reglab/statecodes huggingface dataset:
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 G - RETAILER REQUIREMENTS › Section 372.1705 - Manual Voucher Transaction Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) Retailers that must provide manual
				  voucher services are:
(1) stores that do not
				  qualify for equipment because they do not average at least $100 a month in SNAP
				  transactions; or
(2) do not have
				  electricity or a phone line at the time of the purchase.
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 G - RETAILER REQUIREMENTS › Section 372.1706 - Electronic Manual Voucher Transaction Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) Electronic voucher transaction. A
				  retailer may enter a manual voucher into a point-of-sale terminal at the
				  retailer location and submit it as an electronic voucher in the form of an
				  Advice transaction.
(b) Electronic
				  Benefit Transfer (EBT) electronic manual voucher procedures. If a retailer with
				  electronic voucher capacity uses a manual voucher, the retailer or its
				  third-party processor must complete the manual voucher as specified in §
										RSA
				  372.1705 of this subchapter (relating to
				  Manual Voucher Transaction Requirements) and:
(1) obtain voice authorization from the EBT
				  call center before completing the manual voucher transaction;
(2) enter the authorization code on the
				  manual voucher and in the Advice; and
(3) submit the Advice transaction within 15
				  calendar days after the date of purchase.
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 G - RETAILER REQUIREMENTS › Section 372.1707 - Liability Implications for Manual Transactions

Current through Reg. 49, No. 28; July 12, 2024
(a) The Texas Health and Human Services
				  Commission's (HHSC's) manual transactions liability is only for those manual
				  transactions performed in accordance with the written agreement under
				  RSA
				  274.12(g)(6) and
				  processing standards in
				  RSA
				  274.12(h).
(b) HHSC reimburses a retailer for manual
				  transactions, as required by the terms and conditions of the retailer
				  agreement, for which an insufficient amount of benefits remain in the client's
				  account at the time the manual voucher is presented for processing and
				  payment.
(c) If authorization
				  cannot be obtained before or at the time of purchase, a retailer assumes the
				  risk of insufficient benefits being available in the client's
				  account.
(d) A retailer using voice
				  authorization and electronic voucher is liable if the retailer management EBT
				  contractor rejects its or its third-party processor's submission because of
				  failure to follow the procedures in §
										RSA
				  372.1706 of this subchapter (relating to
				  Electronic Manual Voucher Transaction Requirements).
(e) Neither the retailer management EBT
				  contractor nor the retailer may re-present a manual voucher for payment if
				  insufficient funds exist when the voucher is submitted for processing and
				  payment.
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 G - RETAILER REQUIREMENTS › Section 372.1708 - Store-and-Forward as an Alternative to Manual Transaction

Current through Reg. 49, No. 28; July 12, 2024
In compliance with
					 RSA
					 274.12(m), a
					 Texas EBT third-party processor may be certified for store-and-forward
					 approvals as an alternative to manual voucher transactions. Store-and-forward
					 is an electronic back-up for the retailer's online system. It is also known as
					 stand-in processing.
(1) At the
				  retailer's own choice and liability, a retailer may store transactions when the
				  EBT central processing system cannot be accessed for any reason and then
				  forward the transactions to the EBT central processing system after the system
				  again becomes available.
(2) A
				  retailer may forward the transaction to the EBT central processing system one
				  time within 24 hours after the system again becomes available. If the 24-hour
				  period crosses into the beginning of a new benefit issuance period, the
				  retailer may draw against all available benefits in the account.
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 G - RETAILER REQUIREMENTS › Section 372.1709 - Liability Implications for Store-and-Forward Transactions

Current through Reg. 49, No. 28; July 12, 2024
If there are insufficient funds to authorize the full
					 amount of an otherwise approvable store-and-forward transaction, the balance
					 remaining in the client's account is paid to the retailer in accordance with
					 the following:
(1) The EBT central
				  processing system approves a partial amount of the store-and-forward
				  transaction, crediting the retailer with the balance remaining in the client's
				  account through a one-step process.
(2) The transaction must be in accordance
				  with the standard message format requirements for store-and-forward
				  transactions.
(3) The retailer must
				  not obtain the uncollected balance from a client's current or future month's
				  benefits.
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 G - RETAILER REQUIREMENTS › Section 372.1710 - Third-Party Processor Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Retailers entering the EBT system that choose to use an authorized third-party
				  processor must choose one that is certified to the Texas EBT system.
(b) A third-party processor must:
(1) comply with performance and technical
				  standards set forth in
				  RSA
				  274.12(h);
(2) execute a written agreement adopted in
				  accordance with
				  RSA
				  274.12(g)(6)
				  with the retailer management EBT contractor;
(3) meet the qualifications established in
				  §
											RSA
				  372.1702 of this subchapter (relating to EBT
				  System Requirements); and
(4)
				  comply with applicable general conditions established in §
											RSA
				  372.1702 of this subchapter.
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 G - RETAILER REQUIREMENTS › Section 372.1711 - Reimbursement for Electronic Benefit Transfer Transactions

