reglab/housing_qa huggingface dataset:
TX Hum Res Code § 32.036 (2021)
2021 Texas Statutes|Human Resources Code|Title 2 - Human Services and Protective Services in General|Subtitle C - Assistance Programs|Chapter 32 - Medical Assistance Program|Subchapter B. Administrative Provisions|Section 32.036. Program Payments Nonassignable and Exempt From Legal Process

Sec. 32.036.  PROGRAM PAYMENTS NONASSIGNABLE AND EXEMPT FROM LEGAL PROCESS.  (a)  Neither medical assistance nor payments to providers of medical assistance under this chapter are transferable or assignable at law or in equity.(b)  No money paid or payable under the provisions of this chapter is subject to execution, levy, attachment, garnishment, or any other legal process, or the operation of any insolvency law.(c)  This section does not apply to the extent that it conflicts with the Social Security Act (42 U.S.C. Section 1396a(a)(32)).|Acts 1979, 66th Leg., p. 2353, ch. 842, art. 1, Sec. 1, eff. Sept. 1, 1979.  Amended by Acts 1997, 75th Leg., ch. 216, Sec. 1, eff. May 23, 1997.|
TX Hum Res Code § 32.038 (2021)
2021 Texas Statutes|Human Resources Code|Title 2 - Human Services and Protective Services in General|Subtitle C - Assistance Programs|Chapter 32 - Medical Assistance Program|Subchapter B. Administrative Provisions|Section 32.038. Collection of Insurance Payments

Sec. 32.038.  COLLECTION OF INSURANCE PAYMENTS.  (a)  The commission may receive directly from an insurance company any payments to which the commission is entitled under Section 1204.153, Insurance Code.(b)  The executive commissioner shall adopt rules to implement this section, including rules establishing procedures relating to:(1)  notification to the commission that a child receiving benefits under Chapter 31 or this chapter is covered by an insurance policy under which the commission is eligible to receive direct payments;(2)  claims made by the commission to receive payments under Subsection (a);(3)  notification to the commission of any change in the status of the child or the parent; and(4)  notification to the insurance company that the commission is to receive payments under Subsection (a).(c)  Commission rules relating to the notice prescribed by Subsection (b)(4) must require the notice to be attached to the claim for insurance benefits when the claim is first submitted to the insurance company.|Added by Acts 1987, 70th Leg., ch. 1052, Sec. 2.03, eff. Sept. 1, 1987.Amended by: Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.128, eff. September 1, 2005.Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.112, eff. April 2, 2015.|
TX Hum Res Code § 32.0381 (2021)
2021 Texas Statutes|Human Resources Code|Title 2 - Human Services and Protective Services in General|Subtitle C - Assistance Programs|Chapter 32 - Medical Assistance Program|Subchapter B. Administrative Provisions|Section 32.0381. Icf-Iid Payment Rates

Sec. 32.0381.  ICF-IID PAYMENT RATES.  (a)  The executive commissioner shall set the payment rates for ICF-IID facilities at least annually.(b)  The executive commissioner shall adopt by rule the methodology used by the executive commissioner in setting payment rates for ICF-IID facilities.  The methodology shall clearly define the procedures and methods used in projecting the costs of economic and efficient facilities and the procedures and methods used in setting payment rates that reasonably reimburse facilities at each level of care and in each class of providers, including size categories.(c)  The executive commissioner shall ensure that the methodology used in projecting costs and setting payment rates and its implementation is the same for state-operated ICF-IID facilities and for private ICF-IID facilities.  Methods used to project costs, including those involving the handling of gifts, grants, and donations, upper limits on facility and administrative costs, occupancy adjustments, and in assessing the cost impact of new or revised requirements, must be the same for state-operated and private facilities.(d)  To the extent allowed by federal law, any differences in methodology or its implementation between state-operated facilities and private facilities must be stated explicitly in the rule, must be related to actual differences in the nature of the expenses incurred by the class of providers, including size categories, and must not favor state-operated facilities in setting payment rates.  When the proposed rule or amendments to the rule are published for public comment, the executive commissioner must certify that any differences in methodology between classes of providers, including size categories, are necessitated by cost structure and will not favor state-operated facilities in the setting of payment rates.|Added by Acts 1989, 71st Leg., ch. 1141, Sec. 11(a), eff. Sept. 1, 1989.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.112, eff. April 2, 2015.|
TX Hum Res Code § 32.0391 (2021)
2021 Texas Statutes|Human Resources Code|Title 2 - Human Services and Protective Services in General|Subtitle C - Assistance Programs|Chapter 32 - Medical Assistance Program|Subchapter B. Administrative Provisions|Section 32.0391. Criminal Offense

