Current Rules from Title 40, Part 1 Texas Department of Human Services |
Transferred to Title 1, Part 15 Texas Health and Human Services Commission | ||||||
---|---|---|---|---|---|---|---|
Chapter and Subchapter |
Section | Heading | Chapter and Subchapter |
Section | Heading | ||
6 | Disaster Assistance Program | 386 | Disaster Assistance Program | ||||
A | General Information | A | General Information | ||||
§6.101 | What does this chapter cover? | §386.101 | What does this chapter cover? | ||||
§6.102 | Are the Individual and Family Grant Program and Temporary Housing Program still available? | §386.102 | Are the Individual and Family Grant Program and Temporary Housing Program still available? | ||||
§6.103 | How are the terms in this chapter defined? | §386.103 | How are the terms in this chapter defined? | ||||
§6.104 | Who funds and administers the assistance within the Federal Assistance to Individuals and Households Program? | §386.104 | Who funds and administers the assistance within the Federal Assistance to Individuals and Households Program? | ||||
§6.105 | Does this chapter cover Housing Assistance (HA)? | §386.105 | Does this chapter cover Housing Assistance (HA)? | ||||
§6.106 | What is Other Needs Assistance (ONA)? | §386.106 | What is Other Needs Assistance (ONA)? | ||||
§6.107 | Can Other Needs Assistance (ONA) funds be used for housing repair or replacement? | §386.107 | Can Other Needs Assistance (ONA) funds be used for housing repair or replacement? | ||||
§6.108 | What is the maximum grant amount I can receive? | §386.108 | What is the maximum grant amount I can receive? | ||||
§6.109 | Who is responsible for helping me apply for a grant? | §386.109 | Who is responsible for helping me apply for a grant? | ||||
B | Eligibility Criteria for Other Needs Assistance (ONA) Grants | B | Eligibility Criteria for Other Needs Assistance (ONA) Grants | ||||
§6.201 | Under what circumstances may I apply for disaster assistance? | §386.201 | Under what circumstances may I apply for disaster assistance? | ||||
§6.202 | Must I be a citizen to qualify for an Other Needs Assistance grant? | §386.202 | Must I be a citizen to qualify for an Other Needs Assistance grant? | ||||
§6.203 | What types of losses are eligible for me to receive an Other Needs Assistance (ONA) grant? | §386.203 | What types of losses are eligible for me to receive an Other Needs Assistance (ONA) grant? | ||||
§6.204 | What are the Other Needs Assistance (ONA) grant categories? | §386.204 | What are the Other Needs Assistance (ONA) grant categories? | ||||
§6.205 | What types of personal property are eligible for grant assistance? | §386.205 | What types of personal property are eligible for grant assistance? | ||||
§6.206 | What types of disaster-related transportation expenses are covered? | §386.206 | What types of disaster-related transportation expenses are covered? | ||||
§6.207 | Are disaster-related medical or dental expenses covered? | §386.207 | Are disaster-related medical or dental expenses covered? | ||||
§6.208 | Are disaster-related funeral expenses covered? | §386.208 | Are disaster-related funeral expenses covered? | ||||
§6.209 | What types of moving and storage expenses are covered? | §386.209 | What types of moving and storage expenses are covered? | ||||
§6.210 | Can I receive a grant to purchase flood insurance? | §386.210 | Can I receive a grant to purchase flood insurance? | ||||
§6.211 | What types of losses are ineligible for an Other Needs Assistance (ONA) grant? | §386.211 | What types of losses are ineligible for an Other Needs Assistance (ONA) grant? | ||||
§6.212 | Are any other categories of assistance covered under an Other Needs Assistance (ONA) grant? | §386.212 | Are any other categories of assistance covered under an Other Needs Assistance (ONA) grant? | ||||
§6.213 | Must I file a claim with my insurance company(ies) if my expenses are eligible for an Other Needs Assistance (ONA) grant? | §386.213 | Must I file a claim with my insurance company(ies) if my expenses are eligible for an Other Needs Assistance (ONA) grant? | ||||
§6.214 | Must I apply for assistance from the U.S. Small Business Administration (SBA) before I can receive an Other Needs Assistance (ONA) grant? | §386.214 | Must I apply for assistance from the U.S. Small Business Administration (SBA) before I can receive an Other Needs Assistance (ONA) grant? | ||||
