SECTION 354.1731. Medicaid and Low-income or Uninsured Patient Population by Provider  


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  • For the purposes of determining the Medicaid and Low-income or Uninsured Patient Population by Provider (PPP):

    (1) An individual is classified a Medicaid individual served if the individual was enrolled in Medicaid or the Children's Health Insurance Program at the time of at least one encounter during the applicable DY.

    (2) An individual is classified a low-income or uninsured individual (LIU) served if the individual was either at or below 200 percent of the FPL or did not have health insurance at the time of at least one encounter during the applicable DY.

    (3) If an individual was enrolled in Medicaid or the Children's Health Insurance Program at the time of one encounter during the applicable DY and was LIU at the time of a separate encounter during the applicable DY, that individual is classified as a Medicaid individual served.

Source Note: The provisions of this §354.1731 adopted to be effective November 12, 2019, 44 TexReg 6854