Current through Reg. 49, No. 28; July 12, 2024
(a) A retailer or third-party processor must
				  have a bank account with a federally insured financial institution capable of
				  accepting credits and debits in the Automated Clearing House Network (ACH)
				  format.
(b) A retailer management
				  EBT contractor transfers the reimbursement for Electronic Benefit Transfer
				  transactions into the third-party processor's bank account for reimbursement to
				  the retailer's bank account.
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 G - RETAILER REQUIREMENTS › Section 372.1712 - Account Discrepancies

Current through Reg. 49, No. 28; July 12, 2024
(a) If there is
				  a discrepancy between the retailer management EBT contractor's settlement total
				  and a retailer's or third-party processor's settlement total, the retailer or
				  third party-processor must:
(1) notify the
				  retailer management EBT contractor in writing within 10 banking business days
				  after discovering the discrepancy; and
(2) submit all applicable
				  documentation.
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 G - RETAILER REQUIREMENTS › Section 372.1713 - Transaction Disputes

Current through Reg. 49, No. 28; July 12, 2024
(a) If a retailer
				  or third-party processor does not receive or disagrees with the amount of an
				  Electronic Benefit Transfer (EBT) to its bank account, the retailer or
				  third-party processor must contact the retailer management EBT contractor to
				  dispute the reimbursement or lack of reimbursement. (Participant or
				  household-related disputes are resolved as required by §
										RSA
				  372.1521 of this chapter (relating to Account
				  Balance and Transaction Errors).)
(b) A dispute may be initiated for any reason
				  deemed valid by the initiator, including:
(1)
				  processing errors, including duplicate processing; or
(2) incorrect manual vouchers.
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 G - RETAILER REQUIREMENTS › Section 372.1714 - Transaction Dispute Resolution

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				  retailer management EBT contractor:
(1)
				  investigates and resolves transaction disputes between a retailer and
				  third-party processor; and
(2)
				  requests information from the initiator and responder as needed.
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 G - RETAILER REQUIREMENTS › Section 372.1715 - Appeal of Transaction Dispute Resolution

Current through Reg. 49, No. 28; July 12, 2024
(a) If a retailer or third-party processor
				  disagrees with the resolution of a transaction dispute, the retailer or
				  third-party processor:
(1) must first file a
				  complaint in writing with the retailer management EBT contractor; and
(2) may send a written request for an
				  informal review within 15 days after the official notice of action from the
				  retailer management EBT contractor to the Texas Health and Human Services
				  Commission, Lone Star Business Services, Electronic Benefit Transfer, P.O. Box
				  12688, Mail Code 2033, Austin, Texas 78751.
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 G - RETAILER REQUIREMENTS › Section 372.1716 - Out-of-State Transactions of Texas-Issued Benefits

Current through Reg. 49, No. 28; July 12, 2024
(a) Retailers outside of Texas may accept the
				  Electronic Benefits Transfer (EBT) card and process transactions if they route
				  those transactions through a third-party processor or transaction switch
				  providers certified to the Texas EBT system.
(b) Third-party processors may accept and
				  route transactions from retailers outside of Texas if they are certified to the
				  Texas EBT system or if they route transactions through a switch provider
				  certified to the Texas EBT system.
(c) Retailers outside of Texas must:
(1) provide their own equipment and arrange
				  for their own training for electronic transaction processing; or
(2) obtain equipment and training from the
				  state in which they are located.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 373 - MEDICAID ESTATE RECOVERY PROGRAM › Subchapter A - GENERAL › Section 373.101 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
The purpose of this chapter is to implement section
					 RSA
					 531.077, Government Code, consistent with
					 applicable federal law at
					 RSA
					 1396p(b)(1),
					 which requires the Health and Human Services Commission, as the State Medicaid
					 Agency, to operate a Medicaid Estate Recovery Program (MERP) to recover the
					 costs of Medicaid long-term care benefits received by certain Medicaid
					 recipients.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 373 - MEDICAID ESTATE RECOVERY PROGRAM › Subchapter A - GENERAL › Section 373.103 - Applicability