Sec. 32.0391.  CRIMINAL OFFENSE.  (a)  A person commits an offense if the person intentionally or knowingly commits a violation under Section 32.039(b)(1-b), (1-c), (1-d), (1-e), or (1-f).(b)  An offense under this section is a state jail felony.(c)  If conduct constituting an offense under this section also constitutes an offense under another provision of law, including a provision in the Penal Code, the person may be prosecuted under either this section or the other provision.(d)  With the consent of the appropriate local county or district attorney, the attorney general has concurrent jurisdiction with that consenting local prosecutor to prosecute an offense under this section.|Added by Acts 2003, 78th Leg., ch. 257, Sec. 6, eff. Sept. 1, 2003.Amended by: Acts 2007, 80th Leg., R.S., Ch. 127 (S.B. 1694), Sec. 3, eff. September 1, 2007.|
TX Hum Res Code § 32.040 (2021)
2021 Texas Statutes|Human Resources Code|Title 2 - Human Services and Protective Services in General|Subtitle C - Assistance Programs|Chapter 32 - Medical Assistance Program|Subchapter B. Administrative Provisions|Section 32.040. Identification of Husband or Alleged Father

Sec. 32.040.  IDENTIFICATION OF HUSBAND OR ALLEGED FATHER.  (a)  A woman receiving medical assistance in the form of prenatal care, child delivery care, and obstetrical care related to prenatal care and child delivery care shall identify her husband, or, if unmarried, shall provide the name and last known address of the alleged father of the unborn child.(b)  If the woman receiving medical assistance is under 18 years of age and resides with one or both parents, the parents shall cooperate in identifying the husband or the alleged father.|Added by Acts 1989, 71st Leg., 1st C.S., ch. 25, Sec. 37, eff. Jan. 1, 1990.|
TX Hum Res Code § 32.0421 (2021)
2021 Texas Statutes|Human Resources Code|Title 2 - Human Services and Protective Services in General|Subtitle C - Assistance Programs|Chapter 32 - Medical Assistance Program|Subchapter B. Administrative Provisions|Section 32.0421. Administrative Penalty for Failure to Provide Information

Sec. 32.0421.  ADMINISTRATIVE PENALTY FOR FAILURE TO PROVIDE INFORMATION.  (a)  The commission may impose an administrative penalty on a person who does not comply with a request for information made under Section 32.042(b).(b)  The amount of the penalty may not exceed $10,000 for each day of noncompliance that occurs after the 180th day after the date of the request.  The amount shall be based on:(1)  the seriousness of the violation, including the nature, circumstances, extent, and gravity of the violation;(2)  the economic harm caused by the violation;(3)  the history of previous violations;(4)  the amount necessary to deter a future violation;(5)  efforts to correct the violation;  and(6)  any other matter that justice may require.(c)  The enforcement of the penalty may be stayed during the time the order is under judicial review if the person pays the penalty to the clerk of the court or files a supersedeas bond with the court in the amount of the penalty.  A person who cannot afford to pay the penalty or file the bond may stay the enforcement by filing an affidavit in the manner required by the Texas Rules of Civil Procedure for a party who cannot afford to file security for costs, subject to the right of the commission to contest the affidavit as provided by those rules.(d)  The attorney general may sue to collect the penalty.(e)  A proceeding to impose the penalty is considered to be a contested case under Chapter 2001, Government Code.|Added by Acts 1999, 76th Leg., ch. 88, Sec. 2, eff. Sept. 1, 1999.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.116, eff. April 2, 2015.|
TX Hum Res Code § 32.0423 (2021)
2021 Texas Statutes|Human Resources Code|Title 2 - Human Services and Protective Services in General|Subtitle C - Assistance Programs|Chapter 32 - Medical Assistance Program|Subchapter B. Administrative Provisions|Section 32.0423. Recovery of Reimbursements From Health Coverage Providers

