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Texas Administrative Code (Last Updated: March 27,2024) |
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TITLE 1. ADMINISTRATION |
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PART 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION |
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CHAPTER 370. STATE CHILDREN'S HEALTH INSURANCE PROGRAM |
| SUBCHAPTER A. PROGRAM ADMINISTRATION |
| § 370.1. Purpose |
| § 370.4. Definitions |
| § 370.10. Duties and Responsibilities of HHSC |
| § 370.12. Maternal Depression Screening |
| SUBCHAPTER B. APPLICATION SCREENING, REFERRAL, PROCESSING, RENEWAL, AND DISENROLLMENT |
| DIVISION 1. APPLICATION PROCESSES |
| § 370.20. Application Availability and File Date |
| § 370.21. Application Assistance |
| § 370.22. Completion of Telephone Applications |
| § 370.25. Missing Information |
| DIVISION 2. APPLICANT RIGHTS AND RESPONSIBILITIES REGARDING APPLICATION AND ELIGIBILITY |
| § 370.30. Applicant Rights and Responsibilities |
| DIVISION 4. ELIGIBILITY CRITERIA |
| § 370.42. Age Limits |
| § 370.43. Citizenship and Residency |
| § 370.44. Income and Assets |
| § 370.45. Medicaid Eligibility |
| § 370.46. Waiting Period |
| § 370.47. Social Security Number |
| § 370.49. Medicaid Referrals for Pregnant CHIP Members |
| DIVISION 5. REVIEW AND RECONSIDERATION OF ELIGIBILITY DENIALS AND TEMPORARY ENROLLMENT |
| § 370.50. Matters Subject to Review |
| § 370.51. Deadline and Method for Requesting Review |
| § 370.52. Disposition of a Request for Review |
| § 370.54. Temporary Enrollment Pending Disposition of Review or Reconsideration |
| DIVISION 6. RENEWAL PROCESS |
| § 370.60. Renewal |
| DIVISION 7. DISENROLLMENT |
| § 370.70. Income Eligibility Check in 6th Month of Coverage |
| § 370.71. Review and Reconsideration of Disenrollment Determination |
| SUBCHAPTER C. ENROLLMENT, RENEWAL, DISENROLLMENT, AND COST SHARING |
| DIVISION 1. ENROLLMENT AND DISENROLLMENT |
| § 370.301. CHIP Enrollment Packet |
| § 370.303. Completion of Enrollment |
| § 370.305. Enrollment of Children with Special Health Care Needs (CSHCN) |
| § 370.307. Continuous Enrollment Period |
| § 370.309. Incomplete or Missing Information |
| § 370.311. Disenrollment |
| DIVISION 2. COST-SHARING REQUIREMENTS |
| § 370.321. Requirements and Exemptions |
| § 370.325. Cost-Sharing Cap |
| SUBCHAPTER D. ELIGIBILITY FOR UNBORN CHILDREN |
| § 370.401. Perinates |
| SUBCHAPTER E. PROVIDER REQUIREMENTS |
| § 370.452. Significant Traditional Provider |
| § 370.453. Balance Billing |
| § 370.454. Experience Rebate in the Children's Health Insurance Program |
| § 370.455. Provider Complaints and Appeals Processes |
| SUBCHAPTER F. SPECIAL INVESTIGATIVE UNITS |
| § 370.501. Purpose |
| § 370.502. Managed Care Organization's Plans and Responsibilities in Preventing and Reducing Waste, Abuse, and Fraud |
| § 370.503. Managed Care Organization's Contracts |
| § 370.504. Review of Managed Care Organization's Records |
| § 370.505. Recovery of Funds |
| SUBCHAPTER G. STANDARDS FOR CHIP MANAGED CARE |
| § 370.601. Applicability of Medicaid Managed Care Standards to CHIP |
| § 370.602. Member Complaints and Appeals |
| § 370.604. Managed Care Organization Requirements Concerning Out-of-Network Providers |
| SUBCHAPTER H. OUTPATIENT PHARMACY SERVICES |
| § 370.701. Applicability of Medicaid Managed Care Standards for Outpatient Pharmacy Services to CHIP |
| SUBCHAPTER I. MODIFIED ADJUSTED GROSS INCOME METHODOLOGY |
| § 370.801. Purpose and Scope |
| § 370.803. Definitions |
| § 370.805. Methodology |
| § 370.807. Determination of Household Composition |
| § 370.809. Calculation of Individual Income |
| § 370.811. Determination Regarding Inclusion of Individual Income in the Household Income |
| § 370.813. Calculation of Household Income |
| § 370.815. Modification |