Section 270.22 - Medicaid Capitation Payments(a) The provider agency must accept the Medicaid capitation payment as payment in full for all services to a Medicaid eligible client.(b) If the client is also a Medicare beneficiary, the Centers for Medicare and Medicaid Services will also pay a Medicare capitation payment to the provider agency.(c) An exception to subsection (a) of this section occurs when a client enters a nursing facility and the client has applied income. To receive this exception: (1) the provider agency must collect the client's applied income, unless the purpose of the stay is for the client to receive respite care; and(2) the applied income must be determined in accordance with §§15.100, 15.450, 15.501-15.503, and 15.506 of this title (relating to Definitions; General Principles Concerning Income; Vendor Living Arrangements; Allowable Deductions; Protection of Spousal Income and Resources; and Mandatory Payroll Deductions from Earned Income).26 Tex. Admin. Code § 270.22
Transferred from 40 TAC § 60.22 Texas Register, Volume 49, Number 27, July 5, 2024, TexReg 4934, eff. 7/31/2024