Sec. 32.0423.  RECOVERY OF REIMBURSEMENTS FROM HEALTH COVERAGE PROVIDERS.  To the extent allowed by federal law, a health care service provider must seek reimbursement from available third-party health coverage or insurance that the provider knows about or should know about before billing the medical assistance program.|Added by Acts 2003, 78th Leg., ch. 198, Sec. 2.106(a), eff. Sept. 1, 2003.|
TX Hum Res Code § 32.0424 (2021)
2021 Texas Statutes|Human Resources Code|Title 2 - Human Services and Protective Services in General|Subtitle C - Assistance Programs|Chapter 32 - Medical Assistance Program|Subchapter B. Administrative Provisions|Section 32.0424. Requirements of Third-Party Health Insurers

Sec. 32.0424.  REQUIREMENTS OF THIRD-PARTY HEALTH INSURERS.  (a)  A third-party health insurer is required to provide to the commission, on the commission's request, information in a form prescribed by the executive commissioner necessary to determine:(1)  the period during which an individual entitled to medical assistance, the individual's spouse, or the individual's dependents may be, or may have been, covered by coverage issued by the health insurer;(2)  the nature of the coverage; and(3)  the name, address, and identifying number of the health plan under which the person may be, or may have been, covered.(b)  A third-party health insurer shall accept the state's right of recovery and the assignment under Section 32.033 to the state of any right of an individual or other entity to payment from the third-party health insurer for an item or service for which payment was made under the medical assistance program.(c)  A third-party health insurer shall respond to any inquiry by the commission regarding a claim for payment for any health care item or service reimbursed by the commission under the medical assistance program not later than the third anniversary of the date the health care item or service was provided.(d)  A third-party health insurer may not deny a claim submitted by the commission or the commission's designee for which payment was made under the medical assistance program solely on the basis of the date of submission of the claim, the type or format of the claim form, or a failure to present proper documentation at the point of service that is the basis of the claim, if:(1)  the claim is submitted by the commission or the commission's designee not later than the third anniversary of the date the item or service was provided; and(2)  any action by the commission or the commission's designee to enforce the state's rights with respect to the claim is commenced not later than the sixth anniversary of the date the commission or the commission's designee submits the claim.(e)  This section does not limit the scope or amount of information required by Section 32.042.|Added by Acts 2009, 81st Leg., R.S., Ch. 745 (S.B. 531), Sec. 3, eff. September 1, 2009.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.118, eff. April 2, 2015.|
TX Hum Res Code § 32.04242 (2021)
2021 Texas Statutes|Human Resources Code|Title 2 - Human Services and Protective Services in General|Subtitle C - Assistance Programs|Chapter 32 - Medical Assistance Program|Subchapter B. Administrative Provisions|Section 32.04242. Payor of Last Resort

Sec. 32.04242.  PAYOR OF LAST RESORT.  The executive commissioner shall adopt rules to ensure, to the extent allowed by federal law, that the Medicaid program:(1)  is the payor of last resort; and(2)  provides reimbursement for services, including long-term care services, only if, and to the extent, other adequate public or private sources of payment are not available.|Added by Acts 2011, 82nd Leg., R.S., Ch. 821 (H.B. 2722), Sec. 1, eff. June 17, 2011.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.119, eff. April 2, 2015.|
TX Hum Res Code § 32.043 (2021)
2021 Texas Statutes|Human Resources Code|Title 2 - Human Services and Protective Services in General|Subtitle C - Assistance Programs|Chapter 32 - Medical Assistance Program|Subchapter B. Administrative Provisions|Section 32.043. Procurement Rules for Public Disproportionate Share Hospitals

