Texas Administrative Code

Texas Administrative Code

TITLE 1	ADMINISTRATION
PART 15	TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 366	MEDICAID ELIGIBILITY FOR WOMEN, CHILDREN, YOUTH, AND NEEDY FAMILIES
SUBCHAPTER B	PRESUMPTIVE MEDICAID PROGRAM
DIVISION 4	OVERSIGHT
RULE §366.263	HHSC Responsibilities to Qualified Hospitals and Qualified Entities

(a) HHSC provides Medicaid during a presumptive eligibility period to individuals who are determined by a qualified hospital or qualified entity on the basis of preliminary information to be presumptively eligible for Medicaid.

(b) HHSC provides the qualified hospital or qualified entity with application forms for Medicaid and information on how to assist individuals in completing and filing such forms.

(c) HHSC establishes procedures to ensure that qualified hospitals and qualified entities adhere to the requirements in 42 C.F.R. §435.1102(b)(2) relating to:

(1) notifying an individual determined presumptively eligible orally and in writing of the presumptive eligibility determination and the effective dates of the presumptive eligibility period;

(2) providing the individual with a Medicaid application form;

(3) notifying HHSC of the presumptive eligibility determination;

(4) notifying an individual determined not presumptively eligible orally and in writing of the reason for the determination and that he or she can file an application for Medicaid with HHSC; and

(5) not delegating authority to determine presumptive eligibility to another entity.

Source Note: The provisions of this §366.263 adopted to be effective January 18, 2015, 40 TexReg 31