26 Tex. Admin. Code § 554.410

Current through Reg. 49, No. 25; June 21, 2024
Section 554.410 - Refunds in Medicaid-Certified Facilities
(a) The nursing facility must refund private funds paid to the facility for periods covered by Medicaid, including retroactive periods of Medicaid coverage, when:
(1) the Medicaid vendor payment has been accepted by the nursing facility; or
(2) the nursing facility has been notified by HHSC about an individual's eligibility for Medicaid.
(b) The nursing facility must make the refund within 30 days of:
(1) notification of eligibility for nursing home coverage;
(2) notification of correction of applied income; or
(3) receipt of any vendor payment from HHSC for any covered period.
(c) When the facility becomes aware of the need for a refund as indicated in subsection (a) of this section, facility staff must write to the resident or resident representative, notifying the resident about the right to a refund and the amount due.

26 Tex. Admin. Code § 554.410

The provisions of this §19.410 adopted to be effective May 1, 1995, 20 TexReg 2393; Amended by Texas Register, Volume 45, Number 12, March 20, 2020, TexReg 2036, eff. 3/24/2020; Entire chapter transferred from Title 40, Pt. 1, Ch. 19 by Texas Register, Volume 45, Number 50, December 11, 2020, TexReg 8871, eff. 1/15/2021