Tex. Fam. Code Section 154.1826
Health Care Program for Certain Children in Title Iv-d Cases


(a)

In this section:

(1)

“Health benefit plan issuer” means an insurer, health maintenance organization, or other entity authorized to provide health benefits coverage under the laws of this state.

(2)

“Health care provider” means a physician or other person who is licensed, certified, or otherwise authorized to provide a health care service in this state.

(3)

“Program” means the child health care program developed under this section.

(4)

“Reasonable cost” has the meaning assigned by Section 154.181 (Medical Support Order)(e).

(5)

“Third-party administrator” means a person who is not a health benefit plan issuer or agent of a health benefit plan issuer and who provides administrative services for the program, including processing enrollment of eligible children in the program and processing premium payments on behalf of the program.

(b)

In consultation with the Texas Department of Insurance, the Health and Human Services Commission, and representatives of the insurance industry in this state, the Title IV-D agency shall develop and implement a statewide program to address the health care needs of children in Title IV-D cases for whom health insurance is not available to either parent at reasonable cost under Section 154.182 (Health Care Coverage for Child)(b)(1) or under Section 154.182 (Health Care Coverage for Child)(b)(2) from a source other than the program.

(c)

The director of the Title IV-D agency may establish an advisory committee to consult with the director regarding the implementation and operation of the program. If the director establishes an advisory committee, the director may appoint any of the following persons to the advisory committee:

(1)

representatives of appropriate public and private entities, including state agencies concerned with health care management;

(2)

members of the judiciary;

(3)

members of the legislature; and

(4)

representatives of the insurance industry.

(d)

The principal objective of the program is to provide basic health care services, including office visits with health care providers, hospitalization, and diagnostic and emergency services, to eligible children in Title IV-D cases at reasonable cost to the parents obligated by court order to provide medical support for the children.

(e)

The Title IV-D agency may use available private resources, including gifts and grants, in administering the program.

(f)

The Title IV-D agency shall adopt rules as necessary to implement the program. The Title IV-D agency shall consult with the Texas Department of Insurance and the Health and Human Services Commission in establishing policies and procedures for the administration of the program and in determining appropriate benefits to be provided under the program.

(g)

A health benefit plan issuer that participates in the program may not deny health care coverage under the program to eligible children because of preexisting conditions or chronic illnesses. A child who is determined to be eligible for coverage under the program continues to be eligible until the termination of the parent’s duty to pay child support as specified by Section 154.006 (Termination of Duty of Support). Enrollment of a child in the program does not preclude the subsequent enrollment of the child in another health care plan that becomes available to the child’s parent at reasonable cost, including a health care plan available through the parent’s employment or the state child health plan under Chapter 62 (Child Health Plan for Certain Low-income Children), Health and Safety Code.

(h)

The Title IV-D agency shall contract with an independent third-party administrator to provide necessary administrative services for operation of the program.

(i)

A person acting as a third-party administrator under Subsection (h) is not considered an administrator for purposes of Chapter 4151 (Third-party Administrators), Insurance Code.

(j)

The Title IV-D agency shall solicit applications for participation in the program from health benefit plan issuers that meet requirements specified by the agency. Each health benefit plan issuer that participates in the program must hold a certificate of authority issued by the Texas Department of Insurance.

(k)

The Title IV-D agency shall promptly notify the courts of this state when the program has been implemented and is available to provide for the health care needs of children described by Subsection (b). The notification must specify a date beginning on which children may be enrolled in the program.

(l)

On or after the date specified in the notification required by Subsection (k), a court that orders health care coverage for a child in a Title IV-D case shall order that the child be enrolled in the program authorized by this section unless other health insurance is available for the child at reasonable cost, including the state child health plan under Chapter 62 (Child Health Plan for Certain Low-income Children), Health and Safety Code.

(m)

Payment of premium costs for the enrollment of a child in the program may be enforced by the Title IV-D agency against the obligor by any means available for the enforcement of a child support obligation, including income withholding under Chapter 158 (Withholding from Earnings for Child Support).

(n)

The program is not subject to any provision of the Insurance Code or other law that requires coverage or the offer of coverage of a health care service or benefit.