Sec. 32.043.  PROCUREMENT RULES FOR PUBLIC DISPROPORTIONATE SHARE HOSPITALS.  (a)  A public hospital that is designated as a disproportionate share hospital during a fiscal year may acquire goods and services in accordance with this section during the succeeding fiscal year.  A procurement of goods or services made in accordance with this section is considered to satisfy any state law requiring purchases by competitive bidding or competitive proposals.(b)  The public hospital shall acquire goods or services by any procurement method approved by the commission that provides the best value to the public hospital.  The public hospital shall document that it considered all relevant factors under Subsection (c) in making the acquisition.(c)  The public hospital may consider all relevant factors in determining the best value, including:(1)  any installation costs;(2)  the delivery terms;(3)  the quality and reliability of the vendor's goods or services;(4)  the extent to which the goods or services meet the public hospital's needs;(5)  indicators of probable vendor performance under the contract such as past vendor performance, the vendor's financial resources and ability to perform, the vendor's experience and responsibility, and the vendor's ability to provide reliable maintenance agreements;(6)  the impact on the ability of the public hospital to comply with laws and rules relating to historically underutilized businesses or relating to the procurement of goods and services from persons with disabilities;(7)  the total long-term cost to the public hospital of acquiring the vendor's goods or services;(8)  the cost of any employee training associated with the acquisition;(9)  the effect of an acquisition on the public hospital's productivity;(10)  the acquisition price;  and(11)  any other factor relevant to determining the best value for the public hospital in the context of a particular acquisition.(d)  The state auditor or the commission may audit the public hospital's acquisitions of goods and services to the extent that state money or federal money appropriated by the state is used to acquire the goods and services.(e)  The public hospital may adopt rules and procedures for the acquisition of goods and services under this section.|Added by Acts 1997, 75th Leg., ch. 1045, Sec. 2, eff. Sept. 1, 1997.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.122, eff. April 2, 2015.|
TX Hum Res Code § 32.044 (2021)
2021 Texas Statutes|Human Resources Code|Title 2 - Human Services and Protective Services in General|Subtitle C - Assistance Programs|Chapter 32 - Medical Assistance Program|Subchapter B. Administrative Provisions|Section 32.044. Group Purchasing for Disproportionate Share Hospitals

Sec. 32.044.  GROUP PURCHASING FOR DISPROPORTIONATE SHARE HOSPITALS.  (a)  A public or private hospital that is designated as a disproportionate share hospital during a fiscal year may purchase goods and services in accordance with this section during the succeeding fiscal year.  A purchase of goods or services made in accordance with this section is considered to satisfy any state law requiring purchases by competitive bidding or competitive proposals.(b)  A state or local governmental entity may allow the public or private hospital to purchase goods or services by participating in one or more of the entity's contracts for the purchase of goods or services.(c)  The public or private hospital may purchase goods or services in accordance with this section through a group purchasing program that offers discount prices to hospitals or other providers of health care services.(d)  The executive commissioner with the assistance of the comptroller shall adopt rules under this section that allow the public or private hospital to make purchases through group purchasing programs except when the commission has reason to believe that a better value is available through another procurement method.(e)  This section applies to private hospitals only to the extent it authorizes private hospitals to participate in purchasing contracts with governmental entities or to satisfy any state law that may require goods and services the hospital purchases to be competitively procured.  This section does not impose new purchasing requirements on a private hospital, except to the extent that the private hospital agrees to be bound by the terms of a contract that is authorized by this section and that it chooses to enter.  This section does not affect any explicit or implicit authority that a private hospital has under other law to participate in a group purchasing program or to participate in a purchasing contract with a public entity.|Added by Acts 1997, 75th Leg., ch. 1045, Sec. 2, eff. Sept. 1, 1997.Amended by: Acts 2007, 80th Leg., R.S., Ch. 937 (H.B. 3560), Sec. 1.95, eff. September 1, 2007.Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.123, eff. April 2, 2015.|
TX Hum Res Code § 32.045 (2021)
2021 Texas Statutes|Human Resources Code|Title 2 - Human Services and Protective Services in General|Subtitle C - Assistance Programs|Chapter 32 - Medical Assistance Program|Subchapter B. Administrative Provisions|Section 32.045. Enhanced Reimbursement

Sec. 32.045.  ENHANCED REIMBURSEMENT.  The commission shall develop a procedure for:(1)  identifying each service provided under the medical assistance program for which the state is eligible to receive enhanced reimbursement of costs from the federal government; and(2)  ensuring that the state seeks the highest level of federal reimbursement available for each service provided.|Added by Acts 1997, 75th Leg., ch. 1153, Sec. 1.04(a), eff. June 20, 1997.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.124, eff. April 2, 2015.|
TX Hum Res Code § 32.046 (2021)
2021 Texas Statutes|Human Resources Code|Title 2 - Human Services and Protective Services in General|Subtitle C - Assistance Programs|Chapter 32 - Medical Assistance Program|Subchapter B. Administrative Provisions|Section 32.046. Sanctions and Penalties Related to the Provision of Pharmacy Products

