reglab/housing_qa huggingface dataset:
TX Hum Res Code § 32.031 (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 32.031. Receipt and Expenditure of Funds

Sec. 32.031.  RECEIPT AND EXPENDITURE OF FUNDS.  (a)  The commission may accept federal funds for the support of the medical assistance program and may expend the funds in the manner prescribed by this chapter or other laws.  The expenditures must be made in accordance with appropriate agreements between the state and the federal government.(b)  The commission may administer and expend state funds appropriated for the program in accordance with commission rules and the provisions of this chapter.(c)  The amount of state funds spent for medical assistance on behalf of a qualified individual may not exceed the amount that is matchable with federal funds, and the total amount of state funds spent for all medical assistance on behalf of all qualified individuals may not exceed the amount that is matchable with federal funds.(d)  The executive commissioner is empowered and authorized to pursue the use of local funds as part of the state share under the Medicaid program as provided by federal law and regulation.(e)  Public hospitals, including hospitals owned, operated, or leased by a governmental entity, including a municipality, county, hospital district, or this state, and specifically including a state teaching hospital, may transfer funds to the commission for use as the state share under the Medicaid disproportionate share program.|Acts 1979, 66th Leg., p. 2352, ch. 842, art. 1, Sec. 1, eff. Sept. 1, 1979.  Amended by Acts 1989, 71st Leg., ch. 1215, Sec. 4, eff. Sept. 1, 1989;  Acts 1995, 74th Leg., ch. 6, Sec. 6, eff. March 23, 1995.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.102, eff. April 2, 2015.|
TX Hum Res Code § 32.0311 (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 32.0311. Drug Reimbursement Under Certain Programs

Sec. 32.0311.  DRUG REIMBURSEMENT UNDER CERTAIN PROGRAMS.  The commission shall require a recipient of medical assistance to exhaust drug benefits available under the medical assistance program before reimbursing the recipient, pharmacist, or other health care provider for drugs purchased by or on behalf of the recipient under the Kidney Health Care Program or the Children with Special Health Care Needs Services Program.|Added by Acts 1999, 76th Leg., ch. 669, Sec. 1, eff. June 18, 1999.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.103, eff. April 2, 2015.|For expiration of this section, see Subsection (e).
TX Hum Res Code § 32.03115 (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 32.03115. Reimbursement for Medication-Assisted Treatment for Opioid or Substance Use Disorder

Sec. 32.03115.  REIMBURSEMENT FOR MEDICATION-ASSISTED TREATMENT FOR OPIOID OR SUBSTANCE USE DISORDER.  (a)  In this section, "medication-assisted opioid or substance use disorder treatment" means the use of methadone, buprenorphine, oral buprenorphine/naloxone, or naltrexone to treat opioid or substance use disorder. Text of subsection as added by Acts 2019, 86th Leg., R.S., Ch. 640 (S.B. 1564), Sec. 2, and Ch. 1167 (H.B. 3285), Sec. 9 (b)  Notwithstanding Sections 531.072 and 531.073, Government Code, or any other law and subject to Subsections (c) and (d), the commission shall provide medical assistance reimbursement for medication-assisted opioid or substance use disorder treatment without requiring a recipient of medical assistance or health care provider to obtain prior authorization or precertification for the treatment. Text of subsection as added by Acts 2019, 86th Leg., R.S., Ch. 1105 (H.B. 2174), Sec. 13 (b)  Notwithstanding Sections 531.072 and 531.073, Government Code, or any other law and subject to Subsections (c) and (d), the commission shall provide medical assistance reimbursement for medication-assisted opioid or substance use disorder treatment without requiring a recipient of medical assistance or health care provider to obtain prior authorization or precertification for the treatment, except as needed to minimize the opportunity for fraud, waste, or abuse.(c)  The duty to provide medical assistance reimbursement for medication-assisted opioid or substance use disorder treatment under Subsection (b) does not apply with respect to:(1)  a prescription for methadone;(2)  a recipient for whom medication-assisted opioid or substance use disorder treatment is determined to be medically contraindicated by the recipient's physician; or(3)  a recipient who is subject to an age-related restriction applicable to medication-assisted opioid or substance use disorder treatment.(d)  The commission may provide medical assistance reimbursement for medication-assisted opioid or substance use disorder treatment only if the treatment is prescribed to a recipient of medical assistance by a licensed health care provider who is authorized to prescribe methadone, buprenorphine, oral buprenorphine/naloxone, or naltrexone.(e)  This section expires August 31, 2023.|Added by Acts 2019, 86th Leg., R.S., Ch. 640 (S.B. 1564), Sec. 2, eff. June 10, 2019.Added by Acts 2019, 86th Leg., R.S., Ch. 1105 (H.B. 2174), Sec. 13, eff. September 1, 2019.Added by Acts 2019, 86th Leg., R.S., Ch. 1167 (H.B. 3285), Sec. 9, eff. September 1, 2019.|
TX Hum Res Code § 32.0312 (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 32.0312. Reimbursement for Services Associated With Preventable Adverse Events

