reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 371 - MEDICAID AND OTHER HEALTH AND HUMAN SERVICES FRAUD AND ABUSE PROGRAM INTEGRITY › Subchapter G - ADMINISTRATIVE ACTIONS AND SANCTIONS › Division 1 - GENERAL PROVISIONS › Section 371.1617 - Finality and Collections

Current through Reg. 49, No. 28; July 12, 2024
(a) Unless
					 otherwise provided in this subchapter, a sanction becomes final upon any of the
					 following events:
(1) expiration of 30
					 calendar days after service of the notice of final sanction if no request for
					 appeal of imposition of the sanction is received by the OIG by the 30th
					 calendar day after service ;
(2)
					 execution of a settlement agreement with the OIG; or
(3) a final order entered by the Executive
					 Commissioner or his designee after an administrative hearing.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 371 - MEDICAID AND OTHER HEALTH AND HUMAN SERVICES FRAUD AND ABUSE PROGRAM INTEGRITY › Subchapter G - ADMINISTRATIVE ACTIONS AND SANCTIONS › Division 1 - GENERAL PROVISIONS › Section 371.1619 - Award for Reporting Medicaid Fraud, Waste, Abuse, or Overcharges

Current through Reg. 49, No. 28; July 12, 2024
(a) The OIG may grant an award to a person
					 who reports activity that constitutes fraud, waste, or abuse of funds in the
					 Medicaid program or reports overcharges in the program if the OIG determines
					 that the disclosure results in the recovery of a damage or penalty imposed
					 under §
											RSA
					 32.039, Texas Human Resources Code, and
					 described in this subchapter. Unless the person is the original source of the
					 information as defined in §
											RSA
					 36.113(b), Texas
					 Human Resources Code, the OIG may not grant an award to a person in connection
					 with a report if:
(1) The OIG or the OAG had
					 independent knowledge of the activity;
(2) The OIG or the OAG had an open complaint
					 or investigation on the provider or person;
(3) the state or any agent of the state was a
					 party to civil or criminal proceedings in which the allegations were
					 disclosed;
(4) the allegations were
					 disclosed in a legislative or administrative report, hearing, audit, or
					 investigation; or
(5) the
					 allegations were disclosed by the news media.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 371 - MEDICAID AND OTHER HEALTH AND HUMAN SERVICES FRAUD AND ABUSE PROGRAM INTEGRITY › Subchapter G - ADMINISTRATIVE ACTIONS AND SANCTIONS › Division 2 - GROUNDS FOR ENFORCEMENT › Section 371.1651 - Provider Eligibility

Current through Reg. 49, No. 28; July 12, 2024
A person is subject to administrative actions or
						sanctions if the person:
(1) is
					 suspended, terminated, or otherwise sanctioned by Medicare, Medicaid, another
					 HHS program, CHIP, or any state or federally funded health care
					 program;
(2) is affiliated with a
					 person who has been suspended, terminated, or otherwise prohibited from
					 participating in Medicare, Texas Medicaid, CHIP, or other HHS
					 program;
(3) is a provider and any
					 person with an ownership interest in the provider has been convicted of a
					 criminal offense related to that person's involvement with the Medicare,
					 Medicaid, or Title XXI program in the last ten years;
(4) is a person with an ownership or control
					 interest in a provider or is an agent or managing employee of the provider and
					 fails to:
(A) disclose or submit timely and
					 accurate information, including fingerprints if required by federal or state
					 rule, statute, regulation, or published policy; or
(B) cooperate with any and all screening
					 methods required during the provider screening process under statute or
					 regulation;
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 371 - MEDICAID AND OTHER HEALTH AND HUMAN SERVICES FRAUD AND ABUSE PROGRAM INTEGRITY › Subchapter G - ADMINISTRATIVE ACTIONS AND SANCTIONS › Division 2 - GROUNDS FOR ENFORCEMENT › Section 371.1655 - Program Compliance

