The following words and terms, when used in this subchapter
shall have the following meanings, unless the context clearly indicates
otherwise.
(1) Act--The Texas Primary Health Care Services Act,
Health and Safety Code, Chapter 31.
(2) Applicant--An individual and/or family applying
to receive primary health care services.
(3) Commission--The Texas Health and Human Services
Commission.
(4) Commissioner--The Commissioner of Health.
(5) Department--The Department of State Health Services.
(6) Eligible individual--An eligible recipient of primary
health care services under the Act.
(7) Other benefit--A benefit, other than a benefit
provided under the Act, to which an individual is entitled for payment
of the costs of primary health care services, including:
(A) benefits available from:
(i) an insurance policy, group health plan, or prepaid
medical care plan;
(ii) Title XVIII or Title XIX of the Social Security
Act;
(iii) the Veterans Administration;
(iv) the Civilian Health and Medical Program of the
Uniformed Services; and
(v) workers compensation or any other compulsory employer's
insurance program.
(B) a public program created by federal or state law,
or by an ordinance or rule of a municipality or political subdivision
of the state, except those benefits created by the establishment of
a city or county hospital, a joint city-county hospital, a county
hospital authority, a hospital district, or by the facilities of a
publicly supported medical school; or
(C) benefits resulting from a cause of action for medical,
facility, or medical transportation expenses, or a settlement or judgment
based on the cause of action, if the expenses are related to the need
for services provided by the Act.
(8) Primary Health Care Services--May include the following:
(A) diagnosis and treatment;
(B) emergency medical services;
(C) family planning services;
(D) preventive health services;
(E) health education;
(F) laboratory, x-ray, nuclear medicine, or other appropriate
diagnostic services;
(G) nutrition services;
(H) health screening;
(I) home health care;
(J) dental care;
(K) transportation;
(L) prescription drugs and devices and durable supplies;
(M) environmental health services;
(N) podiatry services; and
(O) social services.
(9) Program--The primary health care services program
created by the Act.
(10) Provider--An entity that, through a grant or a
contract with the department, delivers primary health care services
that are purchased by the department for the purposes of the Act.
(11) Recipient--An individual receiving primary health
care services under the Act.
(12) Request for proposal--A solicitation providing
guidance and instructions issued by the department to entities interested
in submitting applications to provide primary health care services
under the Act.
(13) Services--Primary health care services.
(14) Texas resident--An individual who is physically
present within the geographic boundaries of the state, and who:
(A) intends to remain within the state, whether permanently
or for an indefinite period;
(B) does not claim residency in any other state or
country;
(C) is under 18 years of age, and at least one of his/her
parents, managing conservator, or guardian is a bona fide resident
of Texas;
(D) is a person residing in Texas and his/her legally
dependent spouse is a bona fide resident of Texas; or
(E) is an adult residing in Texas whose legal guardian
is a bona fide resident of Texas.
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| Source Note: The provisions of this §364.3 adopted to be effective May 28, 2006, 31 TexReg 4218; amended to be effective February 14, 2013, 38 TexReg 645; amended to be effective September 1, 2013, 38 TexReg 5505; transferred effective March 1, 2022, as published in the Texas Register February 11, 2022, 47 TexReg 674 |