§6.215 | Am I eligible for an Other Needs Assistance (ONA) grant if the U.S. Small Business Administration (SBA) will not provide assistance? | §386.215 | Am I eligible for an Other Needs Assistance (ONA) grant if the U.S. Small Business Administration (SBA) will not provide assistance? | ||||
§6.216 | Can I get an Other Needs Assistance grant even if I receive assistance from another source? | §386.216 | Can I get an Other Needs Assistance grant even if I receive assistance from another source? | ||||
§6.217 | Are there any exceptions to federal regulations regarding the duplication of benefits? | §386.217 | Are there any exceptions to federal regulations regarding the duplication of benefits? | ||||
§6.218 | Do I have to accept assistance from other sources if I am eligible for an Other Needs Assistance grant? | §386.218 | Do I have to accept assistance from other sources if I am eligible for an Other Needs Assistance grant? | ||||
§6.219 | May I keep the Other Needs Assistance (ONA) grant money if I receive other assistance? | §386.219 | May I keep the Other Needs Assistance (ONA) grant money if I receive other assistance? | ||||
§6.220 | Why would Other Needs Assistance (ONA) deny my grant application? | §386.220 | Why would Other Needs Assistance (ONA) deny my grant application? | ||||
§6.221 | Am I eligible for a grant if the U.S. Small Business Administration (SBA) denies my application for failure to maintain flood insurance required as a condition of a previous loan? | §386.221 | Am I eligible for a grant if the U.S. Small Business Administration (SBA) denies my application for failure to maintain flood insurance required as a condition of a previous loan? | ||||
§6.222 | Are there any additional restrictions on receiving a grant if flooding damaged my residence? | §386.222 | Are there any additional restrictions on receiving a grant if flooding damaged my residence? | ||||
C | Applying for an Other Needs Assistance Grant | C | Applying for an Other Needs Assistance Grant | ||||
§6.301 | How do I apply for an Other Needs Assistance grant? | §386.301 | How do I apply for an Other Needs Assistance grant? | ||||
§6.302 | Do I need identification? | §386.302 | Do I need identification? | ||||
§6.303 | How much time do I have to apply for a grant? | §386.303 | How much time do I have to apply for a grant? | ||||
§6.304 | What if I cannot apply within 60 days of the disaster declaration? | §386.304 | What if I cannot apply within 60 days of the disaster declaration? | ||||
§6.305 | What does FEMA consider extenuating circumstances if I miss the 60-day application deadline? | §386.305 | What does FEMA consider extenuating circumstances if I miss the 60-day application deadline? | ||||
§6.306 | Do I have the right to withdraw my application for a grant? | §386.306 | Do I have the right to withdraw my application for a grant? | ||||
§6.307 | What happens if I withdraw my application? | §386.307 | What happens if I withdraw my application? | ||||
§6.308 | How will I be notified of the grant decision on my application? | §386.308 | How will I be notified of the grant decision on my application? | ||||
§6.309 | What do I do if my grant warrant is lost or stolen? | §386.309 | What do I do if my grant warrant is lost or stolen? | ||||
§6.310 | Why would I have to return grant funds? | §386.310 | Why would I have to return grant funds? | ||||
§6.311 | Can I receive additional funds after the initial grant decision? | §386.311 | Can I receive additional funds after the initial grant decision? | ||||
D | Reconsideration and Appeals | D | Reconsideration and Appeals | ||||
§6.401 | What do I do if I disagree with the grant decision? | §386.401 | What do I do if I disagree with the grant decision? | ||||
§6.402 | What happens if I miss the 60-day deadline? | §386.402 | What happens if I miss the 60-day deadline? | ||||
§6.403 | What is good cause? | §386.403 | What is good cause? | ||||
§6.404 | Where do I send my request for reconsideration? | §386.404 | Where do I send my request for reconsideration? | ||||
