reglab/housing_qa huggingface dataset:
TX Hum Res Code § 32.02611 (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 32.02611. Exclusion of Assets in Prepaid Tuition Programs and Higher Education Savings Plans

Sec. 32.02611.  EXCLUSION OF ASSETS IN PREPAID TUITION PROGRAMS AND HIGHER EDUCATION SAVINGS PLANS.  (a)  Except as provided by Subsection (b), in determining eligibility and need for medical assistance, the commission may not consider as assets or resources, to the extent applicable under federal law, a right to assets held in or a right to receive payments or benefits under:(1)  any fund or plan established under Subchapter G, H, or I, Chapter 54, Education Code, including an interest in a savings trust account, prepaid tuition contract, or related matching account;(2)  any qualified tuition program of any state that meets the requirements of Section 529, Internal Revenue Code of 1986; or(3)  any school-based account or bond described by Section 28.0024(b)(2), Education Code.(a-1)  The amount of exclusion under Subsection (a)(3) of assets held in or the right to receive payments or benefits under a school-based account or bond described by Section 28.0024(b)(2)(C), (D), or (E), Education Code, is limited to the amount of the cost of undergraduate resident tuition and required fees for one academic year consisting of 30 semester credit hours charged by the general academic teaching institution with the highest such tuition and fee costs for the most recent academic year, as determined by the Texas Higher Education Coordinating Board under Section 54.753, Education Code.(b)  In determining eligibility and need for medical assistance for an applicant who may be eligible on the basis of the applicant's eligibility for medical assistance for the aged, blind, or disabled under 42 U.S.C. Section 1396a(a)(10), the commission may consider as assets or resources, to the extent applicable under federal law, a right to assets held in or a right to receive payments or benefits under any fund, account, bond, plan, or tuition program described by Subsection (a).(c)  Notwithstanding Subsection (b), the commission shall seek a federal waiver authorizing the commission to exclude, for purposes of determining the eligibility of an applicant described by that subsection and to the extent included under federal law, the right to assets held in or a right to receive payments or benefits under any fund, account, bond, plan, or tuition program described by Subsection (a) if the fund, account, bond, plan, or tuition program was established before the 21st birthday of the beneficiary of the fund, account, bond, plan, or tuition program.|Added by Acts 2011, 82nd Leg., R.S., Ch. 1186 (H.B. 3708), Sec. 9, eff. June 17, 2011.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.090, eff. April 2, 2015.Acts 2015, 84th Leg., R.S., Ch. 1265 (H.B. 3987), Sec. 4, eff. June 20, 2015.|
TX Hum Res Code § 32.0262 (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 32.0262. Eligibility Transition

Sec. 32.0262.  ELIGIBILITY TRANSITION.  (a)  The executive commissioner shall develop procedures to ensure that all necessary information regarding a child who will be denied continued medical assistance under this chapter because of an increase in income, assets, or resources but who is eligible for enrollment in the child health plan under Chapter 62, Health and Safety Code, is promptly transmitted to the child health plan in accordance with the standards established under Section 62.104(d), Health and Safety Code.(b)  The executive commissioner shall develop procedures to ensure that the parent or caretaker of a child who will be denied continued medical assistance under this chapter because of a failure to keep an appointment, including an appointment for recertification of eligibility, a failure to provide information, or for another procedural reason, is promptly contacted and informed of:(1)  the need to recertify eligibility for continued medical assistance under this chapter; and(2)  the availability of medical coverage under the child health plan under Chapter 62, Health and Safety Code.(c)  The commission shall develop materials under this section in consultation with the appropriate agencies administering all or part of the child health plan under Chapter 62, Health and Safety Code.(d)  The executive commissioner by rule shall adopt procedures to assist a family whose child loses eligibility for medical assistance under this chapter in making a transition to the child health plan under Chapter 62, Health and Safety Code, with no interruption in coverage.|Added by Acts 2001, 77th Leg., ch. 584, Sec. 4.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.092, eff. April 2, 2015.|
TX Hum Res Code § 32.0263 (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 32.0263. Health Care Orientation

Sec. 32.0263.  HEALTH CARE ORIENTATION.  (a)  The commission shall require that the parent or guardian of a child under 19 years of age who originally establishes eligibility for medical assistance must:(1)  attend an in-person counseling session with a commission representative not later than the 31st day after the date the child originally establishes eligibility; or(2)  accompany the child to an appointment with a health care provider for a comprehensive health care orientation not later than the 61st day after the date the child originally establishes eligibility.(b)  The executive commissioner by rule shall develop procedures to verify that:(1)  the parent or guardian of the child who originally establishes eligibility complies with the requirement of Subsection (a)(2), if applicable; and(2)  the child is provided a comprehensive health care orientation at the appointment with the health care provider.|Added by Acts 2001, 77th Leg., ch. 584, Sec. 4.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.092, eff. April 2, 2015.|
TX Hum Res Code § 32.0264 (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 32.0264. Suspension and Reinstatement of Eligibility for Children in Juvenile Facilities

