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TITLE 1ADMINISTRATION
PART 15TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 366MEDICAID ELIGIBILITY FOR WOMEN, CHILDREN, YOUTH, AND NEEDY FAMILIES
SUBCHAPTER ECHILDREN'S MEDICAID
RULE §366.511Application Processing

(a) HHSC processes Children's Medicaid applications received electronically, by paper, or by telephone.

(b) HHSC allows any office of a state health and human services agency to accept an initial application.

(c) HHSC contracts with third parties to accept applications from hospital districts (including state-owned teaching hospitals), federally qualified health centers, and county health departments.

(d) HHSC may conduct an interview with an initial applicant.

(e) HHSC reopens a denied initial application, so long as the applicant complies with the missed requirements within 60 days after the date the application was submitted. HHSC otherwise requires the applicant to file a new application.

(f) HHSC reconsiders the eligibility of a recipient who is terminated for failure to submit a renewal form or necessary information, so long as the recipient complies with the missed requirements within 90 days after the date of termination. HHSC otherwise requires the recipient to file a new application.

(g) HHSC may reopen an application for three months prior coverage if:

  (1) within two years after the application was filed, the applicant requests that the application be reopened; and

  (2) a Medicaid eligibility determination was not previously made for the three-month prior period.


Source Note: The provisions of this §366.511 adopted to be effective January 1, 2014, 38 TexReg 9467; amended to be effective June 1, 2014, 39 TexReg 3981

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