Texas Administrative Code
|PART 15||TEXAS HEALTH AND HUMAN SERVICES COMMISSION|
|CHAPTER 355||REIMBURSEMENT RATES|
|SUBCHAPTER J||PURCHASED HEALTH SERVICES|
|DIVISION 28||PHARMACY SERVICES: REIMBURSEMENT|
|RULE §355.8550||Third-Party Resources|
The Texas Vendor Drug Program assumes liability after Medicare or other third-party benefits are exhausted. Benefits available under the Texas Medical Assistance (Medicaid) Program are reduced to the extent that they are payable through other federal, state, or local program, insurance coverage, or third-party coverage to which the eligible recipient may be entitled, or to the extent coverage is provided under federal or state law. When these benefits are available, they are considered a resource. In agreement with the department, exceptions must be on an individual claim basis. Free benefits to recipients from other sources are considered a resource when determining what benefits, if any, are available under the Medicaid program.
|Source Note: The provisions of this §355.8550 adopted to be effective November 16, 1987, 12 TexReg 3553; transferred effective September 1, 1993, as published in the Texas Register September 7, 1993, 18 TexReg 5978; transferred effective September 1, 1997, as published in the Texas Register December 11, 1998, 23 TexReg 12660|