Sec. 32.0264.  SUSPENSION AND REINSTATEMENT OF ELIGIBILITY FOR CHILDREN IN JUVENILE FACILITIES.  (a)  In this section, "juvenile facility" means a facility for the placement, detention, or commitment of a child under Title 3, Family Code.(b)  To the extent allowed under federal law, if a child is placed in a juvenile facility, the commission shall suspend the child's eligibility for medical assistance during the period the child is placed in the facility.(b-1)  Notwithstanding Subsection (b), if, during the period a child is placed in a juvenile facility, the child is hospitalized or becomes an inpatient in another type of medical facility, the commission shall reinstate the child's eligibility for medical assistance during the period of the child's inpatient stay.  The executive commissioner shall adopt rules necessary to implement this subsection, including rules governing the procedure for reinstating a child's eligibility for medical assistance under this subsection.(c)  Not later than 48 hours after the commission is notified of the release from a juvenile facility of a child whose eligibility for medical assistance has been suspended under this section, the commission shall reinstate the child's eligibility.  Following the reinstatement, the child remains eligible until the expiration of the period for which the child was certified as eligible, excluding the period during which the child's eligibility was suspended.|Added by Acts 2015, 84th Leg., R.S., Ch. 862 (H.B. 839), Sec. 2, eff. June 18, 2015.Amended by: Acts 2021, 87th Leg., R.S., Ch. 667 (H.B. 1664), Sec. 1, eff. September 1, 2021.Acts 2021, 87th Leg., R.S., Ch. 667 (H.B. 1664), Sec. 2, eff. September 1, 2021.|
TX Hum Res Code § 32.0265 (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 32.0265. Notice of Certain Placements in Juvenile Facilities

Sec. 32.0265.  NOTICE OF CERTAIN PLACEMENTS IN JUVENILE FACILITIES.  (a)  In this section:(1)  "Custodian" and "guardian" have the meanings assigned by Section 51.02, Family Code.(2)  "Juvenile facility" has the meaning assigned by Section 32.0264.(b)  A juvenile facility may notify the commission on the placement in the facility of a child who is receiving medical assistance benefits.(c)  If a juvenile facility chooses to provide the notice described by Subsection (b), the facility shall provide the notice electronically or by other appropriate means as soon as possible, but not later than the 30th day, after the date of the child's placement.(d)  A juvenile facility may notify the commission of the release of a child who, immediately before the child's placement in the facility, was receiving medical assistance benefits.(e)  If a juvenile facility chooses to provide the notice described by Subsection (d), the facility shall provide the notice electronically or by other appropriate means not later than 48 hours after the child's release from the facility.(f)  If a juvenile facility chooses to provide the notice described by Subsection (d), at the time of the child's release, the facility shall provide the child's guardian or custodian, as appropriate, with a written copy of the notice and a telephone number at which the commission may be contacted regarding confirmation of or assistance relating to reinstatement of the child's eligibility for medical assistance benefits.(g)  The commission shall establish a means by which a juvenile facility, or an employee of the facility, may determine whether a child placed in the facility is or was, as appropriate, receiving medical assistance benefits for purposes of this section.(h)  A juvenile facility, or an employee of the facility, is not liable in a civil action for damages resulting from a failure to comply with this section.|Added by Acts 2015, 84th Leg., R.S., Ch. 862 (H.B. 839), Sec. 2, eff. June 18, 2015.|
TX Hum Res Code § 32.0266 (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 32.0266. Suspension, Termination, and Automatic Reinstatement of Eligibility for Individuals Confined in County Jails