Current through Reg. 49, No. 28; July 12, 2024
(a) A Medicaid Estate Recovery claim may be
				  filed against the estate of a deceased Medicaid recipient for covered Medicaid
				  services if the recipient:
(1) Was age 55
				  years or older at the time the services were received; and
(2) Initially applied for covered Medicaid
				  long-term care services on or after March 1, 2005, the effective date of these
				  rules.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 373 - MEDICAID ESTATE RECOVERY PROGRAM › Subchapter B - RECOVERY CLAIMS › Section 373.201 - Basis for Claims

Current through Reg. 49, No. 28; July 12, 2024
The acceptance of Medicaid medical assistance, as defined
					 by Title XIX of the Social Security Act, including mandatory and optional
					 payments under the Social Security Act, provides a basis for: A Class 7 probate
					 claim, as defined in §
										RSA 322 of the Texas
					 Probate Code, Classification of Claims against Estates of Decedents, in favor
					 of the Medicaid Estate Recovery Program as an interested party in the estate of
					 the deceased Medicaid recipient.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 373 - MEDICAID ESTATE RECOVERY PROGRAM › Subchapter B - RECOVERY CLAIMS › Section 373.203 - Claims Procedures

Current through Reg. 49, No. 28; July 12, 2024
(a) The Medicaid
				  Estate Recovery Program (MERP) may file or present a: Class 7 probate claim
				  under §298, Claims Against Estates of Decedents, Texas Probate Code,
				  against the estate of deceased Medicaid recipients in accordance with the
				  priorities contained in §322, Classification of Claims against Estates of
				  Decedents, Texas Probate Code.
(b)
				  A claim may be filed in accordance with applicable provisions of the Texas
				  Probate Code, including §298, Claims Against Estates of Decedents, which
				  allows unsecured claims to be presented at any time before the estate is closed
				  or within 4 months of receipt of notice from the estate
				  administrator.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 373 - MEDICAID ESTATE RECOVERY PROGRAM › Subchapter B - RECOVERY CLAIMS › Section 373.205 - Medicaid Estate Recovery Program (MERP) Claim

Current through Reg. 49, No. 28; July 12, 2024
(a) Contents of MERP Recovery Claim. The MERP
				  claim will be presented to the estate personal representative (executor,
				  administrator, or guardian) or filed by depositing it in the appropriate
				  Probate Court and will include the amount of the claim, the date or dates of
				  the covered Medicaid services provided, and a statement that to MERP's best
				  knowledge the deceased Medicaid recipient had:
(1) No surviving spouse;
(2) No surviving child under age
				  21;
(3) No surviving child of any
				  age who is blind or disabled as defined by
				  RSA
				  1382c;
(4) No unmarried adult child residing
				  continuously in the decedent's homestead for at least one year prior to the
				  time of the Medicaid recipient's death; and
(5) That to the best knowledge of the MERP no
				  undue hardship, as defined by these rules, exists and that recovery will be
				  cost-effective.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 373 - MEDICAID ESTATE RECOVERY PROGRAM › Subchapter B - RECOVERY CLAIMS › Section 373.207 - Exemptions from Claims

Current through Reg. 49, No. 28; July 12, 2024
(a) Medicaid
				  Estate Recovery claims will be sought only after the death of the Medicaid
				  recipient, and if there is no:
(1) Surviving
				  spouse;
(2) Surviving child or
				  children under 21 years of age;
(3)
				  Surviving child of any age who is blind or disabled as defined by
				  RSA
				  1382c; or
(4) Unmarried adult child residing
				  continuously in the decedent's homestead for at least one year prior to the
				  time of the Medicaid recipient's death.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 373 - MEDICAID ESTATE RECOVERY PROGRAM › Subchapter B - RECOVERY CLAIMS › Section 373.209 - Undue Hardship Waivers

Current through Reg. 49, No. 28; July 12, 2024
(a) The Medicaid
				  Estate Recovery Program (MERP) will not recover from estates if recovery would
				  cause undue hardship. An undue hardship waiver request form will be provided
				  with the MERP Notice of Intent to File a Claim, and undue hardship waiver
				  requests must be made within 60 days of the date of the MERP Notice of Intent
				  to File a Claim.
(b) An undue
				  hardship does not exist solely because:
(1)
				  Recovery would prevent heirs or legatees from receiving an anticipated
				  inheritance; or
(2) The
				  circumstances giving rise to the hardship were created by, or are the result
				  of, estate planning methods under which assets were sheltered or divested
				  contrary to the requirements of Medicaid law in order to avoid estate
				  recovery.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 373 - MEDICAID ESTATE RECOVERY PROGRAM › Subchapter B - RECOVERY CLAIMS › Section 373.211 - Right to a Review of an Undue Hardship Waiver Denial

