1 Tex. Admin. Code § 373.105 - Definitions
For the purposes of this chapter, the following words and terms have the following meanings, unless the context clearly indicates otherwise:
(1) Applied for Covered
Medicaid Long-Term Care Services--An individual or his or her representative
files an application, a nursing facility submits an admission notice and
medical necessity determination, or an individual elects Medicaid waiver
services, which results in a covered service being approved under
Medicaid.
(2) Claim--A right to
recover the total amount of Medicaid assistance paid for the following
services: nursing facility; Intermediate Care Facility for the Mentally
Retarded (ICF-MR); Home and Community-Based Services (§1915(c), SSA) and
Community Attendant Services (§1929(b), SSA); and all related hospital and
prescription drug services, provided from the time the decedent was 55 years of
age or older.
(3)
Cost-effective--Economical to the extent that the amount reasonably expected to
be recovered by the Medicaid Estate Recovery Program exceeds the cost of
recovery by the program as provided in this chapter.
(4) Decedent--A deceased individual who was
55 years of age or older at the time that covered Medicaid long-term care
assistance was received.
(5)
Effective date--March 1, 2005, the date on which these rules take effect under
§
2001.036, Government
Code.
(6) Estate--The real and
personal property of a decedent, both as such property originally existed and
as from time to time changed in form by sale, reinvestment, or otherwise, and
as augmented by any accretions and additions and substitutions that are
included in the definition of the probate estate found in §3(l),
Definitions and Use of Terms, Texas Probate Code.
(7) Federal Poverty Level--Income guidelines
established annually by the federal government.
(8) Heirs--Those persons, including the
surviving spouse, who are entitled under the statutes of descent and
distribution to the estate of a decedent who dies intestate, as defined in
§3(o), Definitions and Use of Terms, Texas Probate Code.
(9) Intestate--To die without leaving a valid
will.
(10) Legatee--Any person
entitled to a legacy under a will, as defined in §3(s), Definitions and
Use of Terms, Texas Probate Code.
(11) MERP--The Medicaid Estate Recovery
Program.
(12) Personal
Representative--Includes executor, independent executor, administrator,
temporary administrator, together with their successors as defined in
§3(aa), Definitions and Use of Terms, Texas Probate Code.
(13) Recipient--An individual who received
covered long-term care Medicaid services on or after the effective date of
these rules.
(14) Value of real
property--Property value determined by current year tax appraisal
district.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.