reasonable determination about whether an applicant meets the medical necessity criteria for nursing facility care and is likely to be eligible for Medicaid. If approved, applicants will receive medical assistance benefits for up to 90 days while their full application is being processed. Applicants must sign an agreement attesting to the accuracy of their provided information and complete a full medical assistance application. The Texas Health and Human Services Commission must make a final eligibility determination within 45 days, and if they fail to do so, they may be required to reimburse the nursing facility for services provided during the presumptive eligibility period. If the applicant is ultimately found ineligible, the nursing facility must repay any reimbursements received. The bill requires the executive commissioner to develop rules for implementing this process and allows for potential delays if federal waivers are necessary. The provisions of this bill are set to take effect on September 1, 2025.

Health and Social Services

https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB3910