|(a) Persons meeting the aforementioned eligibility
requirements must submit a complete application for benefits to the
department, on the form specified by the department, accompanied by
the required supporting documentation. A complete application shall
consist of all of the following:
(1) a complete Application for Services, with the original
signature of the applicant, or the person legally responsible for
the applicant, certifying that the statements made within the application
are factual and true;
(2) documentation of current Texas residency;
(3) documentation acceptable to the department to establish
the applicant's financial qualifications;
(4) verification that the applicant has a diagnosis
of HIV disease and is under the care of a physician licensed to practice
medicine in the United States of America, who prescribes drugs for
(b) Any application that does not meet all of the requirements
in subsection (a) of this section is considered incomplete. Incomplete
applications will not be processed further, and the applicant will
be contacted concerning the insufficiency of the application.
(c) To request an application packet, call toll-free
1-800-255-1090 or write to: Department of State Health Services, HIV/STD
Prevention and Care Branch, Texas HIV Medication Program, Attn: MSJA,
Mail Code 1873, P.O. Box 149347, Austin, Texas 78714-9347. The program's
application for assistance is also available online at http://www.dshs.state.tx.us/hivstd/meds/.
(d) Submit completed application, along with accompanying
documentation and certification forms, to: Department of State Health
Services, HIV/STD Prevention and Care Branch, Texas HIV Medication
Program, Attn: MSJA, Mail Code 1873, P.O. Box 149347, Austin, Texas
(e) The applicant is expected to give informed consent
to the department so that the program may contact a medical provider,
Medicare, or Medicare prescription drug plan to verify information
contained in the application and/or to request additional supporting
documentation pertaining to the application.
(f) The department may, at any time, verify the eligibility
status of an enrolled recipient to determine if the recipient is continuing
to meet the eligibility criteria of the program. The recipient must
cooperate with the department, and furnish requested documentation
to the department as directed.
(g) A recipient must renew enrollment in the program
every three years according to the procedures established by the department.
Recipient must demonstrate, at that time, continuing eligibility for
the program to the satisfaction of the department. Recipients must
use the department's renewal application form (which may be obtained
from the department calling toll-free 1-800-255-1090 or writing to:
Department of State Health Services, HIV/STD Prevention and Care Branch,
Texas HIV Medication Program, Attn: MSJA, Mail Code 1873, P.O. Box
149347, Austin, Texas 78714-9347), and comply with all associated
deadlines and requirements for accompanying documents.
|Source Note: The provisions of this §98.110 adopted to be effective August 28, 2003, 28 TexReg 6855; amended to be effective December 16, 2007, 32 TexReg 9128; amended to be effective November 20, 2013, 38 TexReg 8244