Current through Reg. 49, No. 28; July 12, 2024
(a) A Medicaid Estate Recovery Program (MERP)
				  undue hardship waiver applicant may request a review of the denial of an undue
				  hardship waiver request within 60 days of receiving notice of the denial from
				  MERP. The review is an informal process and is not a hearing.
(b) MERP will review the request within 40
				  days from the date the request is received by MERP. All requests for a review
				  of the denial of an undue hardship waiver request must be made in writing to
				  MERP, Hardship Waiver Denial Review Request, P.O. Box 13247, Austin, Texas
				  78711.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 373 - MEDICAID ESTATE RECOVERY PROGRAM › Subchapter B - RECOVERY CLAIMS › Section 373.213 - Deduction Allowed for Expenses for Home Maintenance and Costs of Care

Current through Reg. 49, No. 28; July 12, 2024
(a) An amount equal to necessary and
				  reasonable maintenance expenses and taxes may be deducted from the Medicaid
				  Estate Recovery Program (MERP) claim for maintaining the home of the deceased
				  Medicaid recipient, provided that sufficient supporting documentation of these
				  expenditures, such as receipts, is provided to MERP by estate personal
				  representatives, heirs, or legatees. Necessary and reasonable expenses for
				  maintaining the home include real estate taxes, utility bills, insurance, home
				  repairs, and home maintenance expenses such as lawn care.
(b) An amount equal to the necessary and
				  reasonable expenses for the direct payment of the costs of care (including
				  payment of personal attendant care) provided for a deceased Medicaid recipient
				  that enabled the recipient to remain in his or her home and thereby delayed the
				  institutionalization of the Medicaid recipient may be deducted from the MERP
				  claim, provided that sufficient supporting documentation of these expenditures,
				  such as receipts, is provided to MERP by estate personal representatives,
				  heirs, or legatees.
(c) Requests
				  for obtaining allowable deductions from MERP claims for expenses under
				  subsections (a) or (b) of this section must be made in writing within 60 days
				  after receipt of the Notice of the Intent to File a Claim by MERP. All
				  supporting documentation must be attached to the request and sent to MERP, Home
				  Maintenance/Costs of Care Request, P.O. Box 13247, Austin, Texas
				  78711.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 373 - MEDICAID ESTATE RECOVERY PROGRAM › Subchapter B - RECOVERY CLAIMS › Section 373.215 - Recovery Not Cost-Effective

Current through Reg. 49, No. 28; July 12, 2024
No Medicaid estate recovery claim will be filed if it is
					 not cost effective. A claim will not be cost-effective if:
(1) the value of the recoverable estate is
				  $10,000 or less,
(2) the
				  recoverable amount of Medicaid costs is $3,000 or less, or
(3) the cost involved in the sale of the
				  property would be equal to or greater than the value of the property.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 373 - MEDICAID ESTATE RECOVERY PROGRAM › Subchapter B - RECOVERY CLAIMS › Section 373.217 - Claim Amount

Current through Reg. 49, No. 28; July 12, 2024
(a) The amount of
				  the Medicaid Estate Recovery Program (MERP) claim will be calculated as the
				  amount paid under §
										RSA
				  373.103(c) of
				  this title for the benefit of a Medicaid recipient for covered medical
				  assistance services received after the Medicaid recipient reached 55 years of
				  age.
(b) No claim will be filed for
				  services received prior to the effective date of these rules.
(c) The claim amount may be amended prior to
				  and after MERP files the recovery claim.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 373 - MEDICAID ESTATE RECOVERY PROGRAM › Subchapter B - RECOVERY CLAIMS › Section 373.219 - Claim Payments

Current through Reg. 49, No. 28; July 12, 2024
(a) All payments on
				  estate recovery claims must be made payable to the "Texas Medicaid Account for
				  Long-Term Care," and must be sent to MERP, P.O. Box 13247, Austin, Texas
				  78711.
(b) HHSC MERP may
				  compromise, settle, or waive any claim that does not qualify for an undue
				  hardship waiver upon good cause shown. Interest on the unpaid portion of any
				  claim is the same as the amount provided under §
										RSA
				  2251.025(b),
				  Government Code.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 373 - MEDICAID ESTATE RECOVERY PROGRAM › Subchapter C - NOTICE › Section 373.301 - Notice Upon Application