Sec. 32.0312.  REIMBURSEMENT FOR SERVICES ASSOCIATED WITH PREVENTABLE ADVERSE EVENTS.  The executive commissioner shall adopt rules regarding the denial or reduction of reimbursement under the medical assistance program for preventable adverse events that occur in a hospital setting.  In adopting the rules, the executive commissioner:(1)  shall ensure that the commission imposes the same reimbursement denials or reductions for preventable adverse events as the Medicare program imposes for the same types of health care-associated adverse conditions and the same types of health care providers and facilities under a policy adopted by the federal Centers for Medicare and Medicaid Services;(2)  shall consult an advisory committee on health care quality, if established by the executive commissioner, to obtain the advice of that committee regarding denial or reduction of reimbursement claims for any other preventable adverse events that cause patient death or serious disability in health care settings, including events on the list of adverse events identified by the National Quality Forum; and(3)  may allow the commission to impose reimbursement denials or reductions for preventable adverse events described by Subdivision (2).|Added by Acts 2009, 81st Leg., R.S., Ch. 724 (S.B. 203), Sec. 3(a), eff. September 1, 2009.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.104, eff. April 2, 2015.|
TX Hum Res Code § 32.0313 (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 32.0313. Induced Deliveries or Cesarean Sections Before 39th Week

Sec. 32.0313.  INDUCED DELIVERIES OR CESAREAN SECTIONS BEFORE 39TH WEEK.  (a)  The commission shall achieve cost savings with improved outcomes by adopting and implementing quality initiatives that are evidence-based, tested, and fully consistent with established standards of clinical care and that are designed to reduce the number of elective or nonmedically indicated induced deliveries or cesarean sections performed at a hospital on a medical assistance recipient before the 39th week of gestation.(b)  The commission shall coordinate with physicians, hospitals, managed care organizations, and the commission's billing contractor for the medical assistance program to develop a process for collecting information regarding the number of induced deliveries and cesarean sections described by Subsection (a) that occur during prescribed periods.|Added by Acts 2011, 82nd Leg., R.S., Ch. 299 (H.B. 1983), Sec. 1, eff. September 1, 2011.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.105, eff. April 2, 2015.|
TX Hum Res Code § 32.0314 (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 32.0314. Reimbursement for Durable Medical Equipment and Supplies

Sec. 32.0314.  REIMBURSEMENT FOR DURABLE MEDICAL EQUIPMENT AND SUPPLIES.  The executive commissioner shall adopt rules requiring the electronic submission of any claim for reimbursement for durable medical equipment and supplies under the medical assistance program.|Added by Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7), Sec. 1.18, eff. September 28, 2011.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.105, eff. April 2, 2015.|
TX Hum Res Code § 32.03141 (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 32.03141. Authority of Advanced Practice Registered Nurses and Physician Assistants Regarding Durable Medical Equipment and Supplies

Sec. 32.03141.  AUTHORITY OF ADVANCED PRACTICE REGISTERED NURSES AND PHYSICIAN ASSISTANTS REGARDING DURABLE MEDICAL EQUIPMENT AND SUPPLIES.  To the extent allowed by federal law, an advanced practice registered nurse or physician assistant acting under adequate physician supervision and to whom a physician has delegated the authority to prescribe and order drugs and devices under Chapter 157, Occupations Code, may order and prescribe durable medical equipment and supplies under the medical assistance program.|Added by Acts 2013, 83rd Leg., R.S., Ch. 418 (S.B. 406), Sec. 26, eff. November 1, 2013.|
TX Hum Res Code § 32.0315 (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 32.0315. Funds for Graduate Medical Education