Current through Reg. 49, No. 28; July 12, 2024
A person is subject to administrative actions or
						sanctions if the person:
(1) is
					 excluded or terminated for cause on or after January 1, 2011, under Title XVIII
					 of the Social Security Act or under the Medicaid program or CHIP of any other
					 state;
(2) commits an act for which
					 sanctions, damages, penalties, or liability could be or are assessed by the
					 OIG;
(3) fails to repay
					 overpayments or other assessments after receiving written notice of the
					 overpayment or of delinquency by the OIG or any HHS program or HHS
					 agency;
(4) fails to repay
					 overpayments within 60 calendar days of self-identifying or discovering an
					 overpayment that was made to the person by the Medicaid, CHIP or other HHS
					 program;
(5) fails to comply, when
					 required for participation in Medicaid or other HHS program or award, with
					 financial record and supporting document retention requirements designed to
					 ensure that a person's claims or costs may be reviewed objectively for accuracy
					 and validity. Such requirements include compliance with:
(A) United States Office of Management and
					 Budget (OMB) circulars;
(B)
					 generally accepted accounting principles (GAGAS);
(C) state or federal law; or
(D) contractual requirements;
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 371 - MEDICAID AND OTHER HEALTH AND HUMAN SERVICES FRAUD AND ABUSE PROGRAM INTEGRITY › Subchapter G - ADMINISTRATIVE ACTIONS AND SANCTIONS › Division 2 - GROUNDS FOR ENFORCEMENT › Section 371.1657 - Unallowable Fiscal Gain

Current through Reg. 49, No. 28; July 12, 2024
A person is subject to administrative actions or
						sanctions if the person:
(1) requests
					 payment from a recipient for services or items delivered within the Medicaid or
					 other HHS program when payment for the services was recouped by Medicaid or
					 another HHS program for any reason;
(2) requests payment from recipients for
					 services or items furnished , directed , ordered, or prescribed by an excluded
					 person without first:
(A) informing the
					 recipient, before delivery of the item or service, that those services are not
					 reimbursable by the Medicaid or other HHS program; and
(B) obtaining and retaining, before delivery
					 of the item or service, a written signed consent from the recipient indicating
					 that the recipient understands he or she is responsible for payment for the
					 services and that the services or items are still desired;
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 371 - MEDICAID AND OTHER HEALTH AND HUMAN SERVICES FRAUD AND ABUSE PROGRAM INTEGRITY › Subchapter G - ADMINISTRATIVE ACTIONS AND SANCTIONS › Division 2 - GROUNDS FOR ENFORCEMENT › Section 371.1659 - Compliance with Health Care Standards

Current through Reg. 49, No. 28; July 12, 2024
A person is subject to administrative actions or
						sanctions if the person:
(1) engages
					 in any negligent or abusive practice that results in death, injury, or
					 substantial probability of death or injury to a recipient;
(2) fails to provide an item or service to a
					 recipient in accordance with accepted medical community standards or standards
					 required by statute, regulation, or contract, including statutes and standards
					 that govern occupations;
(3)
					 furnishes or orders services or items for a recipient under the Medicaid or
					 other HHS program that substantially exceed a recipient's needs, are not
					 medically necessary, are not provided economically or are of a quality that
					 fails to meet professionally recognized standards of health care;
(4) is the subject of a voluntary or
					 involuntary action taken by a licensing or certification agency or board, which
					 action is based upon the agency or board's receipt of evidence of noncompliance
					 with licensing or certification requirements;
(5) has its license to provide health care
					 revoked, suspended, or probated by any state's licensing or certification
					 authority, or surrenders a license or certification while a formal disciplinary
					 proceeding is pending before any state's licensing or certification
					 authority;
(6) fails to abide by
					 applicable statutes and standards governing providers;
(7) fails to comply with the security,
					 privacy, marketing, disclosure, notification, business associate and breach
					 requirements of HIPAA and regulations promulgated under HIPAA or the Texas
					 Medical Records Privacy Act in chapter 181 of the Texas Health and Safety Code
					 and regulations promulgated under that Act;
(8) fails to timely provide notice of
					 electronic disclosure to a recipient for whom the person creates or receives
					 protected health information that is subject to electronic
					 disclosure;
(9) electronically
					 discloses or permits the electronic disclosure of a recipient's protected
					 health information to any person without a separate, documented authorization
					 from the recipient or the recipient's legally authorized representative for
					 each disclosure, unless the disclosure is:
(A)
					 to a covered entity as defined by §
												RSA
					 181.001 of the Texas Health and Safety Code
					 or to a covered entity as that term is defined by §
												RSA
					 602.001 of the Texas Insurance Code for the
					 purpose of:
(i) treatment;
(ii) payment;
(iii) health care operations; or
(iv) performing an insurance or health
					 maintenance organization function as described by §
													RSA
					 602.053 of the Texas Insurance Code;
					 or
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 371 - MEDICAID AND OTHER HEALTH AND HUMAN SERVICES FRAUD AND ABUSE PROGRAM INTEGRITY › Subchapter G - ADMINISTRATIVE ACTIONS AND SANCTIONS › Division 2 - GROUNDS FOR ENFORCEMENT › Section 371.1661 - Convictions and Prohibited Acts

