| (C) Those applicants or clients financially eligible
for CHIP, Medicaid, or other programs with eligibility income guidelines
that meet the program's eligibility income guidelines, and who also
meet the program age and residency requirements, will be considered
financially eligible. The applicant, client, or family must notify
the program, if the applicant or client is no longer eligible for
such programs.
(8) Determination of continuing eligibility for health
care benefits. Financial criteria for eligibility for health care
benefits must be re-established at least annually or as directed by
statute. Medical or dental criteria must be re-established at least
annually (i.e., within 365 days from the first day of the client's
initial date of program eligibility or within 366 days during a leap
year). Clients for health care benefits will be notified of program
deadlines for re-establishment of eligibility. If an ongoing client
for health care benefits does not meet program deadlines for submitting
information required for the determination of continuing eligibility,
the client's eligibility for health care benefits will end. If the
then former client re-applies to the program after such lapse in eligibility
and is determined eligible for health care benefits, the former client
will be considered a new client. If the program has a waiting list
for health care benefits, the new client will be placed on the waiting
list in order according to the date and time the client is determined
eligible for health care benefits.
(b) Eligibility for case management services. The
program may provide or reimburse for case management services to persons
in need of such services who are Texas residents and who are determined
not to have another primary provider or funding source for such services.
The program's case management services are focused on individuals
(and their families) who are eligible, seeking eligibility, or potentially
seeking eligibility for the program's health care benefits (this includes
clients who are on the waiting list for health care benefits). However,
the program may offer and provide case management services to individuals
(and their families) who are not eligible or not seeking eligibility
for the program's health care benefits.
|
| Source Note: The provisions of this §351.3 adopted to be effective July 1, 2001, 26 TexReg 2979; amended to be effective March 27, 2003, 28 TexReg 2523; amended to be effective June 1, 2006, 31 TexReg 4200; amended to be effective October 3, 2010, 35 TexReg 8921; amended to be effective April 21, 2013, 38 TexReg 2362; transferred effective March 15, 2022, as published in the February 25, 2022 issue of the Texas Register, 47 TexReg 982 |