Sec. 32.0266.  SUSPENSION, TERMINATION, AND AUTOMATIC REINSTATEMENT OF ELIGIBILITY FOR INDIVIDUALS CONFINED IN COUNTY JAILS. (a)  In this section, "county jail" means a facility operated by or for a county for the confinement of persons accused or convicted of an offense.(b)  To the extent allowed by federal law, if an individual is confined in a county jail and the sheriff of the county has notified the commission of the confinement under Section 351.046, Local Government Code, the commission shall suspend or terminate, as appropriate, the individual's eligibility for medical assistance during the period the individual is confined in the county jail.(c)  Not later than 48 hours after the commission is notified under Section 351.046, Local Government Code, of the release from a county jail of an individual whose eligibility for medical assistance has been suspended under this section, the commission shall reinstate the individual's eligibility, provided the individual's eligibility certification period has not elapsed.  To the extent allowed by federal law, following the reinstatement, the individual remains eligible until the expiration of the period for which the individual was certified as eligible.|Added by Acts 2017, 85th Leg., R.S., Ch. 778 (H.B. 337), Sec. 1, eff. September 1, 2017.|
TX Hum Res Code § 32.0275 (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 32.0275. Military Medical Treatment Facilities and Affiliated Health Care Providers; Reimbursement

Sec. 32.0275.  MILITARY MEDICAL TREATMENT FACILITIES AND AFFILIATED HEALTH CARE PROVIDERS; REIMBURSEMENT.  (a) In this section, "military medical treatment facility" means a military medical treatment facility described by 10 U.S.C. Section 1073d(b), (c), or (d).(b)  This section applies only to a military medical treatment facility located in this state that has been verified as a Level 1 trauma center by the American College of Surgeons or an equivalent organization.(c)  A military medical treatment facility or a health care provider providing services at a military medical treatment facility is considered a provider under Medicaid for purposes of providing and receiving reimbursement for:(1)  inpatient emergency services; and (2)  related outpatient services to the extent those services are not available from an enrolled Medicaid provider at the time the services are needed.|Added by Acts 2021, 87th Leg., R.S., Ch. 696 (H.B. 2365), Sec. 1, eff. September 1, 2021.|
TX Hum Res Code § 32.0281 (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 32.0281. Rules and Notice Relating to Payment Rates

Sec. 32.0281.  RULES AND NOTICE RELATING TO PAYMENT RATES.  (a)  The executive commissioner shall by rule describe the process used to determine payment rates for medical assistance and shall notify providers, consumers, the Legislative Budget Board, and the Governor's Office of Budget, Planning, and Policy of that process.(b)  The executive commissioner shall adopt rules relating to payment rates that include:(1)  a description of the process used to determine payment rates;(2)  a description of each cost of living index used in calculating inflation rates and the procedure for determining the level of inflation used in the executive commissioner's calculations;(3)  the criteria for desk audits;(4)  the procedure for notifying providers of exclusions and adjustments to reported expenses, if notification is requested; and(5)  a method of adjusting rates if new legislation, regulations, or economic factors affect costs.(c)  The commission shall include in the Title XIX State Medicaid Plan submitted to the federal government for approval the procedures for making available to the public the data and methodology used in establishing payment rates.(d)  The procedures for adopting rules under this section shall be governed by Chapter 2001, Government Code.(e)  An interested party may appeal an action taken by the commission under this section, and an appeal of such action shall be governed by the procedures for a contested case hearing under Chapter 2001, Government Code.  The filing of an appeal under this section shall not stay the implementation of payment rates adopted by the executive commissioner in accordance with commission rules.|Added by Acts 1989, 71st Leg., ch. 1085, Sec. 2, eff. Sept. 1, 1989.  Amended by Acts 1995, 74th Leg., ch. 76, Sec. 5.95(49), eff. Sept. 1, 1995.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.097, eff. April 2, 2015.|
TX Hum Res Code § 32.0282 (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 32.0282. Public Hearing on Rates

Sec. 32.0282.  PUBLIC HEARING ON RATES.  (a)  The commission shall hold a public hearing to allow interested persons to present comments relating to proposed payment rates for medical assistance.(b)  The commission shall provide notice of each hearing to the public.|Added by Acts 1989, 71st Leg., ch. 1085, Sec. 2, eff. Sept. 1, 1989.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.098, eff. April 2, 2015.|
TX Hum Res Code § 32.0284 (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 32.0284. Calculation of Payments Under Certain Supplemental Hospital Payment Programs