Sec. 32.0315.  FUNDS FOR GRADUATE MEDICAL EDUCATION.  (a)  Subject to appropriated state funds, the executive commissioner shall establish procedures and formulas for the allocation of federal medical assistance funds that are directed to be used to support graduate medical education in connection with the medical assistance program.(b)  The executive commissioner shall allocate the funds in the manner the executive commissioner determines most effectively and equitably achieves the purposes for which those federal funds are received, consistent with the needs of this state for graduate medical education and the training of resident physicians in accredited residency programs in appropriate fields and specialties, taking into account other money available to support graduate medical education.  In determining the needs of this state for graduate medical education, the executive commissioner shall give primary emphasis to graduate medical education in primary care specialties and shall also recognize the growth in residency training slots since 1997 in the Lower Rio Grande Valley and other health care shortage areas of this state.(c)  The executive commissioner shall consult with the Texas Higher Education Coordinating Board before adopting or revising a formula under this section.  At the request of the executive commissioner, the coordinating board shall provide the executive commissioner with any information the board possesses to assist the executive commissioner in administering this section.|Added by Acts 1997, 75th Leg., ch. 252, Sec. 1, eff. Sept. 1, 1997.  Amended by Acts 2003, 78th Leg., ch. 198, Sec. 2.100(a), (b), eff. Sept. 1, 2003.Amended by: Acts 2005, 79th Leg., Ch. 733 (H.B. 2420), Sec. 1, eff. September 1, 2005.Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.106, eff. April 2, 2015.|
TX Hum Res Code § 32.0316 (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 32.0316. Electronic Transactions; Medicaid

Sec. 32.0316.  ELECTRONIC TRANSACTIONS; MEDICAID.  The executive commissioner shall adopt and the commission shall implement policies that encourage the use of electronic transactions in Medicaid.  The policies shall require payment to Medicaid providers by electronic funds transfer, including electronic remittance and status reports.  The policies shall also include the establishment of incentives to submit claims electronically and of disincentives to submit claims on paper that are reasonably based on the higher administrative costs to process claims submitted on paper.|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 12.0124 by Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0017, eff. April 2, 2015.|
TX Hum Res Code § 32.0317 (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 32.0317. Reimbursement for Services Provided Under School Health and Related Services Program

Sec. 32.0317.  REIMBURSEMENT FOR SERVICES PROVIDED UNDER SCHOOL HEALTH AND RELATED SERVICES PROGRAM.  The executive commissioner shall adopt rules requiring parental consent for services provided under the school health and related services program in order for a school district to receive reimbursement for the services.  The rules must allow a school district to seek a waiver to receive reimbursement for services provided to a student who does not have a parent or legal guardian who can provide consent.|Added by Acts 2021, 87th Leg., R.S., Ch. 820 (H.B. 2658), Sec. 7, eff. September 1, 2021.|
TX Hum Res Code § 32.032 (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 32.032. Prevention and Detection of Fraud and Abuse

Sec. 32.032.  PREVENTION AND DETECTION OF FRAUD AND ABUSE.  The executive commissioner  shall adopt reasonable rules for minimizing the opportunity for fraud and abuse, for establishing and maintaining methods for detecting and identifying situations in which a question of fraud or abuse in the program may exist, and for referring cases where fraud or abuse appears to exist to the appropriate law enforcement agencies for prosecution.|Acts 1979, 66th Leg., p. 2352, ch. 842, art. 1, Sec. 1, eff. Sept. 1, 1979.  Amended by Acts 2003, 78th Leg., ch. 198, Sec. 2.104, eff. Sept. 1, 2003;  Acts 2003, 78th Leg., ch. 257, Sec. 2, eff. Sept. 1, 2003.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.106, eff. April 2, 2015.|
TX Hum Res Code § 32.0321 (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 32.0321. Surety Bond

Sec. 32.0321.  SURETY BOND.  (a)  The executive commissioner  by rule may require each provider of medical assistance in a provider type that has demonstrated significant potential for fraud or abuse to file with the commission a surety bond in a reasonable amount.  The executive commissioner by rule shall require a provider of medical assistance to file with the commission a surety bond in a reasonable amount if the commission identifies a pattern of suspected fraud or abuse involving criminal conduct relating to the provider's services under the medical assistance program that indicates the need for protection against potential future acts of fraud or abuse.(b)  The bond under Subsection (a) must be payable to the commission to compensate the commission for damages resulting from or penalties or fines imposed in connection with an act of fraud or abuse committed by the provider under the medical assistance program.(c)  Subject to Subsection (d) or (e), the executive commissioner by rule may require each provider of medical assistance that establishes a resident's trust fund account to post a surety bond to secure the account.  The bond must be payable to the commission to compensate residents of the bonded provider for trust funds that are lost, stolen, or otherwise unaccounted for if the provider does not repay any deficiency in a resident's trust fund account to the person legally entitled to receive the funds.(d)  The executive commissioner may not require the amount of a surety bond posted for a single facility provider under Subsection (c) to exceed the average of the total average monthly balance of all the provider's resident trust fund accounts for the 12-month period preceding the bond issuance or renewal date.(e)  If an employee of a provider of medical assistance is responsible for the loss of funds in a resident's trust fund account, the resident, the resident's family, and the resident's legal representative are not obligated to make any payments to the provider that would have been made out of the trust fund had the loss not occurred.|Added by Acts 1997, 75th Leg., ch. 1153, Sec. 2.03, eff. Sept. 1, 1997.  Amended by Acts 2003, 78th Leg., ch. 198, Sec. 2.105, eff. Sept. 1, 2003;  Acts 2003, 78th Leg., ch. 257, Sec. 3, eff. Sept. 1, 2003.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.107, eff. April 2, 2015.|
TX Hum Res Code § 32.033 (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 32.033. Subrogation

