reglab/housing_qa huggingface dataset:
TX Hum Res Code § 32.068 (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 32.068. In-Person Evaluation Required for Certain Services

Sec. 32.068.  IN-PERSON EVALUATION REQUIRED FOR CERTAIN SERVICES.  (a)  A medical assistance provider may order or otherwise authorize the provision of home health services for a recipient only if the provider has conducted an in-person evaluation of the recipient within the 12-month period preceding the date the order or other authorization was issued.(b)  A physician, physician assistant, nurse practitioner, clinical nurse specialist, or certified nurse-midwife that orders or otherwise authorizes the provision of durable medical equipment for a recipient in accordance with Chapter 157, Occupations Code, and other applicable law, including rules, must certify on the order or other authorization that the person conducted an in-person evaluation of the recipient within the 12-month period preceding the date the order or other authorization was issued.(c)  The executive commissioner shall adopt rules necessary to implement this section.  The executive commissioner may by rule adopt limited exceptions to the requirements of this section.|Added by Acts 2011, 82nd Leg., R.S., Ch. 980 (H.B. 1720), Sec. 31, eff. September 1, 2011.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.141, eff. April 2, 2015.|
TX Hum Res Code § 32.069 (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 32.069. Chronic Kidney Disease Management Initiative

Sec. 32.069.  CHRONIC KIDNEY DISEASE MANAGEMENT INITIATIVE.  A provider of disease management programs under Section 32.057 shall develop a program to provide screening for and diagnosis and treatment of chronic kidney disease and its medical complications under the medical assistance program.  The program must use generally recognized clinical practice guidelines and laboratory assessments that identify chronic kidney disease on the basis of impaired kidney function or the presence of kidney damage.|Added by Acts 2005, 79th Leg., Ch. 1047 (H.B. 1252), Sec. 3, eff. September 1, 2005.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.142, eff. April 2, 2015.|
TX Hum Res Code § 32.0705 (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 32.0705. External Audits of Certain Medicaid Contractors Based on Risk

Sec. 32.0705.  EXTERNAL AUDITS OF CERTAIN MEDICAID CONTRACTORS BASED ON RISK.  (a)  In this section, "Medicaid contractor" means an entity that:(1)  is not a health and human services agency as defined by Section 531.001, Government Code; and(2)  under a contract with the commission or otherwise on behalf of the commission, performs one or more administrative services in relation to the commission's operation of Medicaid, such as claims processing, utilization review, client enrollment, provider enrollment, quality monitoring, or payment of claims.(b)  The commission shall contract with an independent auditor to perform annual independent external financial and performance audits of any Medicaid contractor used in the commission's operation of Medicaid.  The commission regularly shall review the Medicaid contracts and ensure that:(1)  the frequency and extent of audits of a Medicaid contractor under this section are based on the amount of risk to the state involved in the administrative services being performed by the contractor;(2)  audit procedures related to financial audits and performance audits are used consistently in audits under this section; and(3)  to the extent possible, audits under this section are completed in a timely manner.(c)  If another state agency succeeds to the commission's operation of a part of Medicaid for which the commission used a Medicaid contractor, the successor agency shall comply with this section with regard to the Medicaid contractor, including the requirement to contract with an independent auditor to perform the external financial and performance audits required by this section.(d)  An audit required by this section must be completed before the end of the fiscal year immediately following the fiscal year for which the audit is performed.|Added by Acts 1999, 76th Leg., ch. 1411, Sec. 1.10, eff. Sept. 1, 1999.Transferred, redesignated and amended from Health and Safety Code, Section 12.0123 by Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0016, eff. April 2, 2015.|
TX Hum Res Code § 32.072 (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 32.072. Direct Access to Eye Health Care Services

Sec. 32.072.  DIRECT ACCESS TO EYE HEALTH CARE SERVICES.  (a)  Notwithstanding any other law, a recipient of medical assistance is entitled to:(1)  select an ophthalmologist or therapeutic optometrist who is a medical assistance provider to provide eye health care services, other than surgery, that are within the scope of:(A)  services provided under the medical assistance program; and(B)  the professional specialty practice for which the ophthalmologist or therapeutic optometrist is licensed; and(2)  have direct access to the selected ophthalmologist or therapeutic optometrist for the provision of the nonsurgical services without any requirement that the patient or ophthalmologist or therapeutic optometrist obtain:(A)  a referral from a primary care physician or other gatekeeper or health care coordinator; or(B)  any other prior authorization or precertification.(b)  The commission may require an ophthalmologist or therapeutic optometrist selected as provided by this section by a recipient of medical assistance who is otherwise required to have a primary care physician or other gatekeeper or health care coordinator to forward to the recipient's physician, gatekeeper, or health care coordinator information concerning the eye health care services provided to the recipient.(c)  This section may not be construed to expand the scope of eye health care services provided under the medical assistance program.|Added by Acts 2007, 80th Leg., R.S., Ch. 268 (S.B. 10), Sec. 21(a), eff. September 1, 2007.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.145, eff. April 2, 2015.Acts 2017, 85th Leg., R.S., Ch. 901 (H.B. 3675), Sec. 1, eff. September 1, 2017.|
TX Hum Res Code § 32.073 (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 32.073. Health Information Technology Standards