Current through Reg. 49, No. 28; July 12, 2024
(a) Written
				  notice of the MERP provisions will be provided to:
(1) Individuals for Medicaid-covered nursing
				  facility services:
(A) With an application
				  packet or notice of eligibility for Medicaid nursing facility
				  services;
(B) Within 14 days of the
				  Department of Aging and Disability Services' receipt of a nursing facility
				  admission notice for a Medicaid recipient.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 373 - MEDICAID ESTATE RECOVERY PROGRAM › Subchapter C - NOTICE › Section 373.303 - Additional Application Notice Provision to Recipients and Others

Current through Reg. 49, No. 28; July 12, 2024
Written notice about the Medicaid Estate Recovery Program
					 (MERP) will be provided to the following, if known by MERP, upon request for an
					 application for Medicaid benefits, release from a waiver interest list, or
					 notice of admission to a nursing facility or an Intermediate Care Facility for
					 the Mentally Retarded (ICFMR):
(1) The
				  recipient;
(2) The recipient's
				  guardian of the person, if any; guardian of the estate, if any; or guardian of
				  the person and estate, if any, provided that the name and address of the
				  guardian or guardians are known;
(3) The recipient's agent under a durable
				  power of attorney if the name and address of the agent are known;
(4) The recipient's agent under a medical
				  power of attorney if the name and address of the agent are known; or
(5) If none of the above are known, to family
				  members acting on behalf of the recipient, provided that the name and address
				  of those family members acting on behalf of the recipient are known.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 373 - MEDICAID ESTATE RECOVERY PROGRAM › Subchapter C - NOTICE › Section 373.305 - Medicaid Application Estate Recovery Notice Contents

Current through Reg. 49, No. 28; July 12, 2024
The written notice provided about the Medicaid Estate
					 Recovery Program (MERP) to those listed in §
										RSA
					 373.303 of this chapter (relating to
					 Additional Application Notice Provision to Recipients and Others) will contain
					 the following information:
(1)
				  Description of the Medicaid Estate Recovery Program;
(2) Information as to covered Medicaid
				  long-term care services subject to estate recovery;
(3) Claim procedures found in §322,
				  Classification of Claims Against Estates of Decedents, Texas Probate
				  Code;
(4) Information as to
				  applicable "look-back" penalties for transfers of property for less than market
				  value when applying for Medicaid benefits described at 1 TAC
				  §358.430(e);
(5) Description
				  of undue hardship waiver requests and related request procedures in regard to
				  any recovery claim; and
(6)
				  Information concerning the MERP Notice of Intent to File a Claim and the
				  Medicaid Estate Recovery Claim on the death of a Medicaid recipient.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 373 - MEDICAID ESTATE RECOVERY PROGRAM › Subchapter C - NOTICE › Section 373.307 - Notice of Intent to File A Claim upon the Death of a Medicaid Recipient

Current through Reg. 49, No. 28; July 12, 2024
(a) The Medicaid Estate Recovery Program
				  (MERP) will, within 30 days of the notification of the death of a Medicaid
				  recipient, provide a Notice of Intent to File a Claim, to the following:
(1) Estate representative;
(2) Recipient's guardian of the person, if
				  any; guardian of the estate, if any; or guardian of the person and estate, if
				  any, provided that the name and address of the guardian or guardians are known
				  by MERP;
(3) Recipient's agent
				  under a durable power of attorney if the name and address of the agent are
				  known by MERP;
(4) Recipient's
				  agent under a medical power of attorney if the name and address of the agent
				  are known by MERP; or
(5) If none
				  of the above are known, family members who have acted on behalf of the
				  recipient provided that the name and address of those family members who have
				  acted on behalf of the recipient are known by MERP.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter A - PROGRAM PURPOSE AND SCOPE › Section 375.101 - What is the scope of the chapter?

Current through Reg. 49, No. 28; July 12, 2024
The Refugee Cash Assistance (RCA) and Refugee Medical
					 Assistance (RMA) Programs were established by the Refugee Act of 1980 (referred
					 to in this chapter as "the Act"). The Act, among other provisions, provides for
					 Refugee Cash Assistance and Refugee Medical Assistance to help participants
					 become self-sufficient within the first eight months after arrival. Cash
					 assistance payments and medical assistance are provided to eligible
					 participants for a maximum of eight months. Refugee Cash Assistance is
					 administered by the Texas Department of Human Services (DHS) through contracts
					 with local refugee resettlement agencies. The goal of the RCA program is to
					 assist refugees in achieving self-sufficiency. All participants in the RCA
					 program are required to participate in employment programs. Refugee Medical
					 Assistance is administered directly by DHS. Each year the president of the
					 United States decides the regional and total number of refugees the U.S. will
					 admit. The program is 100% federally funded and depends on the availability of
					 federal funds.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter A - PROGRAM PURPOSE AND SCOPE › Section 375.102 - What is the purpose of this chapter?