(o)

Any health information obtained by the program, or by a third-party administrator providing program services, that is subject to the Health Insurance Portability and Accountability Act of 1996 (42 U.S.C. Section 1320d et seq.) or Chapter 181 (Medical Records Privacy), Health and Safety Code, is confidential and not open to public inspection. Any personally identifiable financial information or supporting documentation of a parent whose child is enrolled in the program that is obtained by the program, or by a third-party administrator providing program services, is confidential and not open to public inspection.
Added by Acts 2009, 81st Leg., R.S., Ch. 767 (S.B. 865), Sec. 9, eff. June 19, 2009.

Source: Section 154.1826 — Health Care Program for Certain Children in Title Iv-d Cases, https://statutes.­capitol.­texas.­gov/Docs/FA/htm/FA.­154.­htm#154.­1826 (accessed Mar. 23, 2024).

154.001
Support of Child
154.002
Child Support Through High School Graduation
154.003
Manner of Payment
154.004
Place of Payment
154.005
Payments of Support Obligation by Trust
154.006
Termination of Duty of Support
154.007
Order to Withhold Child Support from Income
154.008
Provision for Medical Support and Dental Support
154.009
Retroactive Child Support
154.010
No Discrimination Based on Marital Status of Parents or Sex
154.011
Support Not Conditioned on Possession or Access
154.012
Support Paid in Excess of Support Order
154.013
Continuation of Duty to Pay Support After Death of Obligee
154.014
Payments in Excess of Court-ordered Amount
154.015
Acceleration of Unpaid Child Support Obligation
154.016
Provision of Support in Event of Death of Parent
154.017
Employment Services-related Orders for Unemployed and Underemployed Obligors
154.061
Computing Net Monthly Income
154.062
Net Resources
154.063
Party to Furnish Information
154.064
Medical Support and Dental Support for Child Presumptively Provided by Obligor
154.065
Self-employment Income
154.066
Intentional Unemployment or Underemployment
154.067
Deemed Income
154.068
Wage and Salary Presumption
154.069
Net Resources of Spouse
154.070
Child Support Received by Obligor
154.121
Guidelines for the Support of a Child
154.122
Application of Guidelines Rebuttably Presumed in Best Interest of Child
154.123
Additional Factors for Court to Consider
154.124
Agreement Concerning Support
154.125
Application of Guidelines to Net Resources
154.126
Application of Guidelines to Additional Net Resources
154.127
Partial Termination of Support Obligation
154.128
Computing Support for Children in More than One Household
154.129
Alternative Method of Computing Support for Children in More than One Household
154.130
Findings in Child Support Order
154.131
Retroactive Child Support
154.132
Application of Guidelines to Children of Certain Disabled Obligors
154.133
Application of Guidelines to Children of Obligors Receiving Social Security
154.181
Medical Support Order
154.182
Health Care Coverage for Child
154.183
Medical and Dental Support Additional Support Duty of Obligor
154.184
Effect of Order
154.185
Parent to Furnish Information
154.186
Notice to Employer Concerning Medical Support or Dental Support
154.187
Duties of Employer
154.188
Failure to Provide or Pay for Required Health Insurance or Dental Insurance
154.189
Notice of Termination or Lapse of Insurance Coverage
154.190
Reenrolling Child for Insurance Coverage
154.191
Remedy Not Exclusive
154.192
Cancellation or Elimination of Insurance Coverage for Child
154.193
Medical Support Order or Dental Support Order Not Qualified
154.241
Local Registry
154.242
Payment or Transfer of Child Support Payments by Electronic Funds Transfer
154.243
Production of Child Support Payment Record
154.301
Definitions
154.302
Court-ordered Support for Disabled Child
154.303
Standing to Sue
154.304
General Procedure
154.305
Specific Procedures
154.307
Modification and Enforcement
154.308
Remedy Not Exclusive
154.309
Possession of or Access to Adult Disabled Child
154.0655
Imputation of Income
154.1815
Dental Support Order
154.1825
Dental Care Coverage for Child
154.1826
Health Care Program for Certain Children in Title Iv-d Cases
154.1827
Administrative Adjustment of Medical Support Order

Accessed:
Mar. 23, 2024

§ 154.1826’s source at texas​.gov