§6.405 | What happens when I request reconsideration of the decision? | §386.405 | What happens when I request reconsideration of the decision? | ||||
§6.406 | How long does it take to respond to my request for reconsideration? | §386.406 | How long does it take to respond to my request for reconsideration? | ||||
§6.407 | Do I have the right to appeal the reconsideration decision? | §386.407 | Do I have the right to appeal the reconsideration decision? | ||||
§6.408 | How do I appeal the reconsideration decision? | §386.408 | How do I appeal the reconsideration decision? | ||||
§6.409 | What steps does the Other Needs Assistance (ONA) staff take when I request a hearing? | §386.409 | What steps does the Other Needs Assistance (ONA) staff take when I request a hearing? | ||||
§6.410 | When will DHS schedule my hearing? | §386.410 | When will DHS schedule my hearing? | ||||
§6.411 | Who decides my appeal? | §386.411 | Who decides my appeal? | ||||
§6.412 | Will I be able to see the records DHS has regarding my claim? | §386.412 | Will I be able to see the records DHS has regarding my claim? | ||||
§6.413 | What documents must the DHS office administering Other Needs Assistance (ONA) send to the DHS Hearings Department when a disaster is declared and the ONA state administrative plan is approved? | §386.413 | What documents must the DHS office administering Other Needs Assistance (ONA) send to the DHS Hearings Department when a disaster is declared and the ONA state administrative plan is approved? | ||||
§6.414 | Do DHS attorneys across the state have access to disaster-related documents? | §386.414 | Do DHS attorneys across the state have access to disaster-related documents? | ||||
§6.415 | How will I learn the decision on my appeal? | §386.415 | How will I learn the decision on my appeal? | ||||
§6.416 | What happens if I decide to withdraw my appeal? | §386.416 | What happens if I decide to withdraw my appeal? | ||||
§6.417 | What DHS rules apply to my appeal? | §386.417 | What DHS rules apply to my appeal? | ||||
§6.418 | What records does DHS keep of my hearing | §386.418 | What records does DHS keep of my hearing | ||||
E | National Flood Insurance Program (NFIP) | E | National Flood Insurance Program (NFIP) | ||||
§6.501 | Am I required to purchase and maintain flood insurance as a condition of receiving an Other Needs Assistance (ONA) grant? | §386.501 | Am I required to purchase and maintain flood insurance as a condition of receiving an Other Needs Assistance (ONA) grant? | ||||
§6.502 | How is a Group Flood Insurance Policy (GFIP) administered? | §386.502 | How is a Group Flood Insurance Policy (GFIP) administered? | ||||
§6.503 | How much is the Group Flood Insurance Policy coverage? | §386.503 | How much is the Group Flood Insurance Policy coverage? | ||||
§6.504 | Are there any restrictions on future disaster assistance if I receive a grant that includes a flood insurance premium? | §386.504 | Are there any restrictions on future disaster assistance if I receive a grant that includes a flood insurance premium? | ||||
§6.505 | What must I do when I receive the Group Flood Insurance Policy (GFIP)? | §386.505 | What must I do when I receive the Group Flood Insurance Policy (GFIP)? | ||||
§6.506 | How long must I maintain flood insurance on my home? | §386.506 | How long must I maintain flood insurance on my home? | ||||
§6.507 | If I am a renter, how long must I maintain flood insurance? | §386.507 | If I am a renter, how long must I maintain flood insurance? | ||||
§6.508 | What happens if I fail to maintain my flood insurance policy on flood-damaged property? | §386.508 | What happens if I fail to maintain my flood insurance policy on flood-damaged property? | ||||
§6.509 | Could I be eligible for a Group Flood Insurance Policy if I live in a community that does not participate in or is sanctioned by the National Flood Insurance Program (NFIP)? | §386.509 | Could I be eligible for a Group Flood Insurance Policy if I live in a community that does not participate in or is sanctioned by the National Flood Insurance Program (NFIP)? | ||||
§6.510 | What grants am I eligible to receive if I live in a community that does not participate or is sanctioned by the National Flood Insurance Program (NFIP)? | §386.510 | What grants am I eligible to receive if I live in a community that does not participate or is sanctioned by the National Flood Insurance Program (NFIP)? | ||||
