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
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 32.0212. 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 32.0249. 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 32.027. Selection of Provider of Medical Assistance
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 32.029. 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 32.0312. 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 32.0315. Funds for Graduate Medical Education
Section 32.0316. Electronic Transactions; Medicaid
Section 32.032. Prevention and Detection of Fraud and Abuse
Section 32.0322. Criminal History Record Information; Enrollment of Providers
Section 32.034. Contract Cancellation; Notice and Hearing
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 32.0423. 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 32.059. 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 32.067. 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