Tex. Health & Safety Code Section 62.153
Cost Sharing

(a)

To the extent permitted under 42 U.S.C. Section 1397cc, as amended, and any other applicable law or regulations, the executive commissioner shall require enrollees to share the cost of the child health plan, including provisions requiring enrollees under the child health plan to pay:

(1)

a copayment for services provided under the plan;

(2)

an enrollment fee; or

(3)

a portion of the plan premium.

(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 plan.

(c)

If cost-sharing provisions imposed under Subsection (a) include requirements that enrollees pay a portion of the plan premium, the executive commissioner shall specify the manner in which the premium is paid. The commission may require that the premium be paid to the health plan provider.

(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.
Added by Acts 1999, 76th Leg., ch. 235, Sec. 1, eff. Aug. 30, 1999. Amended by Acts 2003, 78th Leg., ch. 198, Sec. 2.50, eff. Sept. 1, 2003.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0203, eff. April 2, 2015.

Source: Section 62.153 — Cost Sharing, https://statutes.­capitol.­texas.­gov/Docs/HS/htm/HS.­62.­htm#62.­153 (accessed Apr. 20, 2024).

62.001
Objective of the State Child Health Plan 62.002
Definitions 62.003
Not an Entitlement 62.004
Federal Law and Regulations 62.051
Duties of Executive Commissioner and Commission in General 62.052
Authority of Commission Relating to Health Plan Provider Contracts 62.053
Authority of Commission Relating to Eligibility and Medicaid Coordination 62.054
Duties of Texas Department of Insurance 62.055
Contracts for Implementation of Child Health Plan 62.056
Community Outreach Campaign 62.058
Fraud Prevention 62.060
Health Information Technology Standards 62.101
Eligibility 62.102
Continuous Coverage 62.103
Application Form and Procedures 62.104
Eligibility Screening and Enrollment 62.105
Coverage for Qualified Aliens 62.106
Suspension and Automatic Reinstatement of Eligibility for Children in Juvenile Facilities 62.107
Notice of Certain Placements in Juvenile Facilities 62.151
Child Health Plan Coverage 62.152
Application of Insurance Law 62.153
Cost Sharing 62.154
Waiting Period 62.155
Health Plan Providers 62.156
Health Care Providers 62.157
Telemedicine Medical Services, Teledentistry Dental Services, and Telehealth Services for Children with Special Health Care Needs 62.158
State Taxes 62.159
Disease Management Services 62.0531
Authority of Commission Relating to Third Party Administrator 62.0582
Third-party Billing Vendors 62.1011
Verification of Income 62.1015
Eligibility of Certain Children 62.1511
Coverage for Maternal Depression Screening 62.1551
Inclusion of Certain Health Care Providers in Provider Networks 62.1561
Prohibition of Certain Health Care Providers 62.1571
Telemedicine Medical Services, Teledentistry Dental Services, and Telehealth Services
Green check means up to date. Up to date

Accessed:
Apr. 20, 2024

§ 62.153’s source at texas​.gov