§6.511 | Will my application be accepted if my community's petition to FEMA to join the National Flood Insurance Program (NFIP) delays the process? | §386.511 | Will my application be accepted if my community's petition to FEMA to join the National Flood Insurance Program (NFIP) delays the process? | ||||
15 | Medicaid Eligibility | 358 | Medicaid Eligibility | ||||
A | General Information | A | General Information | ||||
§15.100 | Definitions | §358.100 | Definitions | ||||
§15.105 | Description of Eligible Clients | §358.105 | Description of Eligible Clients | ||||
B | Medicare and Third-Party Resources | B | Medicare and Third-Party Resources | ||||
§15.200 | Medicare Benefits | §358.200 | Medicare Benefits | ||||
§15.201 | Qualified Medicare Beneficiaries (QMB) (Type Program 24) | §358.201 | Qualified Medicare Beneficiaries (QMB) (Type Program 24) | ||||
§15.202 | Medicaid Qualified Medicare Beneficiaries | §358.202 | Medicaid Qualified Medicare Beneficiaries | ||||
§15.203 | Qualified Disabled and Working Individuals (QDWI) (Type Program 25) | §358.203 | Qualified Disabled and Working Individuals (QDWI) (Type Program 25) | ||||
§15.204 | Specified Low-Income Medicare Beneficiaries (SLMB) | §358.204 | Specified Low-Income Medicare Beneficiaries (SLMB) | ||||
§15.205 | Eligibility Requirements for Buy-in | §358.205 | Eligibility Requirements for Buy-in | ||||
§15.210 | Time Frames for Buy-in Enrollment | §358.210 | Time Frames for Buy-in Enrollment | ||||
§15.215 | Third-party Resources (TPRs) | §358.215 | Third-party Resources (TPRs) | ||||
§15.220 | Qualifying Individuals (QIs) | §358.220 | Qualifying Individuals (QIs) | ||||
C | Basic Program Requirements | C | Basic Program Requirements | ||||
§15.300 | United States Citizenship and Residence Requirements | §358.300 | United States Citizenship and Residence Requirements | ||||
§15.301 | Texas Residence Requirements | §358.301 | Texas Residence Requirements | ||||
§15.305 | Eligibility Requirements for the Aged, Blind, or Disabled | §358.305 | Eligibility Requirements for the Aged, Blind, or Disabled | ||||
§15.310 | Eligibility Requirements for Residents of Public Institutions | §358.310 | Eligibility Requirements for Residents of Public Institutions | ||||
§15.315 | Preadmission Screening and Annual Resident Review (PASARR) | §358.315 | Preadmission Screening and Annual Resident Review (PASARR) | ||||
§15.316 | Risk Assessment Criteria | §358.316 | Risk Assessment Criteria | ||||
§15.320 | Eligibility Requirements for Redetermination | §358.320 | Eligibility Requirements for Redetermination | ||||
§15.325 | Nursing Facility Recipients Discharged to Hospitals | §358.325 | Nursing Facility Recipients Discharged to Hospitals | ||||
D | Resources | D | Resources | ||||
§15.400 | General Resources | §358.400 | General Resources | ||||
§15.401 | Fiduciary Agent | §358.401 | Fiduciary Agent | ||||
§15.405 | Categories of Resource Limits | §358.405 | Categories of Resource Limits | ||||
§15.410 | Deeming of Resources | §358.410 | Deeming of Resources | ||||
§15.415 | Ownership and Accessibility | §358.415 | Ownership and Accessibility | ||||
§15.416 | Earned Income Tax Credits | §358.416 | Earned Income Tax Credits | ||||
§15.417 | Trusts--August 11, 1993, and After | §358.417 | Trusts--August 11, 1993, and After | ||||
§15.420 | Conversion of Resources | §358.420 | Conversion of Resources | ||||
§15.425 | Replacement Value of Excluded Resources | §358.425 | Replacement Value of Excluded Resources | ||||
§15.430 | Transfer of Assets | §358.430 | Transfer of Assets | ||||
§15.435 | Liquid Resources | §358.435 | Liquid Resources | ||||
§15.440 | Nonliquid Resources | §358.440 | Nonliquid Resources | ||||
§15.441 | Real Property | §358.441 | Real Property | ||||
§15.442 | Personal Property | §358.442 | Personal Property | ||||
§15.443 | Resources Essential to Self-support (Real and Personal Properties) | §358.443 | Resources Essential to Self-support (Real and Personal Properties) | ||||
E | Income | E | Income | ||||
§15.450 | General Principles Concerning Income | §358.450 | General Principles Concerning Income | ||||