Current through Reg. 49, No. 28; July 12, 2024
A person is subject to administrative actions or
						sanctions if the person is convicted of or engages in an act that constitutes
						under state or federal law:
(1) a
					 criminal offense related to performance of a provider agreement or program
					 violation of Medicare, the Medicaid program, other HHS program, or any other
					 state's Medicaid program;
(2) a
					 criminal offense relating to dangerous drugs, controlled substances, or any
					 other drug-related offense, including the unlawful manufacture, distribution,
					 prescription, dispensing, or possession of a controlled substance;
(3) a criminal offense involving moral
					 turpitude;
(4) a criminal offense
					 relating to fraud, theft, embezzlement, breach of fiduciary responsibility, or
					 other financial misconduct relating to the delivery of a health care item or
					 service;
(5) a criminal offense
					 relating to fraud, theft, embezzlement, breach of fiduciary responsibility, or
					 other financial misconduct relating to any act or omission in a program
					 operated or financed, in whole or in part, by any federal, state, or local
					 government agency;
(6) a criminal
					 offense related to the delivery of an item or service under Medicare, the
					 Medicaid program, other HHS program, or any other state's Medicaid program,
					 including the performance of management or administrative services relating to
					 the delivery of items or services under any such program;
(7) a criminal offense related to the neglect
					 or abuse of a patient, in connection with the delivery of a health care item or
					 service, including any offense that the OIG concludes entailed, or resulted in,
					 neglect or abuse of patients; or
(8) a criminal offense related to the
					 interference with or obstruction of any audit or investigation into an alleged
					 criminal offense.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 371 - MEDICAID AND OTHER HEALTH AND HUMAN SERVICES FRAUD AND ABUSE PROGRAM INTEGRITY › Subchapter G - ADMINISTRATIVE ACTIONS AND SANCTIONS › Division 2 - GROUNDS FOR ENFORCEMENT › Section 371.1667 - Records and Documentation

Current through Reg. 49, No. 28; July 12, 2024
A person is subject to administrative actions or
						sanctions if the person:
(1) fails to
					 make, maintain, retain, or produce adequate documentation according to Medicaid
					 or other HHS policy, state or federal law, rule or regulation, or contract for
					 a minimum period of:
(A) five years from the
					 date of service or until all audit questions, administrative hearings,
					 investigations, court cases, or appeals are resolved;
(B) six years or until all audit questions,
					 administrative hearings, investigations, court cases, or appeals are resolved
					 if the person is a Freestanding Rural Health Clinic; and
(C) ten years or until all audit questions,
					 administrative hearings, investigations, court cases, or appeals are resolved
					 if the person is a hospital-based Rural Health Clinic;
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 371 - MEDICAID AND OTHER HEALTH AND HUMAN SERVICES FRAUD AND ABUSE PROGRAM INTEGRITY › Subchapter G - ADMINISTRATIVE ACTIONS AND SANCTIONS › Division 3 - ADMINISTRATIVE ACTIONS AND SANCTIONS › Section 371.1701 - Administrative Actions

Current through Reg. 49, No. 28; July 12, 2024
(a) The OIG may
					 impose one or more administrative actions if it determines that the person
					 committed an act for which a person is subject to administrative actions or
					 sanctions, including the following:
(1)
					 commits a program violation;
(2)
					 commits an act for which sanctions, damages, penalties, or liability could be
					 or are assessed by the OIG;
(3)
					 commits an act that amounts to fraud, abuse, overpayment, or waste in relation
					 to Medicaid or an HHS program or service; or
(4) is affiliated with a person who commits
					 an act described in paragraphs (1) - (3) of this subsection.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 371 - MEDICAID AND OTHER HEALTH AND HUMAN SERVICES FRAUD AND ABUSE PROGRAM INTEGRITY › Subchapter G - ADMINISTRATIVE ACTIONS AND SANCTIONS › Division 3 - ADMINISTRATIVE ACTIONS AND SANCTIONS › Section 371.1707 - Permissive Exclusion

