(a) The following prior authorized Medical Transportation
Program (MTP) clients are eligible to receive reasonable transportation
to covered health care services if no other means of transportation
are available, the mode of transportation is the most cost-effective
mode available, and the facility is reasonably close and meets the
client's health care needs:
(1) current Medicaid clients authorized and identified
by the Health and Human Services Commission (HHSC) as eligible for
Medicaid services under a specific category;
(2) Children with Special Health Care Needs (CSHCN)
services program clients; and
(3) Transportation for Indigent Cancer Patients (TICP)
Program clients.
(b) Eligibility for participation in the TICP Program
must be determined by HHSC. The individual:
(1) must reside in Webb, Zapata, Starr, Jim Hogg, Hidalgo,
Cameron, Willacy, or Nueces County and provide a copy of a federal
or state ID (driver's license or identification card) and one of the
following as proof of residency:
(A) a copy of a utility bill under the applicant's
name; or
(B) if residing with a family member, a written verification
from that family member stating that the applicant resides in the
household and proof that the household is in an eligible county;
(2) must not be eligible for Medicaid;
(3) must not be eligible for CSHCN services program;
(4) must be at or below 100% of federal poverty guidelines.
Before program services are provided, the monthly household gross
income shall be verified by:
(A) financial information obtained through HHSC;
(B) check stub or other written verification for each
person in the household who is employed. This form must contain the
name, address of employer, income and dates covered for each pay period;
or
(C) award letter or other written verification of unearned
income (such as Social Security, Worker's Compensation, Unemployment
or Veteran's Administration benefits);
(5) is permitted the following allowable deductions
from the total monthly household gross income:
(A) $120 standard deduction per person in household
who is employed (the standard deduction per person will be the rate
set by HHSC); and
(B) dependent care:
(i) up to $200 per child under two years of age; or
(ii) up to $175 per child two years of age and older;
(6) is not permitted to take deductions on unearned
income;
(7) if over the age of 18 and residing with a family
member, the family member's household income is not considered. The
applicant's gross income, less standard deductions, is used to determine
the applicant's eligibility;
(8) has zero income and shall therefore submit written
verification from two family members or individuals who can attest
that the household receives no monthly earned or unearned income.
Unearned income refers to monetary assistance provided by family,
friends, charitable organizations, and such given to the client for
household expenses;
(9) must provide initial confirmation of cancer or
cancer-related diagnosis by a licensed medical physician to HHSC.
The following restrictions apply:
(A) the applicant is eligible for up to four diagnostic
visits to a licensed medical physician to determine cancer or cancer-related
diagnosis if HHSC is provided written verification that diagnostic
visits are to rule out the possibility of cancer or cancer-related
illness; and
(B) confirmation of cancer or cancer-related diagnosis
must be provided on or following the last diagnostic visit for transportation
services to continue; and
(10) must be accepted for evaluation or treatment by
a medical institution in Texas capable of providing quality cancer
services.
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Source Note: The provisions of this §380.201 adopted to be effective April 10, 2001, 26 TexReg 2720; amended to be effective May 11, 2003, 28 TexReg 3722; transferred effective March 1, 2004, as published in the Texas Register April 30, 2004, 29 TexReg 4267; amended to be effective August 6, 2013, 38 TexReg 4888; amended to be effective September 1, 2014, 39 TexReg 5731 |