§15.451 | Sources of Earned Income | §358.451 | Sources of Earned Income | ||||
§15.452 | Earned Income Tax Credits | §358.452 | Earned Income Tax Credits | ||||
§15.453 | Wage-related Exemptions | §358.453 | Wage-related Exemptions | ||||
§15.454 | Reduction of Pension and Benefit Checks for Recoupment of Overpayments | §358.454 | Reduction of Pension and Benefit Checks for Recoupment of Overpayments | ||||
§15.455 | Unearned Income | §358.455 | Unearned Income | ||||
§15.460 | Income Exemptions | §358.460 | Income Exemptions | ||||
§15.461 | Indian-related Exemptions | §358.461 | Indian-related Exemptions | ||||
§15.465 | Income Exclusions | §358.465 | Income Exclusions | ||||
§15.466 | Special Income Exclusions | §358.466 | Special Income Exclusions | ||||
§15.470 | Variable Monthly Income | §358.470 | Variable Monthly Income | ||||
§15.475 | Deeming of Income | §358.475 | Deeming of Income | ||||
F | Budgets and Payment Plans | F | Budgets and Payment Plans | ||||
§15.500 | Nonvendor Living Arrangements | §358.500 | Nonvendor Living Arrangements | ||||
§15.501 | Vendor Living Arrangements | §358.501 | Vendor Living Arrangements | ||||
§15.502 | Allowable Deductions | §358.502 | Allowable Deductions | ||||
§15.503 | Protection of Spousal Income and Resources | §358.503 | Protection of Spousal Income and Resources | ||||
§15.504 | Diversion of Income to a Dependent Relative | §358.504 | Diversion of Income to a Dependent Relative | ||||
§15.505 | Budget Eligibility Requirements | §358.505 | Budget Eligibility Requirements | ||||
§15.506 | Mandatory Payroll Deductions from Earned Income | §358.506 | Mandatory Payroll Deductions from Earned Income | ||||
§15.510 | Applied Income for SSI Clients | §358.510 | Applied Income for SSI Clients | ||||
§15.515 | Medicare Skilled Nursing Facilities | §358.515 | Medicare Skilled Nursing Facilities | ||||
G | Application for Medicaid | G | Application for Medicaid | ||||
§15.600 | Date of Application | §358.600 | Date of Application | ||||
§15.601 | Eligibility Determination | §358.601 | Eligibility Determination | ||||
§15.603 | Client Notification | §358.603 | Client Notification | ||||
§15.604 | Application Process | §358.604 | Application Process | ||||
§15.605 | Medical Effective Date | §358.605 | Medical Effective Date | ||||
§15.607 | Written Application | §358.607 | Written Application | ||||
§15.609 | Applicants and Their Allowed Representatives | §358.609 | Applicants and Their Allowed Representatives | ||||
§15.610 | Medicaid Coverage | §358.610 | Medicaid Coverage | ||||
§15.611 | Allowed Signatures | §358.611 | Allowed Signatures | ||||
§15.612 | Processing Deadlines | §358.612 | Processing Deadlines | ||||
§15.615 | Medical Care Identification | §358.615 | Medical Care Identification | ||||
§15.617 | Denials | §358.617 | Denials | ||||
§15.619 | Administrative Denials | §358.619 | Administrative Denials | ||||
§15.620 | Cases Placed on Hold | §358.620 | Cases Placed on Hold | ||||
§15.621 | Failure to Furnish Information | §358.621 | Failure to Furnish Information | ||||
§15.623 | Previously Completed Application for Assistance | §358.623 | Previously Completed Application for Assistance | ||||
H | Client Rights and Responsibilities | H | Client Rights and Responsibilities | ||||
§15.700 | Confidentiality of Case Records | §358.700 | Confidentiality of Case Records | ||||
§15.701 | Disclosure and Release of Client Information | §358.701 | Disclosure and Release of Client Information | ||||
§15.705 | Disclosure of Client Medical Records | §358.705 | Disclosure of Client Medical Records | ||||
§15.710 | Requirement To Provide Information (Reporting Changes) | §358.710 | Requirement To Provide Information (Reporting Changes) | ||||
§15.715 | Willful Withholding of Information | §358.715 | Willful Withholding of Information | ||||
§15.720 | Client Right To Appeal | §358.720 | Client Right To Appeal | ||||
§15.725 | Restitution | §358.725 | Restitution | ||||
19 | Nursing Facility Requirements for Licensure and Medicaid Certification | 355 | Reimbursement Rates | ||||
S | Reimbursement Methodology for Nursing Facilities | C | Reimbursement Methodology for Nursing Facilities | ||||
§19.1810 | Vendor Hold | §355.405 | Vendor Hold | ||||