Current through Reg. 49, No. 28; July 12, 2024
(a) The OIG may
					 exclude from participation in Titles V, XVIII , XIX, XX, or CHIP programs any
					 person if it determines that the person:
(1)
					 commits a program violation;
(2) is
					 affiliated with a person who commits a program violation;
(3) commits an act for which damages,
					 penalties, or liability could be or are assessed by the OIG;
(4) is a person not enrolled as a provider
					 whose health care license, certification, or other qualifying requirement to
					 perform certain types of service is revoked, suspended, voluntarily
					 surrendered, or otherwise terminated such that the provider is unable to
					 legally perform their profession due to loss of their license, certification,
					 or other qualifying requirement;
(5) could be excluded for any reason for
					 which the Secretary of the United States Department of Health and Human
					 Services, its Office of Inspector General, or its agents could exclude such
					 person under
					 RSA
					 1320a-7(b) or 42
					 C.F.R. Part 1001 or 1003;
(6) is
					 found liable for any violation under subsection (c) of Texas Human Resources
					 Code §
												RSA
					 32.039 that resulted in injury to a person
					 who is 65 years of age or older, a person with a disability, or a person
					 younger than 18 years of age;
(7)
					 is found liable for any violation under subsection (c) of Texas Human Resources
					 Code §
												RSA
					 32.039 that did not result in injury to a
					 person 65 years of age or older, a person with a disability, or a person
					 younger than 18 years of age; or
(8) has been excluded from participation in
					 Medicare or any other federal health care programs.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 371 - MEDICAID AND OTHER HEALTH AND HUMAN SERVICES FRAUD AND ABUSE PROGRAM INTEGRITY › Subchapter G - ADMINISTRATIVE ACTIONS AND SANCTIONS › Division 3 - ADMINISTRATIVE ACTIONS AND SANCTIONS › Section 371.1709 - Payment Hold

Current through Reg. 49, No. 28; July 12, 2024
(a) Subject to
					 subsections (c) and (d) of this section, the OIG imposes a payment hold against
					 a provider only:
(1) to compel the production
					 records or documents;
(2) when
					 requested by the state's Medicaid Fraud Control Unit; or
(3) upon the determination a credible
					 allegation of fraud exists.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 371 - MEDICAID AND OTHER HEALTH AND HUMAN SERVICES FRAUD AND ABUSE PROGRAM INTEGRITY › Subchapter G - ADMINISTRATIVE ACTIONS AND SANCTIONS › Division 3 - ADMINISTRATIVE ACTIONS AND SANCTIONS › Section 371.1711 - Recoupment of Overpayments and Debts

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 The OIG recovers overpayments made to providers within the Medicaid or other
					 HHS programs, whether the overpayment resulted from error by the provider, the
					 claims administrator, or an operating agency, misunderstanding, or a program
					 violation.
(b) Application. The OIG
					 may recoup from any person if it determines that the person committed an act
					 for which a person is subject to administrative actions or sanctions, including
					 the following:
(1) commits a program
					 violation that leads to the payment of an overpayment;
(2) has failed to pay a debt owed to Medicare
					 or to any Medicaid program as the result of fraudulent or abusive actions by a
					 person participating in such program;
(3) is affiliated with a person who commits a
					 program violation that leads to the payment of an overpayment;
(4) commits an act for which sanctions,
					 damages, penalties, or liability could be or are assessed by the OIG;
					 or
(5) who causes or receives an
					 overpayment.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 371 - MEDICAID AND OTHER HEALTH AND HUMAN SERVICES FRAUD AND ABUSE PROGRAM INTEGRITY › Subchapter G - ADMINISTRATIVE ACTIONS AND SANCTIONS › Division 3 - ADMINISTRATIVE ACTIONS AND SANCTIONS › Section 371.1715 - Damages and Penalties

Current through Reg. 49, No. 28; July 12, 2024
(a) The OIG may
					 assess administrative penalties otherwise authorized by law on behalf of the
					 commission or a health and human services agency.
(b) Any administrative penalties or damages
					 assessed for violations related to health care items or services that are
					 authorized or provided under federal law, including claims submitted by persons
					 for payment under the Medicaid program, are determined as provided in Texas
					 Human Resources Code, §
											RSA 32.039. The
					 OIG will also follow the procedures for imposing penalties or damages in Texas
					 Human Resources Code, §
											RSA 32.039,
					 which include opportunities for a person subject to potential penalties or
					 damages to have an informal review and an appeal, and apply the factors in
					 accordance with §
											RSA
					 371.1603 of this subchapter (relating to
					 Legal Basis and Scope).
(c) This
					 rule shall not be construed to deny any person potentially subject to an
					 administrative sanction imposed by the OIG, including administrative damages or
					 penalties, the right to introduce mitigating evidence in a contested case
					 proceeding. This rule also shall not be construed to deny the OIG the right to
					 introduce any evidence supporting any of the factors described in §
											RSA
					 371.1603 of this subchapter (relating to
					 Legal Basis and Scope) in a contested case proceeding in which the agency seeks
					 to impose an administrative sanction, including administrative damages or
					 penalties, upon a person.
(d) Due
					 process.
(1) After service of a notice of
					 preliminary report recommending the assessment of an administrative penalty, a
					 person has a right to make a written request for an informal review not later
					 than the tenth day after service of the notice.
(2) After receiving written notice of the
					 results of an informal review, a person may make a written request for an
					 administrative appeal hearing no later than ten days after the date of service
					 of the notice.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 371 - MEDICAID AND OTHER HEALTH AND HUMAN SERVICES FRAUD AND ABUSE PROGRAM INTEGRITY › Subchapter G - ADMINISTRATIVE ACTIONS AND SANCTIONS › Division 3 - ADMINISTRATIVE ACTIONS AND SANCTIONS › Section 371.1719 - Recoupment of Overpayments Identified by Audit

