Texas Statutes
Subchapter B. Administrative Provisions
Section 32.02613. Life Insurance Assets; Life Insurance Policy Conversion

Sec. 32.02613. LIFE INSURANCE ASSETS; LIFE INSURANCE POLICY CONVERSION. (a) For purposes of this section, "long-term care services and support" includes home health care, assisted living, and nursing facility services.
(b) The owner of a life insurance policy with a face amount of more than $10,000 may enter into a life settlement contract under Chapter 1111A, Insurance Code, for the benefit of a recipient of long-term care services and support in exchange for direct payments to:
(1) a health care provider for the provision of those services to that recipient; or
(2) the state to offset the costs of providing those services to that recipient under the medical assistance program.
(c) The proceeds of a life settlement contract entered into under this section must be used for the payment of long-term care services and support, except for the amount specified in Subsection (d)(1). To the extent feasible and allowed under federal law, the medical assistance program may act only as the secondary payor for long-term care services and support provided to a person who is eligible for medical assistance and for whose benefit an owner of a life insurance policy has entered into a life settlement contract under this section.
(d) In addition to the requirements under Chapter 1111A, Insurance Code, a life settlement contract entered into under this section must:
(1) provide that the lesser of five percent of the face amount of the life insurance policy or $5,000 is reserved and is payable to the owner's estate or a named beneficiary for funeral expenses;
(2) provide that the balance of proceeds under the life settlement contract that are unpaid on the death of the owner must be paid to the owner's estate or a named beneficiary; and
(3) specify the total amount payable for the benefit of the recipient of long-term care services and support under the life settlement contract.
(e) All proceeds of a life settlement contract entered into under this section must be held in an irrevocable state or federally insured account for the benefit of the recipient of long-term care services and support or for payment as otherwise required by this section.
(f) Only a recipient of long-term care services and support for whose benefit an owner enters into a life settlement contract under this section may choose the provider and type of services provided to the recipient and paid for out of an account described by Subsection (e). Any attempt by a person to require the recipient to choose a specific provider is strictly prohibited and constitutes an unfair method of competition or an unfair or deceptive act or practice under the Insurance Code.
(g) A person who enters into a life settlement contract with an owner of a life insurance policy under this section must maintain:
(1) a surety bond executed and issued by an insurer authorized to issue surety bonds in this state;
(2) a policy of errors and omissions insurance; or
(3) a deposit in the amount of $500,000 in any combination of cash, certificates of deposit, or securities.
(h) In accordance with the requirements of Chapter 1111A, Insurance Code, a life settlement contract provider who enters into life settlement contracts with owners of life insurance policies under this section must file with the Texas Department of Insurance:
(1) all life settlement contract forms used by the provider; and
(2) all advertising and marketing materials used by the provider.
(i) Section 1111A.022(a)(2)(A), Insurance Code, does not apply to a life insurance policy that is the subject of a life settlement contract entered into under this section if the contract has been in force at least five years.
(j) A claim against a life settlement contract provider with whom an owner of a life insurance policy enters into a life settlement contract under this section by the owner, the owner's estate, a named beneficiary, or any other person with respect to the contract may not exceed the face amount of the policy, less the proceeds paid under the contract, plus the total amount of premiums paid by the owner since entering into the contract. A life settlement contract provider must pay a claim under this subsection from the funds in an account described by Subsection (e).
(k) In accordance with Chapter 1111A, Insurance Code, the Texas Department of Insurance may conduct periodic market examinations of each life settlement contract provider who enters into a life settlement contract with an owner of a life insurance policy under this section.
(l) The commission shall educate applicants for long-term care services and support under the medical assistance program about options for life insurance policies, including options that do not allow a life insurance policy to be considered as an asset or resource in determining eligibility for medical assistance.
(m) The executive commissioner, in consultation with the commissioner of insurance, shall adopt rules necessary to implement this section. The rules must ensure that:
(1) proceeds from a life settlement contract are used to reimburse a provider of long-term care services and support or the state to offset the cost of medical assistance long-term care services and support;
(2) eligibility and need for medical assistance are determined without considering the balance of proceeds from a life settlement contract as provided in this section; and
(3) payments to a provider of long-term care services and support and applied income payments are made in accordance with this chapter.
(n) The entry into a life settlement contract by an owner of a life insurance policy under this section is not the only method by which the owner may avoid having the policy considered as an asset or resource in determining the eligibility of the owner for medical assistance.
(o) Notwithstanding the provisions of this section, the commission may not implement a provision of this section if the commission determines that implementation of the provision is not cost-effective or feasible.
Added by Acts 2013, 83rd Leg., R.S., Ch. 1001 (H.B. 2383), Sec. 1, eff. June 14, 2013.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.091, eff. April 2, 2015.

