| (a) HHSC processes Pregnant Women's Medicaid applications
received electronically, by paper, or by telephone.
(b) HHSC allows any office of a state health and human
services agency to accept an initial application.
(c) HHSC contracts with third parties to accept applications
from hospital districts (including state-owned teaching hospitals),
federally qualified health centers, and county health departments.
(d) HHSC may conduct an interview with an initial applicant.
(e) HHSC reopens a denied initial application, so long
as the applicant complies with the missed requirements within 60 days
after the date the application was submitted. HHSC otherwise requires
the applicant to file a new application.
(f) HHSC may reopen an application for three months
prior coverage if:
(1) within two years after the application was filed,
the applicant requests that the application be reopened; and
(2) a Medicaid eligibility determination was not previously
made for the three-month prior period.
(g) For an applicant who is potentially eligible but
unable to provide proof of eligibility, HHSC:
(1) postpones verifications and provides Medicaid coverage
to ensure access to medical care within 30 days after the application
date;
(2) continues the coverage of an applicant who provides
postponed verification by the 30th day after the application date;
and
(3) denies the coverage of an applicant who fails to
meet the 30-day deadline.
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