1 Tex. Admin. Code § 354.2301

Current through Register Vol. 49, No. 48, November 29, 2024

Section 354.2301 - Basis and Purpose

(a) This subchapter implements the requirements of Texas Health & Human Services Commission (HHSC) under federal and state law to:

(1) set forth the requirements of Medicaid applicants and recipients, and representatives of applicants and recipients regarding assignment, identification, and cooperation with HHSC in establishing third party liability and recovery;

(2) set forth the rights, restrictions, and limitations of providers to third party recovery; and

(3) establish the priority of distributions of third party recoveries, including distributions into a trust established under the provisions of the Social Security Act §1917(d)(4) (codified at 42 U.S.C. § 1396p(d)(4)).

(b) This subchapter applies:

(1) to Medicaid fee-for-service (FFS); and

(2) except for §354.2322(e) - (g) of this subchapter (relating to Provider Billing and Recovery from Other Liable Third Parties), § 354.2331 of this subchapter (relating to Requests for Information), § 354.2332 of this subchapter (relating to Distribution of Recoveries), and § 354.2333 of this subchapter (relating to Waiver Authority of the Executive Commissioner), to Medicaid managed care.

1 Tex. Admin. Code § 354.2301

The provisions of this §354.2301 adopted to be effective April 30, 1999, 24 TexReg 3083; transferred effective September 1, 2001, as published in the Texas Register May 24, 2002, 27 TexReg 4562; Amended to be effective March 28, 2004, 29 TexReg 2867; Amended by Texas Register, Volume 49, Number 07, February 16, 2024, TexReg 0855, eff. 2/22/2024