Current through Reg. 49, No. 28; July 12, 2024
This chapter provides procedures and criteria that govern
					 both the Refugee Cash Assistance and Refugee Medical Assistance programs. The
					 chapter assists the Texas Department of Human Services in the management of
					 contracts by ensuring efficient and economical objectives are
					 met.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter B - CONTRACTOR REQUIREMENTS FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA) › Section 375.201 - What is the purpose of this subchapter?

Current through Reg. 49, No. 28; July 12, 2024
This subchapter contains the minimum requirements for
					 contracting with the Texas Department of Human Services (DHS) to provide
					 Refugee Cash Assistance (RCA) benefits to eligible individuals in Texas. An
					 organization becomes a contractor when awarded a contract from
					 DHS.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter B - CONTRACTOR REQUIREMENTS FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA) › Section 375.203 - Who can apply for a RCA contract?

Current through Reg. 49, No. 28; July 12, 2024
An organization may apply for a contract if:
(1) it operates a local refugee resettlement
				  program and provides the Texas Department of Human Services (DHS) a letter of
				  affiliation from a national voluntary resettlement agency that has a
				  cooperative agreement for reception and placement with the U.S. Department of
				  State; and
(2) it is incorporated
				  and maintains the following documents and provides them to DHS upon request:
(A) articles of incorporation;
(B) by-laws;
(C) tax exemption certification;
(D) board minutes;
(E) financial statements;
(F) informational materials related to
				  providing refugee services;
(G)
				  case records; and
(H) other
				  relevant material as described by DHS.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter B - CONTRACTOR REQUIREMENTS FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA) › Section 375.205 - What is the financial responsibility of the contractor's board of directors?

Current through Reg. 49, No. 28; July 12, 2024
When an organization enters into a contract with the Texas
					 Department of Human Services, the agency's board of directors must ensure
					 financial accountability of all funds received and spent by their agency. The
					 board of directors or the finance committee must regularly review actual income
					 and expenses and compare them to approved budgets and year-to-date
					 costs.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter B - CONTRACTOR REQUIREMENTS FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA) › Section 375.207 - Are there accounting requirements the contractor must meet to receive a contract?

Current through Reg. 49, No. 28; July 12, 2024
Yes, each contractor must:
(1) maintain an accounting system that
				  records revenues and expenditures using generally accepted accounting
				  principles as recognized by the American Institute of Certified Public
				  Accountants and follow the Texas Department of Human Services financial
				  management policies and procedures in maintaining fiscal records;
(2) maintain a chart of accounts that
				  includes all accounts using an assigned number;
(3) maintain a general ledger;
(4) maintain supporting documentation of
				  expenses including but not limited to:
(A)
				  receipts or vouchers for incoming cash;
(B) bank statements;
(C) canceled checks (if provided by
				  bank);
(D) deposit slips;
(E) approved invoices;
(F) receipts or vouchers for
				  purchases;
(G) leases;
(H) contracts;
(I) time sheets;
(J) inventory;
(K) written cost allocation methodology;
				  and
(L) cost allocation worksheets;
				  and
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter B - CONTRACTOR REQUIREMENTS FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA) › Section 375.209 - Does the Texas Department of Human Services (DHS) require contractors to have a fidelity bond?

Current through Reg. 49, No. 28; July 12, 2024
Each contractor must have a fidelity bond. The minimum
					 value will be determined by DHS on an annual basis.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter B - CONTRACTOR REQUIREMENTS FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA) › Section 375.211 - What are the confidentiality requirements of a contract?

Current through Reg. 49, No. 28; July 12, 2024
Contractors must keep confidential all information about or
					 obtained from a participant. Contractors may release participant information as
					 long as it does not identify a participant in any way. The following exceptions
					 apply:
(1) information can be released
				  with written consent of the participant;
(2) in the case of minors, information can be
				  released with written consent of the parent or legal guardian; and
(3) federal regulations require the release
				  of confidential information to the Texas Department of Human Services (DHS) or
				  anyone designated by DHS.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter B - CONTRACTOR REQUIREMENTS FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA) › Section 375.213 - Are contractors responsible for having a nepotism policy?