BB | Nursing Facility Program Cost Determination Process | ||||||
§19.2703 | Vendor Hold | §355.406 | Vendor Hold | ||||
40 | Medicaid Managed Care | 353 | Medicaid Managed Care | ||||
A | STAR+PLUS | G | STAR+PLUS | ||||
§40.101 | General Provisions | §353.601 | General Provisions | ||||
§40.103 | Client Participation | §353.603 | Client Participation | ||||
§40.105 | Participating Providers | §353.605 | Participating Providers | ||||
46 | Contracting to Provide Assisted Living and Residential Care Services | 355 | Reimbursement Rates | ||||
B | Provider Contracts | E | Community Care for Aged and Disabled | ||||
§46.27 | Reimbursement Methodology for Residential Care | §355.509 | Reimbursement Methodology for Residential Care | ||||
52 | Emergency Response Services | ||||||
E | Claims | ||||||
§52.504 | Reimbursement Methodology for Emergency Response Services (ERS) | §355.510 | Reimbursement Methodology for Emergency Response Services (ERS) | ||||
55 | Contracting to Provide Home-Delivered Meals | ||||||
§55.45 | Reimbursement Methodology for Home-Delivered Meals | §355.511 | Reimbursement Methodology for Home-Delivered Meals | ||||
79 | Legal Services | 357 | Medical Fair Hearings | ||||
L | Fair Hearings | D | Fair Hearings | ||||
§79.1101 | Rule and Regulation Authority | §357.301 | Rule and Regulation Authority | ||||
§79.1102 | Definitions | §357.302 | Definitions | ||||
§79.1103 | Principles | §357.303 | Principles | ||||
§79.1104 | Requirements | §357.304 | Requirements | ||||
§79.1105 | Administrative Review of Fair Hearing Decisions | §357.305 | Administrative Review of Fair Hearing Decisions | ||||
M | Appeals Process | E | Appeals Process | ||||
§79.1201 | Group Hearings | §357.351 | Group Hearings | ||||
§79.1202 | Information on Right of Appeal | §357.352 | Information on Right of Appeal | ||||
§79.1203 | Hearing Officer | §357.353 | Hearing Officer | ||||
§79.1204 | Notice Requirement--Proposed Termination or Reduction of Assistance | §357.354 | Notice Requirement--Proposed Termination or Reduction of Assistance | ||||
§79.1205 | Food Stamp Client Participation in Fair Hearings | §357.355 | Food Stamp Client Participation in Fair Hearings | ||||
§79.1206 | Fair Hearing Request | §357.356 | Fair Hearing Request | ||||
§79.1207 | Time and Place of Hearing | §357.357 | Time and Place of Hearing | ||||
§79.1208 | Level-of-Care Hearings | §357.358 | Level-of-Care Hearings | ||||
§79.1209 | Notice for Disability Determination Hearings | §357.359 | Notice for Disability Determination Hearings | ||||
§79.1210 | Notice in Preadmission Screening and Annual Resident Reviews | §357.360 | Notice in Preadmission Screening and Annual Resident Reviews | ||||
N | Hearing Procedure | F | Hearing Procedure | ||||
§79.1301 | Conduct of Fair Hearing | §357.401 | Conduct of Fair Hearing | ||||
§79.1302 | Fair Hearing Proceedings | §357.402 | Fair Hearing Proceedings | ||||
§79.1303 | Private (Ex Parte) Consultations | §357.403 | Private (Ex Parte) Consultations | ||||
§79.1304 | Confidential Material | §357.404 | Confidential Material | ||||
§79.1305 | Furnishing Medical Information | §357.405 | Furnishing Medical Information | ||||
§79.1306 | Interrogatories | §357.406 | Interrogatories | ||||
§79.1307 | Prehearing Conference | §357.407 | Prehearing Conference | ||||
§79.1308 | Order of Fair Hearings | §357.408 | Order of Fair Hearings | ||||
§79.1309 | Action by Hearing Officer | §357.409 | Action by Hearing Officer | ||||
§79.1310 | Decisions by Hearing Officer | §357.410 | Decisions by Hearing Officer | ||||
§79.1311 | Public Access to Decisions | §357.411 | Public Access to Decisions | ||||
§79.1312 | Transcripts | §357.412 | Transcripts | ||||
§79.1313 | Retroactive Payments or Restored Benefits or Services | §357.413 | Retroactive Payments or Restored Benefits or Services | ||||
§79.1314 | Recovery of Benefits in 10-day Appeals | §357.414 | Recovery of Benefits in 10-day Appeals | ||||
§79.1315 | Time Limits on Appeals | §357.415 | Time Limits on Appeals | ||||
§79.1316 | Transient Appeals | §357.416 | Transient Appeals | ||||
§79.1317 | Time Periods for Dismissals | §357.417 | Time Periods for Dismissals | ||||
O | Social Service Appeals | G | Social Services Appeals | ||||
§79.1401 | Requirements | §357.441 | Requirements | ||||