Current through Reg. 49, No. 28; July 12, 2024
(a) The OIG may recoup an overpayment if the
					 overpayment was identified in an audit that found claims or cost reports
					 resulted in money paid in excess of what the person is or was entitled to
					 receive under an HHS program, contract, or grant. This section does not include
					 overpayments identified by a Recovery Audit Contractor (RAC) pursuant to
					 RSA
					 455.506.
(b) Audit procedures.
(1) An audit conducted by the OIG or its
					 contractor must:
(A) be conducted and reported
					 in accordance with Generally Accepted Governmental Auditing Standards (GAGAS)
					 or other appropriate standards recognized by the United States Government
					 Accountability Office;
(B) limit
					 the period covered by an audit to five years;
(C) notify the person, and the person's
					 corporate headquarters if the person is incorporated, of the impending audit
					 not later than the seventh day before the date the site visit, if any, begins,
					 except when an element of surprise is critical to the audit objective, such as
					 surprise audits, cash counts, or fraud-related procedures; and
(D) permit the person to produce, for
					 consideration, documentation to address any exception found during an audit not
					 later than the tenth calendar day after the date the exit conference, if any,
					 is completed, or by a later date as specified by the auditor.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter A - OVERVIEW AND PURPOSE › Section 372.1 - Purpose and Scope

Current through Reg. 49, No. 28; July 12, 2024
This chapter covers the following programs:
(1) the Temporary Assistance for Needy
				  Families (TANF) Program; and
(2)
				  the Supplemental Nutrition Assistance Program (SNAP), formerly known as the
				  Food Stamp Program.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter A - OVERVIEW AND PURPOSE › Section 372.3 - Legal Basis

Current through Reg. 49, No. 28; July 12, 2024
(a) For the TANF
				  Program, the federal law basis is:
(1) Title
				  IV of the Social Security Act (RSA 601 et
				  seq.); and
(2) the federal
				  regulations in 45 CFR, Parts 260 through 265.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter A - OVERVIEW AND PURPOSE › Section 372.4 - Purpose of TANF and SNAP

Current through Reg. 49, No. 28; July 12, 2024
(a) The TANF
				  Program encourages self-sufficiency by providing temporary cash assistance and
				  work opportunities to needy families with dependent children.
(b) SNAP encourages improved diets by
				  providing nutrition assistance to low-income individuals or groups.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter A - OVERVIEW AND PURPOSE › Section 372.5 - Funding for TANF and SNAP

Current through Reg. 49, No. 28; July 12, 2024
(a) The federal
				  government and the State of Texas provide the funding for the TANF Program. The
				  State of Texas fully funds the TANF State Program.
(b) The federal government provides most of
				  the funding for SNAP and the State of Texas funds the rest. Federal funds pay
				  for SNAP benefits and for one-half of the administrative costs. The State of
				  Texas pays the other half of the administrative costs.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter A - OVERVIEW AND PURPOSE › Section 372.6 - TANF and SNAP Administrator

Current through Reg. 49, No. 28; July 12, 2024
(a) The Texas
				  Health and Human Services Commission (HHSC) administers the TANF Program in
				  Texas under guidance from the U.S. Department of Health and Human Services.
(1) HHSC:
(A) develops the state plan, policies, and
				  procedures;
(B) certifies eligible
				  children and families for benefits and services; and
(C) provides the benefits and
				  services.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 1 - TANF CERTIFIED GROUPS › Section 372.101 - Receiving TANF Benefits

Current through Reg. 49, No. 28; July 12, 2024
(a) The TANF
					 Program provides benefits by certified group, meaning to an individual or group
					 of relatives living together in a family setting whose needs the Texas Health
					 and Human Services Commission includes together in the TANF case. A certified
					 group must include at least one dependent child.
(b) A recipient of TANF benefits must use the
					 benefits to provide for the needs of the children in the certified
					 group.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 1 - TANF CERTIFIED GROUPS › Section 372.102 - Caretaker