Current through Reg. 49, No. 28; July 12, 2024
Each contractor must have a written board-approved nepotism
					 policy.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter B - CONTRACTOR REQUIREMENTS FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA) › Section 375.215 - Are contractors responsible for having a conflict of interest policy?

Current through Reg. 49, No. 28; July 12, 2024
Each contractor must have a written board-approved conflict
					 of interest policy. The conflict of interest policy must address situations in
					 which board members or employees have a direct or indirect interest, financial
					 or otherwise, of any nature that is in substantial conflict with the proper
					 discharge of their duty to the organization.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter B - CONTRACTOR REQUIREMENTS FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA) › Section 375.217 - Are contractors required to comply with the Limited English Proficiency (LEP) provisions of Title VI of the Civil Rights Act?

Current through Reg. 49, No. 28; July 12, 2024
Yes, each contractor must comply with the provisions of
					 Title VI of the Civil Rights Act and Immigration and Nationality Act as it
					 affects persons with Limited English Language proficiency during the time they
					 are receiving grant funding. Requirements include a regular assessment of
					 language needs; compliance by any discretionary sub-grantee or subcontractor,
					 including written LEP policies and implementation plans; and staff
					 training.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter B - CONTRACTOR REQUIREMENTS FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA) › Section 375.219 - What are the record keeping requirements of the contract?

Current through Reg. 49, No. 28; July 12, 2024
Contractors must keep all records that are needed for
					 federal and state monitoring of the Refugee Cash Assistance program. Required
					 records include:
(1) identification of
				  participants;
(2) statistical and
				  programmatic records on services provided;
(3) records of participant costs;
(4) eligibility determination materials;
				  and
(5) other records required by
				  the Texas Department of Human Services.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter B - CONTRACTOR REQUIREMENTS FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA) › Section 375.221 - How long are contractors required to keep records?

Current through Reg. 49, No. 28; July 12, 2024
Contractors must keep all records for three years and 90
					 days after the end of the contract, or until an open audit is completed, or
					 until litigation is resolved.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter C - PROGRAM ADMINISTRATION FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA) › Section 375.301 - What is the purpose of this subchapter?

Current through Reg. 49, No. 28; July 12, 2024
This subchapter contains eligibility requirements for
					 participants in the Refugee Cash Assistance Assistance Program (RCA). It also
					 contains contractor responsibilities in providing RCA
					 services.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter C - PROGRAM ADMINISTRATION FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA) › Section 375.303 - Who is eligible for Refugee Cash Assistance (RCA) benefits?

Current through Reg. 49, No. 28; July 12, 2024
RCA is restricted to individuals who meet the eligibility
					 requirements as follows:
(1) meet
				  immigration status and identification requirements in Subpart D of 45 CFR Part
				  400 and who can provide documentation of one of the following statuses from the
				  Immigration and Naturalization Service:
(A)
				  paroled as a refugee or asylee under Section 212(d) of the Immigration and
				  Nationality Act (INA);
(B) admitted
				  as a refugee under Section 207 of the INA;
(C) granted asylum under Section 208 of the
				  INA;
(D) admitted as a Cuban or
				  Haitian entrant in accordance with requirements in 45 CFR part 401;
(E) admitted as an Amerasian from Vietnam
				  pursuant to Section 584 of the Foreign Operations, Export Financing, and
				  Related Programs Appropriations Act, 1988 (as contained in Section 101 (e) of
				  Public law 100-202 and amended by the ninth proviso under Migration and Refugee
				  Assistance in Title II of the Foreign Operation, Export, Financing, and Related
				  Programs Appropriations Acts, 1989, (Public Law 100-461 as amended));
(F) certified as a victim of a severe form of
				  trafficking; or
(G) designated as
				  eligible by the director of Office of Refugee Resettlement (ORR).
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter C - PROGRAM ADMINISTRATION FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA) › Section 375.305 - What is the income eligibility standard for months one through four of the eight months of eligibility?

Current through Reg. 49, No. 28; July 12, 2024
The income eligibility standard for enrollment in Refugee
					 Cash Assistance benefits during months one through four is 125% of the Federal
					 Poverty Income Limit.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter C - PROGRAM ADMINISTRATION FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA) › Section 375.307 - What is the income eligibility standard for months five through eight of the eight months of eligibility?