Sec. 32.073.  HEALTH INFORMATION TECHNOLOGY STANDARDS.  (a)  In this section, "health information technology" means information technology used to improve the quality, safety, or efficiency of clinical practice, including the core functionalities of an electronic health record, an electronic medical record, a computerized health care provider order entry, electronic prescribing, and clinical decision support technology.(b)  The commission shall ensure that any health information technology used by the commission or any entity acting on behalf of the commission in the medical assistance program conforms to standards required under federal law.(c)  Not later than the second anniversary of the date national standards for electronic prior authorization of benefits are adopted, the commission shall require a health benefit plan issuer participating in the medical assistance program or the agent of the health benefit plan issuer that manages or administers prescription drug benefits to exchange prior authorization requests electronically with a prescribing provider participating in the medical assistance program who has electronic prescribing capability and who initiates a request electronically.|Added by Acts 2009, 81st Leg., R.S., Ch. 1120 (H.B. 1218), Sec. 4, eff. September 1, 2009.Amended by: Acts 2013, 83rd Leg., R.S., Ch. 1311 (S.B. 8), Sec. 11, eff. September 1, 2013.Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.146, eff. April 2, 2015.|
TX Hum Res Code § 32.074 (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 32.074. Access to Personal Emergency Response System

Sec. 32.074.  ACCESS TO PERSONAL EMERGENCY RESPONSE SYSTEM.  (a)  In this section, "personal emergency response system" has the meaning assigned by Section 1702.331, Occupations Code.(b)  The commission shall ensure that each Medicaid recipient enrolled in a home and community-based services waiver program that includes a personal emergency response system as a service has access to a personal emergency response system, if necessary, without regard to the recipient's access to a landline telephone.|Added by Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7), Sec. 1.20, eff. September 28, 2011.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.147, eff. April 2, 2015.Acts 2015, 84th Leg., R.S., Ch. 838 (S.B. 202), Sec. 3.021, eff. September 1, 2015.|
TX Hum Res Code § 32.075 (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 32.075. Employment Assistance and Supported Employment

Sec. 32.075.  EMPLOYMENT ASSISTANCE AND SUPPORTED EMPLOYMENT.  (a)  In this section:(1)  "Employment assistance" means assistance provided to an individual to help the individual locate paid employment in the community.  Employment assistance includes:(A)  identifying an individual's employment preferences, job skills, and requirements for a work setting and work conditions;(B)  locating prospective employers offering employment compatible with an individual's identified preferences, skills, and requirements; and(C)  contacting a prospective employer on behalf of an individual and negotiating the individual's employment.(2)  "Supported employment" means assistance provided, in order to sustain paid employment, to an individual who, because of a disability, requires intensive, ongoing support to be self-employed, work from home, or perform in a work setting at which individuals without disabilities are employed.  Supported employment includes adaptations, supervision, and training related to an individual's diagnosis.(b)  This section applies only to the following medical assistance waiver programs:(1)  the community based alternatives program;(2)  the community living assistance and support services program;(3)  the deaf-blind with multiple disabilities program;(4)  the home and community-based services program;(5)  the medically dependent children program;(6)  the STAR + PLUS Medicaid managed care program;(7)  the Texas home living program; and(8)  the youth empowerment services program.(c)  The commission shall provide employment assistance and supported employment to participants in the waiver programs identified in Subsection (b).|Added by Acts 2013, 83rd Leg., R.S., Ch. 506 (S.B. 45), Sec. 1, eff. June 14, 2013.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.148, eff. April 2, 2015.|
TX Hum Res Code § 32.076 (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 32.076. Substitute Dentists

Sec. 32.076.  SUBSTITUTE DENTISTS.  To the extent allowed by federal law, the executive commissioner of the Health and Human Services Commission shall adopt rules ensuring that the same standards applying to a physician who bills the medical assistance program for services provided by a substitute physician apply also to a dentist who bills the medical assistance program for services provided by a substitute dentist.|Added by Acts 2015, 84th Leg., R.S., Ch. 739 (H.B. 1661), Sec. 1, eff. June 17, 2015.|
TX Hum Res Code § 32.101 (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 C. Medical Assistance Program Provider Database|Section 32.101. Definitions