Sec. 32.033.  SUBROGATION.  (a)  The filing of an application for or receipt of medical assistance constitutes an assignment of the applicant's or recipient's right of recovery from:(1)  personal insurance;(2)  other sources;  or(3)  another person for personal injury caused by the other person's negligence or wrong.(b)  A person who applies for or receives medical assistance shall inform the commission, at the time of application or at any time during eligibility and receipt of services, of any unsettled tort claim which may affect medical needs and of any private accident or sickness insurance coverage that is or may become available.  A recipient shall inform the commission of any injury requiring medical attention that is caused by the act or failure to act of some other person.  An applicant or a recipient shall inform the commission as required by this subsection within 60 days of the date the person learns of his or her insurance coverage, tort claim, or potential cause of action.  An applicant or recipient who knowingly and intentionally fails to disclose the information required by this subsection commits a Class C misdemeanor.(c)  A claim for damages for personal injury does not constitute grounds for denying or discontinuing assistance under this chapter.(d)  A separate and distinct cause of action in favor of the state is hereby created, and the commission may, without written consent, take direct civil action in any court of competent jurisdiction.  A suit brought under this section need not be ancillary to or dependent upon any other action.(e)  The commission's right of recovery is limited to the amount of the cost of medical care services paid by the commission.  Other subrogation rights granted under this section are limited to the cost of the services provided.(f)  The executive commissioner may waive the commission's right of recovery in whole or in part when the executive commissioner finds that enforcement would tend to defeat the purpose of public assistance.(g)  The commission may designate an agent to collect funds the commission has a right to recover from third parties under this section.  The commission shall use any funds collected to pay costs of administering the medical assistance program.(h)  The executive commissioner may adopt rules for the enforcement of the commission's right of recovery.|Acts 1979, 66th Leg., p. 2352, ch. 842, art. 1, Sec. 1, eff. Sept. 1, 1979.  Amended by Acts 1979, 66th Leg., p. 2436, ch. 842, art. 2, Sec. 10, eff. Sept. 1, 1979.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.109, eff. April 2, 2015.|
TX Hum Res Code § 32.034 (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 32.034. Contract Cancellation; Notice and Hearing

Sec. 32.034.  CONTRACT CANCELLATION;  NOTICE AND HEARING.  (a)  The commission has authority to adjudicate claims of contested cases in accordance with Chapter 2001, Government Code.  When the commission intends to cancel its contract or impose monetary penalties under a contract with a person providing medical assistance, the commission shall give reasonable notice and an opportunity for hearing if one is requested.  The executive commissioner shall adopt rules consistent with Chapter 2001, Government Code, to implement this section, and hearings under this section are contested cases under that act.(b)  The commission may not terminate a contract during the pendency of a hearing under this section.  The commission may withhold payments during the pendency of a hearing, but the commission shall pay the withheld payments and resume contract payments if the final determination is favorable to the contractor.  The commission's authority to withhold payments shall be established by contract.(c)  The section does not apply if federal matching funds are not available to pay the facility whose contract is being cancelled.  If federal matching funds cannot be used, no state funds may be used to pay the facility.|Acts 1979, 66th Leg., p. 2352, ch. 842, art. 1, Sec. 1, eff. Sept. 1, 1979.  Amended by Acts 1987, 70th Leg., ch. 1052, Sec. 2.02, eff. Sept. 1, 1987;  Acts 1991, 72nd Leg., 1st C.S., ch. 15, Sec. 5.22, eff. Sept. 1, 1991;  Acts 1995, 74th Leg., ch. 76, Sec. 5.95(49), eff. Sept. 1, 1995;  Acts 1997, 75th Leg., ch. 1159, Sec. 2.03, eff. Sept. 1, 1997.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.110, eff. April 2, 2015.|
TX Hum Res Code § 32.035 (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 32.035. Appeals

Sec. 32.035.  APPEALS.  The provisions of Section 31.034 governing the right of appeal of an applicant for or recipient of financial assistance authorized under Chapter 31 also apply to applicants for medical assistance authorized in this chapter.|Acts 1979, 66th Leg., p. 2353, ch. 842, art. 1, Sec. 1, eff. Sept. 1, 1979.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.111, eff. April 2, 2015.|