Current through Reg. 49, No. 28; July 12, 2024
The income eligibility standard for enrollment in Refugee
					 Cash Assistance benefits during months five through eight is 165% of the
					 Federal Poverty Income Limit.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter C - PROGRAM ADMINISTRATION FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA) › Section 375.309 - What income must be disregarded when determining eligibility?

Current through Reg. 49, No. 28; July 12, 2024
Contractors must disregard any income or resources:
(1) remaining in the applicant's country of
				  origin;
(2) from a non-spousal
				  sponsor; and
(3) from the
				  Department of State and Department of Justice Reception and Placement
				  programs.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter C - PROGRAM ADMINISTRATION FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA) › Section 375.311 - Are contractors required to report changes in a participant's income to the Texas Department of Human Services (DHS)?

Current through Reg. 49, No. 28; July 12, 2024
Contractors must report changes in a participant's income
					 within 10 days to designated DHS staff.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter C - PROGRAM ADMINISTRATION FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA) › Section 375.313 - Who determines a refugee's eligibility for Refugee Cash Assistance (RCA) benefits?

Current through Reg. 49, No. 28; July 12, 2024
Anyone may apply for RCA. Contractors must determine if the
					 applicant meets the eligibility requirements specified in §§7.303,
					 7.305, and 7.307 (relating to Who is eligible for Refugee Cash Assistance (RCA)
					 benefits?, What is the income eligibility standard for months one through four
					 of the eight months of eligibility?, and What is the income eligibility
					 standard for months five through eight of the eight months of eligibility?) to
					 become a participant and must keep all eligibility determination information in
					 the participant's file.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter C - PROGRAM ADMINISTRATION FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA) › Section 375.315 - Are there special provisions when enrolling families with children in Refugee Cash Assistance?

Current through Reg. 49, No. 28; July 12, 2024
Families with children should be eligible for assistance
					 through the Temporary Assistance for Needy Families (TANF) program. Providers
					 assessing eligibility for family units with children must notify the Office of
					 Immigration and Refugee Affairs (OIRA) prior to enrolling participants. OIRA
					 will assess justification of ineligibility for TANF.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter C - PROGRAM ADMINISTRATION FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA) › Section 375.317 - How long can a participant receive Refugee Cash Assistance (RCA) benefits?

Current through Reg. 49, No. 28; July 12, 2024
The maximum time period a participant may receive benefits
					 is specified by the director of the Office of Refugee Resettlement (ORR). The
					 current time period is up to eight months from the beginning date of
					 eligibility, as indicated in § 7.319 of this title (relating to What is
					 the beginning date of the eligibility period for Refugee Cash Assistance (RCA)
					 benefits?).
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter C - PROGRAM ADMINISTRATION FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA) › Section 375.319 - What is the beginning date of the eligibility period for Refugee Cash Assistance (RCA) benefits?

Current through Reg. 49, No. 28; July 12, 2024
The beginning date of the eligibility period for RCA
					 benefits is as follows:
(1) for
				  refugees, the date of arrival to the U.S., as stamped on the individual's Form
				  I-94;
(2) for asylees, the date
				  that a final grant of asylum was made;
(3) for victims of a severe form of
				  trafficking, the date on the certification letter signed by the director of the
				  Office of Refugee Resettlement (ORR);
(4) for Cuban and Haitian entrants, the date
				  on the individual's Form I-94, or other entry document as specified by ORR and
				  indicated in the Texas Refugee Cash Assistance Provider Manual.
(5) for Amerasians, the date of arrival to
				  the U.S., as stamped on Form I-94, or other entry document as specified by ORR
				  and indicated in the Texas RCA Provider Manual.
Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 375 - REFUGEE CASH ASSISTANCE AND MEDICAL ASSISTANCE PROGRAMS › Subchapter C - PROGRAM ADMINISTRATION FOR THE REFUGEE CASH ASSISTANCE PROGRAM (RCA) › Section 375.321 - How does the contractor determine eligibility for a refugee who has moved from another state to Texas?

Current through Reg. 49, No. 28; July 12, 2024
(a) The contractor
				  determines eligibility on the same basis as for a refugee whose first placement
				  was in Texas, with the following exceptions.
(1) The contractor must verify with the
				  original sponsoring resettlement agency that the refugee has not voluntarily
				  quit employment within the past 30 days.
(2) The contractor must also verify with the
				  sponsoring resettlement agency and/or welfare agency at the original placement
				  site whether the refugee has received an assistance payment for the month of
				  application in Texas.