Current through Reg. 49, No. 28; July 12, 2024
(a) A caretaker is a person who cares for a
					 dependent child, whom the Texas Health and Human Services Commission includes
					 in the certified group, and who ordinarily receives and manages the TANF
					 benefits for the certified group.
(b) To qualify as a caretaker, a person must:
(1) reside in a family setting with,
					 supervise, and care for:
(A) a dependent
					 child;
(B) a child who receives
					 Supplemental Security Income (SSI), foster care, or adoption subsidy payments;
					 or
(C) a child who receives
					 Medicaid based on having received SSI; and
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 1 - TANF CERTIFIED GROUPS › Section 372.103 - Composition of a TANF Certified Group

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 The Texas Health and Human Services Commission (HHSC) may include together in a
					 TANF certified group:
(1) each dependent
					 child; and
(2) each relative of a
					 dependent child:
(A) living with the child in
					 a family setting being established or maintained as shown by the relative
					 through continuing responsibility for the child's day-to-day care;
					 and
(B) whose relationship to the
					 child, by blood, marriage, or adoption extends up to the degree indicated in
					 §372.108 of this division (relating to Relationship
					 Requirement).
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 1 - TANF CERTIFIED GROUPS › Section 372.104 - Required TANF Certified Group Members

Current through Reg. 49, No. 28; July 12, 2024
Unless a person is excluded under §372.107 of this
						division (relating to Excluded TANF Certified Group Members), the Texas Health
						and Human Services Commission requires the TANF certified group to
						include:
(1) the dependent child for
					 whom application is made;
(2) each
					 parent of a dependent child living in the household; and
(3) each sibling of a dependent child living
					 in the household.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 1 - TANF CERTIFIED GROUPS › Section 372.105 - Eligibility for a Stepparent

Current through Reg. 49, No. 28; July 12, 2024
The Texas Health and Human Services Commission includes
						in the TANF certified group a stepparent living in the household only if the
						parent is disabled or is not living in the household.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 1 - TANF CERTIFIED GROUPS › Section 372.106 - Eligibility for the Spouse of a Caretaker

Current through Reg. 49, No. 28; July 12, 2024
If the caretaker is not the child's parent, the Texas
						Health and Human Services Commission does not include the spouse of the
						caretaker in the TANF certified group, except as described in §372.105 of
						this division (relating to Eligibility for a Stepparent).
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 1 - TANF CERTIFIED GROUPS › Section 372.107 - Excluded TANF Certified Group Members

Current through Reg. 49, No. 28; July 12, 2024
The Texas Health and Human Services Commission (HHSC)
						excludes from the TANF certified group:
(1) an authorized representative, payee, or
					 protective payee;
(2) a recipient
					 of Supplemental Security Income (SSI), foster care, or adoption subsidy
					 payments; and
(3) a person
					 disqualified from receiving TANF benefits or ineligible to receive TANF
					 benefits, because HHSC determines the person:
(A) does not meet an eligibility requirement
					 relating to the person's:
(i) age (because,
					 for example, the person does not meet the definition of a child);
(ii) citizenship as explained in Division 3
					 of this subchapter (relating to Citizenship);
(iii) residency as explained in Division 4 of
					 this subchapter (relating to Residency);
(iv) domicile as explained in Division 5 of
					 this subchapter (relating to Domicile); or
(v) relationship status (because, for
					 example, the person is not within the degree of relationship required by
					 §372.108 of this division (relating to Relationship
					 Requirement);
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 1 - TANF CERTIFIED GROUPS › Section 372.108 - Relationship Requirement

Current through Reg. 49, No. 28; July 12, 2024
In the TANF Program, a person meets the relationship
						requirement, if the person is by law, marriage, or adoption a child's:
(1) father, mother, brother, or
					 sister;
(2) stepfather or
					 stepmother (if the child's legal parent is disabled or if there is no legal
					 parent in the household);
(3)
					 stepbrother or stepsister;
(4)
					 grandparent, to the degree of a "great, great, great" grandparent;
(5) uncle or aunt, to the degree of a "great,
					 great" uncle or aunt;
(6) nephew or
					 niece, to the degree of a "great, great" nephew or niece;
(7) first cousin; or
(8) first cousin once removed.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 2 - SNAP HOUSEHOLDS › Section 372.151 - Receiving SNAP Benefits