Sec. 32.101.  DEFINITIONS.  In this subchapter:(1)  Repealed by Acts 2015, 84th Leg., R.S., Ch. 1 , Sec. 4.465(a)(43), eff. April 2, 2015.(2)  "Health care provider" means a person, other than a physician, who:(A)  is licensed or otherwise authorized to provide a health care service in this state, including:(i)  a pharmacist, dentist, optometrist, mental health counselor, social worker, advanced practice nurse, physician assistant, or durable medical equipment supplier;(ii)  a pharmacy, hospital, or other institution or organization; or(iii)  a local public health entity;(B)  is wholly owned or controlled by:(i)  a health care provider or a group of health care providers described by Paragraph (A); or(ii)  one or more hospitals and physicians, including a physician-hospital organization;(C)  is a professional association of physicians organized under the Texas Professional Association Law, as described by Section 1.008, Business Organizations Code;(D)  is an approved nonprofit health corporation certified under Chapter 162, Occupations Code;(E)  is a medical and dental unit, as defined by Section 61.003, Education Code, a medical school, as defined by Section 61.501, Education Code, or a health science center described by Subchapter K, Chapter 74, Education Code, that employs or contracts with physicians to teach or provide medical services, or employs physicians and contracts with physicians in a practice plan; or(F)  is another person wholly owned by physicians.(3)  "Managed care organization" has the meaning assigned by Section 533.001, Government Code.(4)  "Managed care plan" has the meaning assigned by Section 533.001, Government Code.(5)  "Participating provider" means a physician or health care provider who is a provider of medical assistance, including a physician or health care provider who contracts or otherwise agrees with a managed care organization to provide medical assistance under this chapter.(6)  "Physician" means an individual licensed to practice medicine in this state.(7)  "Recipient" means a recipient of medical assistance.|Added by Acts 2007, 80th Leg., R.S., Ch. 883 (H.B. 2042), Sec. 1, eff. June 15, 2007.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.465(a)(43), eff. April 2, 2015.Acts 2021, 87th Leg., R.S., Ch. 535 (S.B. 73), Sec. 3, eff. September 1, 2021.|
TX Hum Res Code § 32.102 (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 C. Medical Assistance Program Provider Database|Section 32.102. Database of Medical Assistance Program Providers

Sec. 32.102.  DATABASE OF MEDICAL ASSISTANCE PROGRAM PROVIDERS.  (a)  The executive commissioner shall establish and administer an electronic, searchable, Internet-based database of all participating providers in the medical assistance program.(b)  The database must include, as applicable, at least the following information regarding each participating provider:(1)  the provider's:(A)  name;(B)  specialty;(C)  location;(D)  office hours, including any office hours outside of regular business hours; and(E)  telephone number;(2)  whether the provider:(A)  is accepting new recipients, and if the provider is accepting new recipients and if applicable, the managed care organization or managed care plan under which new recipients are being accepted;(B)  has any practice limitations, including specific age range limitations; and(C)  speaks any languages other than English;(3)  a list of the medical assistance program services offered by the provider; and(4)  any waiver program or other program within the medical assistance program in which the provider is a participant, including the Texas Health Steps program.(c)  In establishing the database, the executive commissioner shall ensure that the database:(1)  allows a person to search a managed care organization by name and by participating provider within each of the managed care plans offered by that managed care organization;(2)  allows a participating provider to electronically access and change or update the information required by Subsection (b)(1), (2), or (3); and(3)  is available and accessible to each participating provider and each recipient.(d)  The executive commissioner shall ensure that the database is updated continually and at least once a month.|Added by Acts 2007, 80th Leg., R.S., Ch. 883 (H.B. 2042), Sec. 1, eff. June 15, 2007.|
TX Hum Res Code § 32.103 (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 C. Medical Assistance Program Provider Database|Section 32.103. Certain Fees Prohibited

Sec. 32.103.  CERTAIN FEES PROHIBITED.  A person, including the executive commissioner, a person acting under a contract under Section 32.104, or a managed care organization, may not charge a participating provider or a recipient a fee, directly or indirectly, for making information available or for accessing information in the database established under this subchapter.|Added by Acts 2007, 80th Leg., R.S., Ch. 883 (H.B. 2042), Sec. 1, eff. June 15, 2007.|
TX Hum Res Code § 32.104 (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 C. Medical Assistance Program Provider Database|Section 32.104. Authority to Contract

