(a) This subchapter implements the requirements of
Texas Health & Human Services Commission (HHSC) under federal
and state law to:
(1) set forth the requirements of Medicaid applicants
and recipients, and representatives of applicants and recipients regarding
assignment, identification, and cooperation with HHSC in establishing
third party liability and recovery;
(2) set forth the rights, restrictions, and limitations
of providers to third party recovery; and
(3) establish the priority of distributions of third
party recoveries, including distributions into a trust established
under the provisions of the Social Security Act §1917(d)(4) (codified
at 42 U.S.C. §1396p(d)(4)).
(b) This subchapter applies:
(1) to Medicaid fee-for-service (FFS); and
(2) except for §354.2322(e) - (g) of this subchapter
(relating to Provider Billing and Recovery from Other Liable Third
Parties), §354.2331 of this subchapter (relating to Requests
for Information), §354.2332 of this subchapter (relating to Distribution
of Recoveries), and §354.2333 of this subchapter (relating to
Waiver Authority of the Executive Commissioner), to Medicaid managed
care.
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Source Note: The provisions of this §354.2301 adopted to be effective April 30, 1999, 24 TexReg 3083; transferred effective September 1, 2001, as published in the Texas Register May 24, 2002, 27 TexReg 4562; amended to be effective March 28, 2004, 29 TexReg 2867; amended to be effective February 22, 2024, 49 TexReg 855 |