1 Tex. Admin. Code § 366.811 - Application Processing
(a) HHSC processes
Medically Needy Program 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 reconsiders the eligibility of a
recipient who is terminated for failure to submit a renewal form or necessary
information, so long as the recipient complies with the missed requirements
within 90 days after the date of termination. HHSC otherwise requires the
recipient to file a new application.
(g) 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.
(h) For a
pregnant 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 women who
provide postponed verifications by the 30th day after the application date;
and
(3) denies the coverage of
those who fail to meet the 30-day deadline.
(i) There are no conditions limiting the
designation of an authorized representative.
Notes
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