§79.1402 | Reversals | §357.442 | Reversals | ||||
P | Medical Services Appeals | H | Medical Services Appeals | ||||
§79.1501 | Requirements | §357.461 | Requirements | ||||
§79.1502 | Right of Appeal | §357.462 | Right of Appeal | ||||
§79.1503 | Retroactive Benefits | §357.463 | Retroactive Benefits | ||||
Q | Formal Appeals | I | Formal Appeals | ||||
§79.1601 | Definitions | §357.481 | Definitions | ||||
§79.1602 | Computation of Time | §357.482 | Computation of Time | ||||
§79.1603 | Venue | §357.483 | Venue | ||||
§79.1604 | Notice of Adverse Action | §357.484 | Notice of Adverse Action | ||||
§79.1605 | Request for a Hearing | §357.485 | Request for a Hearing | ||||
§79.1606 | Notice of Hearing | §357.486 | Notice of Hearing | ||||
§79.1607 | Administrative Law Judge | §357.487 | Administrative Law Judge | ||||
§79.1608 | Other Procedures | §357.488 | Other Procedures | ||||
§79.1609 | Proposals for Decision, Final Decisions, and Final Orders | §357.489 | Proposals for Decision, Final Decisions, and Final Orders | ||||
§79.1610 | Motions for Rehearing | §357.490 | Motions for Rehearing | ||||
R | Medicaid Third-Party Recovery | J | Medicaid Third-Party Recovery | ||||
§79.1701 | Basis and Purpose | §357.501 | Basis and Purpose | ||||
§79.1702 | Definitions | §357.502 | Definitions | ||||
§79.1703 | Distribution of Recoveries | §357.503 | Distribution of Recoveries | ||||
§79.1704 | Waiver Authority of the Commissioner | §357.504 | Waiver Authority of the Commissioner | ||||
T | Administrative Fraud Disqualification Hearings | K | Administrative Fraud Disqualification Hearings | ||||
§79.1901 | Introduction and Legal Basis | §357.521 | Introduction and Legal Basis | ||||
§79.1902 | Designation of Hearing Officer | §357.522 | Designation of Hearing Officer | ||||
§79.1903 | Disqualification of Hearing Officer | §357.523 | Disqualification of Hearing Officer | ||||
§79.1904 | Hearing Officer's Powers and Duties | §357.524 | Hearing Officer's Powers and Duties | ||||
§79.1905 | Scheduling the Hearing | §357.525 | Scheduling the Hearing | ||||
§79.1906 | Advance Notice of Hearing | §357.526 | Advance Notice of Hearing | ||||
§79.1907 | Participation While Hearing is Pending | §357.527 | Participation While Hearing is Pending | ||||
§79.1908 | Conduct of Hearing | §357.528 | Conduct of Hearing | ||||
§79.1909 | Attendance at Hearing | §357.529 | Attendance at Hearing | ||||
§79.1910 | Household Member's Rights during Hearing | §357.530 | Household Member's Rights during Hearing | ||||
§79.1911 | Consideration of the Case by the Hearing Officer | §357.531 | Consideration of the Case by the Hearing Officer | ||||
§79.1912 | Failure of Household Member To Appear | §357.532 | Failure of Household Member To Appear | ||||
§79.1913 | Postponements | §357.533 | Postponements | ||||
§79.1914 | Recessing the Hearing | §357.534 | Recessing the Hearing | ||||
§79.1915 | Findings of the Hearing Officer | §357.535 | Findings of the Hearing Officer | ||||
§79.1916 | The Hearing Record and Decision | §357.536 | The Hearing Record and Decision | ||||
§79.1917 | Effect of an Administrative Determination of Intentional Program Violation | §357.537 | Effect of an Administrative Determination of Intentional Program Violation | ||||
§79.1918 | Notification of Hearing Decision and the Effect on Remaining Household Members | §357.538 | Notification of Hearing Decision and the Effect on Remaining Household Members | ||||
§79.1919 | Court Actions in Relation to Administrative Disqualification | §357.539 | Court Actions in Relation to Administrative Disqualification | ||||
§79.1920 | Presentation of the Texas Department of Human Services' (DHS's) Case | §357.540 | Presentation of the Texas Department of Human Services' (DHS's) Case | ||||
§79.1921 | Effect of Nondetermination of Intentional Program Violation | §357.541 | Effect of Nondetermination of Intentional Program Violation | ||||
§79.1922 | Consolidation of Administrative Disqualification Hearings and Fair Hearings | §357.542 | Consolidation of Administrative Disqualification Hearings and Fair Hearings | ||||
U | Fraud Involving Recipients | L | Fraud Involving Recipients | ||||
§79.2001 | Terms and General Policy | §357.561 | Terms and General Policy | ||||
