SECTION 366.409. Application Requirements and Processing

(a) An applicant is identified through the Texas Health and Human Services Commission (HHSC) Breast and Cervical Cancer Services (BCCS) Program.

(b) A BCCS Program provider, acting only to the extent permitted by applicable scope of licensure laws under the Texas Occupations Code, screens and diagnoses qualifying medical conditions and makes a determination of presumptive eligibility.

(c) BCCS Program providers have been designated as qualified entities for presumptive eligibility determinations.

(d) A BCCS Program provider sends the applicant's application packet containing the provider's determination of presumptive eligibility and an application for assistance to HHSC within five working days after the date the presumptive eligibility determination is made. HHSC determines eligibility no later than 15 days from the application's file date.

(e) The period of presumptive Medicaid eligibility is specified in 42 U.S.C. §1396r-1b(b)(1) as beginning with the date a qualified entity determines eligibility under the State Plan, based upon preliminary information, and ends with (and includes) the earlier of:

(1) the date an eligibility determination is made by HHSC; or

(2) the last day of the month following the month presumptive eligibility was determined.

Source Note: The provisions of this §366.409 adopted to be effective June 9, 2010, 35 TexReg 4661; amended to be effective March 20, 2023, 48 TexReg 1552