SECTION 373.103. Applicability

(a) A Medicaid Estate Recovery claim may be filed against the estate of a deceased Medicaid recipient for covered Medicaid services if the recipient:

(1) Was age 55 years or older at the time the services were received; and

(2) Initially applied for covered Medicaid long-term care services on or after March 1, 2005, the effective date of these rules.

(b) For purposes of this chapter, an individual will be considered to be age 55 as of the first day of the month following the month in which the recipient attains the age of 55.

(c) Covered Medicaid long-term care services include the following services provided to a recipient age 55 years or older under the State of Texas Medicaid plan under Title XIX of the Social Security Act (SSA):

(1) Nursing facility services;

(2) Intermediate Care Facilities for the Mentally Retarded (ICF-MR);

(3) Home and Community-Based Services (§1915(c), SSA) and Community Attendant Services (§1929(b), SSA); and

(4) Related costs of hospital and prescription drug services.

(d) For the purposes of this chapter, covered services do not include services provided before the effective date of these rules.

Source Note: The provisions of this §373.103 adopted to be effective March 1, 2005, 30 TexReg 830