Sec. 32.0284.  CALCULATION OF PAYMENTS UNDER CERTAIN SUPPLEMENTAL HOSPITAL PAYMENT PROGRAMS.  (a)  In this section, "supplemental hospital payment program" means:(1)  the disproportionate share hospitals supplemental payment program administered according to 42 U.S.C. Section 1396r-4; and(2)  the uncompensated care payment program established under the Texas Health Care Transformation and Quality Improvement Program waiver issued under Section 1115 of the federal Social Security Act (42 U.S.C. Section 1315).(b)  For purposes of calculating the hospital-specific limit used to determine a hospital's uncompensated care payment under a supplemental hospital payment program, the commission shall ensure that to the extent a third-party commercial payment exceeds the Medicaid allowable cost for a service provided to a recipient and for which reimbursement was not paid under the medical assistance program, the payment is not considered a medical assistance payment.|Added by Acts 2013, 83rd Leg., R.S., Ch. 1310 (S.B. 7), Sec. 6.07, eff. September 1, 2013.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.099, eff. April 2, 2015.|
TX Hum Res Code § 32.0285 (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 32.0285. Calculation of Medical Education Add-on for Reimbursement of Teaching Hospitals That Provide Behavioral Health and Physical Health Services

Text of section effective on September 01, 2022Sec. 32.0285.  CALCULATION OF MEDICAL EDUCATION ADD-ON FOR REIMBURSEMENT OF TEACHING HOSPITALS THAT PROVIDE BEHAVIORAL HEALTH AND PHYSICAL HEALTH SERVICES.  The commission shall, on request from a teaching hospital that provides behavioral health and physical health services, update on a biannual basis the education adjustment factor used to calculate the medical education add-on using the most current Medicare education adjustment factor data available under 42 C.F.R. Section 412.105 at the time the commission makes the update.|Added by Acts 2021, 87th Leg., R.S., Ch. 966 (S.B. 1921), Sec. 3, eff. September 1, 2022.|
TX Hum Res Code § 32.029 (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 32.029. Methods of Payment

Sec. 32.029.  METHODS OF PAYMENT.  (a)  The commission may prescribe a method of payment for medical assistance claims by establishing a direct vendor payment program that is administered by the commission, or by an insurance plan, a hospital or medical service plan, or any other health service plan authorized to do business in the state, or by a combination of those plans.(b)  The commission may use any fiscal intermediary, method of payment, or combination of methods it finds most satisfactory and economical.  The commission may make whatever changes it finds necessary from time to time to administer the program in an economical and equitable manner consistent with simplicity of administration and the best interest of the recipients of medical assistance.(c)  If the commission elects to make direct vendor payments, the payments shall be made by vouchers and warrants drawn by the comptroller on the proper account.  The commission shall furnish the comptroller with a list of those vendors entitled to payments and the amounts to which each is entitled.  When the warrants are drawn, they must be delivered to the commission, which shall supervise the delivery to vendors.(d)  If at any time state funds are not available to fully pay all claims for medical assistance, the executive commissioner shall prorate the claims.(e)  The commission or its designee must notify providers of health care services in clear and concise language of the status of their claims on any claim not paid or denied within 30 days of receipt by the payor.|Acts 1979, 66th Leg., p. 2351, ch. 842, art. 1, Sec. 1, eff. Sept. 1, 1979.  Amended by Acts 1985, 69th Leg., ch. 264, Sec. 12, eff. Aug. 26, 1985;  Acts 1993, 73rd Leg., ch. 390, Sec. 3, eff. Sept. 1, 1993;  Acts 1995, 74th Leg., ch. 6, Sec. 4, eff. March 23, 1995.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.100, eff. April 2, 2015.|
TX Hum Res Code § 32.0291 (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 32.0291. Prepayment Reviews and Payment Holds

Sec. 32.0291.  PREPAYMENT REVIEWS AND PAYMENT HOLDS.  (a)  Notwithstanding any other law, the commission may:(1)  perform a prepayment review of a claim for reimbursement under the medical assistance program to determine whether the claim involves fraud or abuse; and(2)  as necessary to perform that review, withhold payment of the claim for not more than five working days without notice to the person submitting the claim.(b)  Subject to Section 531.102, Government Code, and notwithstanding any other law, the commission may impose a payment hold on future claims submitted by a provider.(c)  A payment hold authorized by this section is governed by the requirements and procedures specified for a payment hold under Section 531.102, Government Code, including the notice requirements under Subsection (g) of that section.(d)  Repealed by Acts 2013, 83rd Leg., R.S., Ch. 622, Sec. 6, eff. September 1, 2013.|Added by Acts 2003, 78th Leg., ch. 198, Sec. 2.103, eff. Sept. 1, 2003.Amended by: Acts 2013, 83rd Leg., R.S., Ch. 622 (S.B. 1803), Sec. 4, eff. September 1, 2013.Acts 2013, 83rd Leg., R.S., Ch. 622 (S.B. 1803), Sec. 5, eff. September 1, 2013.Acts 2013, 83rd Leg., R.S., Ch. 622 (S.B. 1803), Sec. 6, eff. September 1, 2013.Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.101, eff. April 2, 2015.|