| (a) HHSC will provide assistance and cooperation to
recipients, attorneys and representatives of recipients who seek recovery
on behalf of HHSC for amounts owed to HHSC under this subchapter.
HHSC will provide information, evidence and documents required to
settle and receive judgment for the amounts owed HHSC and provide
appropriate and necessary releases and authorizations to settle and
distribute amounts owed to HHSC under this subchapter.
(b) HHSC is required to safeguard the best interests
of the recipient under the provisions of Social Security Act §1902(a)(19)
(codified at 42 U.S.C. §1396a(a)(19)).
(c) HHSC is required to provide safeguards which restrict
the use and disclosure of information concerning applicants and recipients
to purposes directly connected with the administration of the Medicaid
program under the provisions of Social Security Act §1902(a)(7)
(codified at 42 U.S.C. §1396a(a)(7)).
(d) Requests for information relating to third party
recoveries under this subchapter must fall within the requirements
of subsections (a) and (b) of this section.
(e) A recipient or an attorney or representative of
a recipient may request information relating to claims submitted or
paid or payable by HHSC, and records within the custody and control
of HHSC, as they relate to this subchapter if:
(1) the request is signed by the recipient or a person
with legal authority to act on behalf of the recipient; or
(2) the attorney or representative making the request
has filed a notice which complies with the requirements of §354.2315
of this subchapter (relating to Duty of Attorney or Representative
of a Recipient).
(f) HHSC will respond to all requests for information
within 10 business days from receipt of the request. HHSC will produce
records and provide information to a person making a request under
this section only if all requirements of this subsection are met.
HHSC will provide the requested information, if all requirements of
this subsection are met, within 15 business days from receipt of the
request.
(g) HHSC has no duty to produce records or to provide
information, which does not meet the requirements of this subsection,
or which would disclose information which HHSC is prohibited from
disclosing by state or federal law.
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| Source Note: The provisions of this §354.2331 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 |