Sec. 32.046.  SANCTIONS AND PENALTIES RELATED TO THE PROVISION OF PHARMACY PRODUCTS.  (a)  The executive commissioner shall adopt rules governing sanctions and penalties that apply to a provider who participates in the vendor drug program or is enrolled as a network pharmacy provider of a managed care organization contracting with the commission under Chapter 533, Government Code, or its subcontractor and who submits an improper claim for reimbursement under the program.(b)  The commission shall notify each provider in the vendor drug program that the provider is subject to sanctions and penalties for submitting an improper claim.|Added by Acts 1997, 75th Leg., ch. 1153, Sec. 3.02, eff. Sept. 1, 1997.Amended by: Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7), Sec. 1.02(k), eff. September 28, 2011.Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.124, eff. April 2, 2015.|
TX Hum Res Code § 32.0461 (2021)
2021 Texas Statutes|Human Resources Code|Title 2 - Human Services and Protective Services in General|Subtitle C - Assistance Programs|Chapter 32 - Medical Assistance Program|Subchapter B. Administrative Provisions|Section 32.0461. Vendor Drug Program; Competitive Bidding

Sec. 32.0461.  VENDOR DRUG PROGRAM; COMPETITIVE BIDDING.  (a)  The commission shall seek competitive bids for the claims processing function of the vendor drug program.(b)  The commission shall require any person seeking to contract for services under this section to comply with competitive bidding procedures adopted by the executive commissioner.(c)  The commission may award a contract under this section to another person only if the commission determines that the provision of services under that contract would be more cost-effective and the time to process claims under the contract would be the same as or faster than having employees of the commission continue to process claims.(d)  The commission may consult with the comptroller in administering this section.|Added by Acts 1999, 76th Leg., ch. 103, Sec. 1, eff. Sept. 1, 1999.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.124, eff. April 2, 2015.Acts 2017, 85th Leg., R.S., Ch. 24 (S.B. 706), Sec. 4, eff. September 1, 2017.|
TX Hum Res Code § 32.0462 (2021)
2021 Texas Statutes|Human Resources Code|Title 2 - Human Services and Protective Services in General|Subtitle C - Assistance Programs|Chapter 32 - Medical Assistance Program|Subchapter B. Administrative Provisions|Section 32.0462. Vendor Drug Program; Pricing Standard

Sec. 32.0462.  VENDOR DRUG PROGRAM; PRICING STANDARD.  (a)  Notwithstanding any other provision of state law, the commission shall:(1)  consider a nationally recognized, unbiased pricing standard for prescription drugs in determining reimbursement amounts under the vendor drug program; and(2)  update reimbursement amounts under the vendor drug program at least weekly.(b)  The executive commissioner shall adopt rules implementing this section.  In adopting rules, the executive  commissioner shall ensure that implementation of this section does not adversely affect the amount of federal funds available to the state for providing benefits under the vendor drug program.|Added by Acts 2003, 78th Leg., ch. 1251, Sec. 10, eff. June 20, 2003.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.124, eff. April 2, 2015.|
TX Hum Res Code § 32.0463 (2021)
2021 Texas Statutes|Human Resources Code|Title 2 - Human Services and Protective Services in General|Subtitle C - Assistance Programs|Chapter 32 - Medical Assistance Program|Subchapter B. Administrative Provisions|Section 32.0463. Medications and Medical Supplies

Sec. 32.0463.  MEDICATIONS AND MEDICAL SUPPLIES.  The executive commissioner may adopt rules establishing procedures for the purchase and distribution of medically necessary, over-the-counter medications and medical supplies under the medical assistance program that were previously being provided by prescription if the executive commissioner determines it is more cost-effective than obtaining those medications and medical supplies through a prescription.|Added by Acts 2003, 78th Leg., ch. 198, Sec. 2.107(a), eff. Sept. 1, 2003.Renumbered from Human Resources Code, Section 32.0462 by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 23.001(58), eff. September 1, 2005.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.124, eff. April 2, 2015.|