Sec. 32.104.  AUTHORITY TO CONTRACT.  (a)  The executive commissioner may contract with a state agency or a private entity for the creation, operation, and maintenance of the database required by this subchapter.(b)  A contract entered into under this section must allow the executive commissioner to oversee and supervise the contractor and the database.|Added by Acts 2007, 80th Leg., R.S., Ch. 883 (H.B. 2042), Sec. 1, eff. June 15, 2007.|
TX Hum Res Code § 32.105 (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 C. Medical Assistance Program Provider Database|Section 32.105. Rules

Sec. 32.105.  RULES.  The executive commissioner shall adopt rules to implement and administer this subchapter.|Added by Acts 2007, 80th Leg., R.S., Ch. 883 (H.B. 2042), Sec. 1, eff. June 15, 2007.|
TX Hum Res Code § 32.251 (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 F. Partnership for Long-Term Care Program|Section 32.251. Definitions

Sec. 32.251.  DEFINITIONS.  In this subchapter:(1)  "Approved plan" means a long-term care benefit plan that is approved by the Texas Department of Insurance under Subchapter C, Chapter 1651, Insurance Code.(2)  "Asset disregard" means the total equity value of  assets and resources not exempt under rules governing the medical assistance program that are disregarded in determining eligibility for the medical assistance program and in determining estate recovery obligations.(3)  "Asset protection" means the right extended to a plan holder of an approved plan to dollar-for-dollar asset disregard under the medical assistance program.(4)  "Dollar-for-dollar asset disregard" means an asset disregard in which the amount of the disregard is equal to the sum of qualifying benefit payments made on behalf of the qualified plan holder.(5)  Repealed by Acts 2015, 84th Leg., R.S., Ch. 1, Sec. 4.465(a)(45), eff. April 2, 2015.(6)  "Partnership for long-term care program" means the program established under this subchapter and Subchapter C, Chapter 1651, Insurance Code.|Added by Acts 2007, 80th Leg., R.S., Ch. 795 (S.B. 22), Sec. 2, eff. March 1, 2008.Renumbered from Human Resources Code, Section 32.101 by Acts 2009, 81st Leg., R.S., Ch. 87 (S.B. 1969), Sec. 27.001(58), eff. September 1, 2009.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.465(a)(45), eff. April 2, 2015.|
TX Hum Res Code § 32.252 (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 F. Partnership for Long-Term Care Program|Section 32.252. Partnership for Long-Term Care Program

Sec. 32.252.  PARTNERSHIP FOR LONG-TERM CARE PROGRAM.  The partnership for long-term care program is administered as part of the medical assistance program by the commission with the assistance of the Texas Department of Insurance.  The program must be consistent with provisions governing the expansion of a state long-term care partnership program established under the federal Deficit Reduction Act of 2005 (Pub. L. No. 109-171).|Added by Acts 2007, 80th Leg., R.S., Ch. 795 (S.B. 22), Sec. 2, eff. March 1, 2008.Renumbered from Human Resources Code, Section 32.102 by Acts 2009, 81st Leg., R.S., Ch. 87 (S.B. 1969), Sec. 27.001(58), eff. September 1, 2009.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.151, eff. April 2, 2015.|
TX Hum Res Code § 32.253 (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 F. Partnership for Long-Term Care Program|Section 32.253. Asset Disregard

Sec. 32.253.  ASSET DISREGARD.  (a)  To the extent allowed by the federal Deficit Reduction Act of 2005 (Pub. L. No. 109-171) and other federal law, the executive commissioner, in adopting rules and standards governing the medical assistance program, shall allow for dollar-for-dollar asset disregard in determining eligibility for medical assistance for an individual receiving long-term care services if the individual is or was covered by a long-term care benefit plan providing coverage for long-term care that meets the applicable minimum benefit standards of the commissioner of the Texas Department of Insurance under Subchapter C, Chapter 1651, Insurance Code, and other requirements for approval under the partnership for long-term care program.(b)  The commission may not consider the resources of an individual who has used all or part of the individual's benefits under an approved plan to the extent those resources are the subject of a dollar-for-dollar asset disregard in determining:(1)  eligibility for medical assistance under the medical assistance program;(2)  the amount of medical assistance provided; or(3)  any subsequent recovery by this state from the individual's estate for medical assistance provided to the individual.(c)  The commission may not provide to an individual eligible for medical assistance under this section those medical assistance services covered under the medical assistance program that are also covered by the individual's benefits under the approved plan until the individual has fully exhausted the individual's benefits under the plan.|Added by Acts 2007, 80th Leg., R.S., Ch. 795 (S.B. 22), Sec. 2, eff. March 1, 2008.Renumbered from Human Resources Code, Section 32.103 by Acts 2009, 81st Leg., R.S., Ch. 87 (S.B. 1969), Sec. 27.001(58), eff. September 1, 2009.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.152, eff. April 2, 2015.|