Structure Texas Statutes

Texas Statutes

Human Resources Code

Title 2 - Human Services and Protective Services in General

Subtitle C - Assistance Programs

Chapter 32 - Medical Assistance Program

Subchapter B. Administrative Provisions

Section 32.021. Administration of the Program

Section 32.0211. Restrictions on Executive Commissioners, Former Members of a Board, Commissioners, and Their Business Partners

Section 32.0212. Delivery of Medical Assistance

Section 32.0213. Nursing Facility Bed Certification and Decertification

Section 32.0214. Designations of Primary Care Provider by Certain Recipients

Section 32.0215. Home or Community Care Providers: Civil Monetary Penalties

Section 32.022. Medical and Hospital Care Advisory Committees

Section 32.023. Cooperation With Other State Agencies

Section 32.0231. Announcement of Funding or Program Change

Section 32.024. Authority and Scope of Program; Eligibility

Section 32.0241. Review of Waiver Request

Section 32.0242. Verification of Certain Information

Section 32.0244. Nursing Facility Beds in Certain Counties

Section 32.0245. Nursing Facility Beds for Certain Facilities Treating Alzheimer's Disease

Section 32.02451. Additional Personal Needs Allowance for Guardianship Expenses of Certain Recipients

Section 32.0246. Medical Assistance Reimbursement for Certain Behavioral Health and Physical Health Services

Section 32.02471. Medical Assistance for Certain Former Foster Care Adolescents Enrolled in Higher Education

Section 32.024715. Streamlined Eligibility Determination Process for Certain Former Foster Care Youth

Section 32.0249. Mental Health Screenings in Texas Health Steps Program

Section 32.025. Application for Medical Assistance

Section 32.0251. Eligibility Notification and Review for Certain Children

Section 32.0255. Transitional Medical Assistance

Section 32.0256. Continuation of Medical Assistance for Certain Individuals

Section 32.026. Certification of Eligibility and Need for Medical Assistance

Section 32.0261. Continuous Eligibility

Section 32.026101. Determination of Eligibility by Health Care Exchanges Prohibited

Section 32.02611. Exclusion of Assets in Prepaid Tuition Programs and Higher Education Savings Plans

Section 32.02613. Life Insurance Assets; Life Insurance Policy Conversion

Section 32.0262. Eligibility Transition

Section 32.0263. Health Care Orientation

Section 32.0264. Suspension and Reinstatement of Eligibility for Children in Juvenile Facilities

Section 32.0265. Notice of Certain Placements in Juvenile Facilities

Section 32.0266. Suspension, Termination, and Automatic Reinstatement of Eligibility for Individuals Confined in County Jails

Section 32.027. Selection of Provider of Medical Assistance

Section 32.0275. Military Medical Treatment Facilities and Affiliated Health Care Providers; Reimbursement

Section 32.028. Fees, Charges, and Rates

Section 32.0281. Rules and Notice Relating to Payment Rates

Section 32.0282. Public Hearing on Rates

Section 32.0284. Calculation of Payments Under Certain Supplemental Hospital Payment Programs

Section 32.0285. Calculation of Medical Education Add-on for Reimbursement of Teaching Hospitals That Provide Behavioral Health and Physical Health Services

Section 32.029. Methods of Payment

Section 32.0291. Prepayment Reviews and Payment Holds

Section 32.031. Receipt and Expenditure of Funds

Section 32.0311. Drug Reimbursement Under Certain Programs

Section 32.03115. Reimbursement for Medication-Assisted Treatment for Opioid or Substance Use Disorder

