HEALTH AND SAFETY CODE

TITLE 2. HEALTH

SUBTITLE B.  HEALTH PROGRAMS

CHAPTER 41. HEMOPHILIA

Sec. 41.001.  DEFINITIONS.  In this chapter:
(1)  "Hemophilia" means a human physical condition characterized by bleeding resulting from a genetically or hereditarily determined deficiency of a blood coagulation factor resulting in an abnormal or deficient plasma procoagulant.
(2)  "Other benefit" means a benefit, other than a benefit under this chapter, to which a person is entitled for payment of the costs of blood factor replacement products and other substances provided under this chapter, including benefits available from:
(A)  an insurance policy, group health plan, or prepaid medical or dental care plan;
(B)  Title XVIII or Title XIX of the Social Security Act (42 U.S.C. Sec. 1395 et seq. or 42 U.S.C. Sec. 1396 et seq.);
(C)  the United States Department of Veterans Affairs;
(D)  the TRICARE program of the United States Department of Defense;
(E)  workers' compensation or any compulsory employers' insurance program;
(F)  a public program created by federal law, state law, or the ordinances or rules of a municipality or political subdivision of the state, excluding benefits created by the establishment of a municipal or county hospital, a joint municipal-county hospital, a county hospital authority, a hospital district, or the facilities of a publicly supported medical school;  or
(G)  a cause of action for medical or dental expenses to a person applying for or receiving services from the department, or a settlement or judgment based on the cause of action, if the expenses are related to the need for services provided under this chapter.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Amended by: 
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0137, eff. April 2, 2015.

Sec. 41.002.  HEMOPHILIA ASSISTANCE PROGRAM.  (a)  The hemophilia assistance program is in the department to assist persons who have hemophilia and who require continuing treatment with blood factor replacement products, but who are unable to pay the entire cost of the treatment.
(b)  The executive commissioner shall establish standards of eligibility for assistance under this chapter in accordance with Section 41.004.
(c)  The department shall provide, through approved providers, financial assistance for medically eligible persons in obtaining blood factor replacement products and other substances for use in medical or dental facilities or in the home.
(d)  In addition to providing financial assistance under Subsection (c), the department may assist an eligible person in obtaining insurance by providing premium payment assistance.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Amended by: 
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0138, eff. April 2, 2015.
Acts 2015, 84th Leg., R.S., Ch. 704 (H.B. 1038), Sec. 1, eff. June 17, 2015.

Sec. 41.003.  ADMINISTRATION.  (a)  The commissioner may employ or appoint an administrator who shall carry out the hemophilia assistance program and report to the commissioner.
(b)  The administrator may employ two persons to help carry out the program.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 41.004.  FINANCIAL ELIGIBILITY.  (a)  A person is not eligible to receive services provided by this chapter:
(1)  to the extent that another person with a legal obligation to provide for the person's care and treatment is financially able to pay for all or part of the services provided by this chapter;  or
(2)  to the extent that the person or a person with a legal obligation to support the person is eligible for some other benefit that would pay for all or part of the services provided by this chapter.
(b)  When the application is made under this chapter or when the services are received, the person applying for or receiving services shall inform the department of any other benefit to which the person or any other person with a legal obligation to support the person may be entitled.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 41.005.  REIMBURSEMENT.  (a)  The department shall require a person receiving services under this chapter who is financially able to bear part of the expense, or a person who has a legal obligation to provide for the person's care and treatment and who is financially able to bear part of the expense, to pay for or reimburse the department for that part of the cost of the services provided to the person by the department.
(b)  A person who has received services that are covered by some other benefit, or any other person with a legal obligation to support that person, shall reimburse the department to the extent of the services provided when the other benefit is received.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 41.006.  RECOVERY OF COSTS.  (a)  The department may recover the cost of services provided under this chapter from a person who does not reimburse the department as required by Section 41.005 or from any third party who has a legal obligation to pay other benefits and to whom notice of the department's interest has been given.
(b)  At the request of the commissioner, the attorney general may bring suit in the appropriate court of Travis County on behalf of the department.
(c)  In a judgment in favor of the department, the court may award attorney's fees, court costs, and interest accruing from the date on which the department provides the service to the date on which the department is reimbursed.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.

Sec. 41.007.  FUNDING.  (a)  The department may accept gifts and grants from individuals, private or public organizations, or federal or local funds to support the hemophilia assistance program.
(b)  The department shall identify any potential sources of funding from federal grants or programs.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Amended by: 
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0139, eff. April 2, 2015.