Current through Reg. 49, No. 28; July 12, 2024
SNAP provides benefits by household, as defined in
						RSA 273.1. A
						household may consist of an individual or a group of individuals who live
						together.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 2 - SNAP HOUSEHOLDS › Section 372.152 - Required SNAP Household Members

Current through Reg. 49, No. 28; July 12, 2024
The Texas Health and Human Services Commission follows
						RSA
						273.1(b), which
						requires including in the household certain people living
						together.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 2 - SNAP HOUSEHOLDS › Section 372.153 - Determining SNAP Household Eligibility

Current through Reg. 49, No. 28; July 12, 2024
To determine eligibility for SNAP benefits of each of the
						following various types of households, the Texas Health and Human Services
						Commission follows the federal regulation or regulations in 7 CFR indicated in
						the following table:
Attached
						Graphic
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 3 - CITIZENSHIP › Section 372.201 - TANF Citizenship Requirements

Current through Reg. 49, No. 28; July 12, 2024
To be eligible for TANF benefits, a person must
						be:
(1) a citizen of the
					 U.S.;
(2) an alien who legally
					 entered the U.S. before August 22, 1996, and who meets the eligibility criteria
					 in RSA 1641(b) or
					 (c); or
(3) an alien who legally entered the U.S. on
					 or after August 22, 1996, and who meets the eligibility criteria in
					 RSA
					 1612(b) and
					 §
											RSA
					 1613, except that a legal permanent resident
					 alien is eligible after residing in the U.S. for five years only if the alien
					 meets one of the following eligibility requirements:
(A) the alien is an honorably discharged
					 veteran or active duty military personnel;
(B) the alien is a spouse, unmarried
					 surviving spouse, or minor unmarried child of an honorably discharged veteran
					 or active duty military personnel (if a surviving spouse of a deceased veteran
					 or active duty military person, the surviving spouse must not have
					 remarried);
(C) the alien entered
					 the U.S. before August 22, 1996, and remained continuously present in the U.S.
					 (a single absence from the U.S. of more than 30 days or a combined absence of
					 more than 90 days interrupts the "continuous presence") since at least August
					 21, 1996, until obtaining qualifying immigrant status (an alien who entered the
					 U.S. without proper documents or overstayed his or her visa, is treated the
					 same as an alien who entered and remained in the U.S. with valid immigration
					 documents);
(D) the alien entered
					 the U.S. with a status described in the
Texas Works Handbook,
Item A-342, Chart C and meets those eligibility criteria, or meets the criteria
					 in the
Texas Works Handbook,
Item A-343, How to Determine
					 Eligibility for Battered Aliens; or
(E) the alien meets the 40 qualifying
					 quarters requirements in the
Texas Works Handbook,
Item A-354,
					 Verifying 40 "Qualifying Quarters," and five years have passed since the
					 alien's legal date of entry.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 3 - CITIZENSHIP › Section 372.202 - Verifying Citizenship for TANF

Current through Reg. 49, No. 28; July 12, 2024
(a) TANF
					 applicants must prove eligibility under §372.201 of this division
					 (relating to TANF Citizenship Requirements). The Texas Health and Human
					 Services Commission (HHSC) determines what proof is required. Applicants are
					 responsible for providing proof. HHSC may obtain proof of citizenship from the
					 Texas Bureau of Vital Statistics or from the Social Security
					 Administration.
(b) HHSC
					 disqualifies TANF applicants HHSC determines have failed without good cause to
					 prove eligibility under §372.201 of this division.
(c) HHSC may grant good cause to a TANF
					 applicant who has not complied with subsection (a) of this section and may
					 postpone the requirement to provide proof until the next eligibility
					 assessment, if the applicant:
(1) made a good
					 faith effort to provide the proof; and
(2) was unable to provide proof because of
					 circumstances beyond the applicant's control.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 3 - CITIZENSHIP › Section 372.203 - SNAP Citizenship Requirements

Current through Reg. 49, No. 28; July 12, 2024
To be eligible for SNAP, a person must be:
(1) a citizen of the U.S.; or
(2) an alien legally admitted to the U.S. who
					 meets the eligibility criteria in
					 RSA
					 1612(a)(2).
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 3 - CITIZENSHIP › Section 372.204 - Verifying Citizenship for SNAP

Current through Reg. 49, No. 28; July 12, 2024
(a) The
					 Texas Health and Human Services Commission (HHSC) requires proof of citizenship
					 from a SNAP applicant if HHSC determines the applicant's citizenship is
					 questionable. Applicants are responsible for proving eligibility under
					 §372.203 of this division (relating to SNAP Citizenship Requirements) upon
					 request.
(b) HHSC disqualifies
					 applicants who fail to prove eligibility under §372.203 of this division
					 until proof is provided.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 3 - CITIZENSHIP › Section 372.205 - Reporting Undocumented Alien Applicants