Section 32.0312. Reimbursement for Services Associated With Preventable Adverse Events

Section 32.0313. Induced Deliveries or Cesarean Sections Before 39th Week

Section 32.0314. Reimbursement for Durable Medical Equipment and Supplies

Section 32.03141. Authority of Advanced Practice Registered Nurses and Physician Assistants Regarding Durable Medical Equipment and Supplies

Section 32.0315. Funds for Graduate Medical Education

Section 32.0316. Electronic Transactions; Medicaid

Section 32.0317. Reimbursement for Services Provided Under School Health and Related Services Program

Section 32.032. Prevention and Detection of Fraud and Abuse

Section 32.0321. Surety Bond

Section 32.0322. Criminal History Record Information; Enrollment of Providers

Section 32.033. Subrogation

Section 32.034. Contract Cancellation; Notice and Hearing

Section 32.035. Appeals

Section 32.036. Program Payments Nonassignable and Exempt From Legal Process

Section 32.038. Collection of Insurance Payments

Section 32.0381. Icf-Iid Payment Rates

Section 32.039. Damages and Penalties

Section 32.0391. Criminal Offense

Section 32.040. Identification of Husband or Alleged Father

Section 32.042. Information Required From Health Insurers

Section 32.0421. Administrative Penalty for Failure to Provide Information

Section 32.0422. Health Insurance Premium Payment Reimbursement Program for Medical Assistance Recipients

Section 32.0423. Recovery of Reimbursements From Health Coverage Providers

Section 32.0424. Requirements of Third-Party Health Insurers

Section 32.04242. Payor of Last Resort

Section 32.0425. Reimbursement for Wheeled Mobility Systems

Section 32.043. Procurement Rules for Public Disproportionate Share Hospitals

Section 32.044. Group Purchasing for Disproportionate Share Hospitals

Section 32.045. Enhanced Reimbursement

Section 32.046. Sanctions and Penalties Related to the Provision of Pharmacy Products

Section 32.0461. Vendor Drug Program; Competitive Bidding

Section 32.0462. Vendor Drug Program; Pricing Standard

Section 32.0463. Medications and Medical Supplies

Section 32.047. Prohibition of Certain Health Care Service Providers

Section 32.048. Managed Care Information and Training Plan

Section 32.049. Managed Care Contract Compliance

Section 32.050. Dual Medicaid and Medicare Coverage

Section 32.051. Misdirected Billing

Section 32.052. Waiver Programs for Children With Disabilities or Special Health Care Needs

Section 32.0531. Pace Program Team

Section 32.0532. Pace Program Reimbursement Methodology

Section 32.0533. Data Collection: Pace and Star + Plus Medicaid Managed Care Programs

Section 32.054. Dental Services

Section 32.055. Catastrophic Case Management

Section 32.0551. Optimization of Case Management Systems

Section 32.056. Compliance With Texas Health Steps Comprehensive Care Program

Section 32.0561. Maternal Depression Screening

Section 32.057. Contracts for Disease Management Programs

Section 32.058. Limitation on Medical Assistance in Certain Alternative Community-Based Care Settings

Section 32.059. Use of Respiratory Therapists for Respiratory Therapy Services

Section 32.061. Community Attendant Services Program

Section 32.062. Admissibility of Certain Evidence Relating to Nursing Institutions

Section 32.063. Third-Party Billing Vendors

Section 32.0641. Recipient Accountability Provisions; Cost-Sharing Requirement to Improve Appropriate Utilization of Services

Section 32.067. Delivery of Comprehensive Care Services to Certain Recipients of Medical Assistance

Section 32.068. In-Person Evaluation Required for Certain Services

Section 32.069. Chronic Kidney Disease Management Initiative

Section 32.070. Audits of Providers

Section 32.0705. External Audits of Certain Medicaid Contractors Based on Risk

Section 32.071. Recipient and Provider Education

Section 32.072. Direct Access to Eye Health Care Services

Section 32.073. Health Information Technology Standards

Section 32.074. Access to Personal Emergency Response System

Section 32.075. Employment Assistance and Supported Employment

Section 32.076. Substitute Dentists