2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 546 - Long-Term Care and Support Options for Individuals With Disabilities and Elderly Individuals › Subchapter J. Medicaid Waiver Programs › Section 546.0455. Interest List Management for Certain Children Enrolled in Medically Dependent Children (Mdcp) Waiver Program

Text of section effective on April 01, 2025
Sec. 546.0455.  INTEREST LIST MANAGEMENT FOR CERTAIN CHILDREN ENROLLED IN MEDICALLY DEPENDENT CHILDREN (MDCP) WAIVER PROGRAM.  (a)  This section applies only to a child who is enrolled in the medically dependent children (MDCP) waiver program but becomes ineligible for services under the program because the child no longer meets:
(1)  the level of care criteria for medical necessity for nursing facility care; or
(2)  the age requirement for the program.
(b)  A legally authorized representative of a child who is notified by the commission that the child is no longer eligible for the medically dependent children (MDCP) waiver program following a Medicaid fair hearing, or without a Medicaid fair hearing if the representative opted in writing to forgo the hearing, may request that the commission:
(1)  return the child to the interest list for the program unless the child is ineligible due to the child's age; or
(2)  place the child on the interest list for another Section 1915(c) waiver program.
(c)  At the time a child's legally authorized representative makes a request under Subsection (b), the commission shall:
(1)  for a child who becomes ineligible for the reason described by Subsection (a)(1), place the child:
(A)  on the interest list for the medically dependent children (MDCP) waiver program in the first position on the list; or
(B)  except as provided by Subdivision (3), on the interest list for another Section 1915(c) waiver program in a position relative to other individuals on the list that is based on the date the child was initially placed on the interest list for the medically dependent children (MDCP) waiver program;
(2)  except as provided by Subdivision (3), for a child who becomes ineligible for the reason described by Subsection (a)(2), place the child on the interest list for another Section 1915(c) waiver program in a position relative to other individuals on the list that is based on the date the child was initially placed on the interest list for the medically dependent children (MDCP) waiver program; or
(3)  for a child who becomes ineligible for a reason described by Subsection (a) and who is already on an interest list for another Section 1915(c) waiver program, move the child to a position on the interest list relative to other individuals on the list that is based on the date the child was initially placed on the interest list for the medically dependent children (MDCP) waiver program, if that date is earlier than the date the child was initially placed on the interest list for the other waiver program.
(d)  Notwithstanding Subsection (c)(1)(B) or (c)(2), a child may be placed on an interest list for a Section 1915(c) waiver program in the position described by those subsections only if the child has previously been placed on the interest list for that waiver program.
(e)  At the time the commission provides notice to a legally authorized representative that a child is no longer eligible for the medically dependent children (MDCP) waiver program following a Medicaid fair hearing, or without a Medicaid fair hearing if the representative opted in writing to forgo the hearing, the commission shall inform the representative in writing about:
(1)  the options under this section for placing the child on an interest list; and
(2)  the process for applying for the Medicaid buy-in program for children with disabilities implemented under Section 532.0353.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.