Current through Reg. 49, No. 28; July 12, 2024
The Texas Health and Human Services Commission reports to
						the United States Citizenship and Immigration Service only those aliens who
						apply for TANF or SNAP benefits and who have a final order of deportation, as
						required for SNAP by
						RSA
						2020(e).
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 4 - RESIDENCY › Section 372.251 - Residency Requirements for TANF

Current through Reg. 49, No. 28; July 12, 2024
(a) A
					 person must be a Texas resident to be eligible for TANF benefits. A person
					 meets the residency requirement if the Texas Health and Human Services
					 Commission (HHSC) determines the person lives in Texas and intends to remain in
					 Texas permanently or for an indefinite time.
(b) A migrant or itinerant worker meets the
					 residency requirement if HHSC determines the migrant or itinerant worker lives
					 in Texas, entered the state with a job commitment or an intention to seek
					 employment, and is not receiving TANF benefits from another state.
(c) A TANF recipient who leaves Texas but
					 returns within 90 days and declares the out-of-state stay was not permanent may
					 establish residency for the period the person was out of state, as determined
					 by HHSC, and may be eligible for retroactive TANF benefits for the period the
					 person was out of state.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 4 - RESIDENCY › Section 372.252 - Residency Requirements for SNAP

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 To be eligible for SNAP benefits, a person must live in Texas.
(b) The Texas Health and Human Services
					 Commission follows
					 RSA
					 273.3 in determining a SNAP applicant's
					 residency, which does not require a person to reside in a permanent dwelling or
					 express an intent to reside in Texas permanently.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 5 - DOMICILE › Section 372.301 - Domicile Requirements for TANF

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 Each person the Texas Health and Human Services Commission (HHSC) includes in a
					 TANF case for benefits must live in the household, unless HHSC has determined
					 the person is temporarily out of the home.
(b) An unmarried minor parent must live in an
					 adult supervised setting, as determined by HHSC, to be eligible for TANF
					 benefits.
(c) HHSC may consider a
					 person to be living in the household even though the person has entered a
					 nursing facility, so long as HHSC determines the person's stay in the nursing
					 facility is temporary.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 6 - RESOURCES › Section 372.351 - Overview of Resources

Current through Reg. 49, No. 28; July 12, 2024
(a) In the TANF
					 Program, resources are cash (or its equivalent) and property that is
					 convertible to cash (or its equivalent). Resources include:
(1) cash from income not obligated in the
					 month of receipt; and
(2) lump sum
					 payments received intermittently and no more often than once
					 annually.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 6 - RESOURCES › Section 372.352 - Resource Eligibility Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 In TANF, a household meets the resources eligibility requirement if the
					 household's countable resources are at or below the applicable resource limits
					 explained in §372.354 of this division (relating to Treatment of Resources
					 in TANF).
(b) In SNAP, a household
					 meets the resources eligibility requirement if the household's countable
					 resources are at or below the applicable resource limits explained in
					 §372.355 of this division (relating to Treatment of Resources in
					 SNAP).
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 6 - RESOURCES › Section 372.353 - Determining the Value of a Non-Cash Resource

Current through Reg. 49, No. 28; July 12, 2024
(a) The Texas Health and Human Services
					 Commission (HHSC) considers the value of a non-cash resource, except for a
					 vehicle, to be the actual amount of money available from the sale of the
					 resource. HHSC determines the value by subtracting any money owed on the
					 resource and any costs usually associated with selling the resource from the
					 resource's fair market value.
(b)
					 HHSC considers the value of a vehicle to be its fair market value.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 372 - TEMPORARY ASSISTANCE FOR NEEDY FAMILIES AND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAMS › Subchapter B - ELIGIBILITY › Division 6 - RESOURCES › Section 372.354 - Treatment of Resources in TANF

Current through Reg. 49, No. 28; July 12, 2024
(a) In the TANF
					 Program, the countable resources limit is $1,000.
(b) Unless a resource is excluded under
					 subsection (c) of this section, the Texas Health and Human Services Commission
					 (HHSC) counts the resources of:
(1) the
					 members of the certified group;
(2)
					 each parent of a child in the certified group living in the household and
					 ineligible or disqualified from receiving TANF benefits;
(3) each sibling of a dependent child in the
					 certified group living in the household and disqualified from receiving TANF
					 benefits; and
(4) the sponsors and
					 the sponsors' spouses, for a household containing a sponsored alien.