§79.2003 | Determination and Disposition of Intentional Program Violations | §357.562 | Determination and Disposition of Intentional Program Violations | ||||
§79.2005 | Eligibility during Investigation | §357.563 | Eligibility during Investigation | ||||
§79.2007 | Appeals | §357.564 | Appeals | ||||
§79.2009 | Referral of Food Stamp and Temporary Assistance for Needy Families (TANF) Intentional Program Violation Claims to Administrative Disqualification Hearing Officer | §357.565 | Referral of Food Stamp and Temporary Assistance for Needy Families (TANF) Intentional Program Violation Claims to Administrative Disqualification Hearing Officer | ||||
§79.2011 | Collection Action on Food Stamp and Temporary Assistance for Needy Families (TANF) Intentional Program Violation Claims | §357.566 | Collection Action on Food Stamp and Temporary Assistance for Needy Families (TANF) Intentional Program Violation Claims | ||||
V | Fraud or Abuse Involving Medical Providers | M | Fraud or Abuse Involving Medical Providers | ||||
§79.2101 | Department Responsibility | §357.581 | Department Responsibility | ||||
§79.2102 | Confidentiality of Fraud or Abuse Investigation Records | §357.582 | Confidentiality of Fraud or Abuse Investigation Records | ||||
§79.2103 | Statutory Bases | §357.583 | Statutory Bases | ||||
§79.2104 | Department Responsibilities in Relation to Provider Fraud and Abuse | §357.584 | Department Responsibilities in Relation to Provider Fraud and Abuse | ||||
§79.2105 | Grounds for Fraud Referral and Administrative Sanction | §357.585 | Grounds for Fraud Referral and Administrative Sanction | ||||
§79.2110 | Administrative Sanctions/Actions, Restitution, and Recoupment | §357.586 | Administrative Sanctions/Actions, Restitution, and Recoupment | ||||
§79.2111 | Definitions | §357.587 | Definitions | ||||
§79.2112 | Administrative Sanctions and Actions | §357.588 | Administrative Sanctions and Actions | ||||
§79.2113 | Scope of Sanction | §357.589 | Scope of Sanction | ||||
§79.2114 | Imposing a Sanction | §357.590 | Imposing a Sanction | ||||
§79.2115 | Notice of Adverse Action | §357.591 | Notice of Adverse Action | ||||
§79.2116 | Informing Other Interested Parties | §357.592 | Informing Other Interested Parties | ||||
§79.2117 | Provider Education | §357.593 | Provider Education | ||||
§79.2118 | Request for Reinstatement | §357.594 | Request for Reinstatement | ||||
§79.2119 | Obligation of Health Care Practitioners and Providers | §357.595 | Obligation of Health Care Practitioners and Providers | ||||
W | Fraud or Abuse Involving Providers (Except Medical) | N | Fraud or Abuse Involving Providers (Except Medical) | ||||
§79.2201 | Responsibilities of the Department In Relation to Provider Fraud | §357.601 | Responsibilities of the Department In Relation to Provider Fraud | ||||
§79.2202 | Statutory Bases for Prosecution | §357.602 | Statutory Bases for Prosecution | ||||
X | Recovery of Benefits Wrongfully Received | O | Recovery of Benefits Wrongfully Received | ||||
§79.2301 | Department Responsibility | §357.621 | Department Responsibility | ||||
§79.2303 | Recovery from Providers | §357.622 | Recovery from Providers | ||||
§79.2304 | Recovery When Fraud Is Involved | §357.623 | Recovery When Fraud Is Involved | ||||
Y | Civil Monetary Penalties | P | Civil Monetary Penalties | ||||
§79.2401 | Definitions | §357.641 | Definitions | ||||
§79.2402 | Liability | §357.642 | Liability | ||||
§79.2403 | Maximum Amount | §357.643 | Maximum Amount | ||||
§79.2404 | Exemptions | §357.644 | Exemptions | ||||
§79.2405 | Determining the Amount | §357.645 | Determining the Amount | ||||
§79.2406 | Assessment of a Civil Monetary Penalty | §357.646 | Assessment of a Civil Monetary Penalty | ||||
§79.2407 | Payment of a Civil Monetary Penalty | §357.647 | Payment of a Civil Monetary Penalty | ||||
§79.2408 | Prohibited Use of Civil Monetary Penalties in Cost Reports or Claims | §357.648 | Prohibited Use of Civil Monetary Penalties in Cost Reports or Claims | ||||
Z | Reimbursement Rates for Prosecution of Intentional Program Violations | Q | Reimbursement Rates for Prosecution of Intentional Program Violations | ||||
§79.2501 | Rates of Reimbursement | §357.661 | Rates of Reimbursement |