Texas Administrative Code (Last Updated: March 27,2024) |
TITLE 1. ADMINISTRATION |
PART 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION |
CHAPTER 358. MEDICAID ELIGIBILITY FOR THE ELDERLY AND PEOPLE WITH DISABILITIES |
SUBCHAPTER B. NONFINANCIAL REQUIREMENTS |
SECTION 358.219. Third-party Resources
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(a) Medicaid is considered the payor of last resort for a person's medical expenses. As a condition of eligibility, in accordance with 42 CFR §§433.138 - 433.148, an applicant or recipient must: (1) assign to the Texas Health and Human Services Commission (HHSC) the applicant's or recipient's right to recover any third-party resources available for payment of medical expenses covered under the Texas State Plan for Medical Assistance; and (2) report to HHSC any third-party resource within 60 days after learning about the third-party resource. (b) If HHSC determines that a person's employer-based health insurance is cost-effective, the person must participate in HHSC's Health Insurance Premium Payment program as a condition of eligibility. HHSC denies eligibility to a person who voluntarily drops his or her employer-based health insurance or fails to provide HHSC with the information needed to determine cost effectiveness. Source Note: The provisions of this §358.219 adopted to be effective September 1, 2009, 34 TexReg 5497