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 Jun. 5, 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

Accessed:
Jun. 5, 2024

§ 62.153’s source at texas​.gov