SECTION 364.13. Coordination of Benefits

(a) An individual is not eligible to receive services delivered under the Primary Health Care Services Program when the individual, or a person with a legal obligation to support the individual, is eligible for some other benefit that would pay for all or part of the services, unless coverage for those services has been denied.

(b) An individual who applies for or receives primary health care services shall inform the provider at the time of application or at the time the individual receives services of any other benefit to which the individual or person who has a legal obligation to support the individual may be entitled.

(c) The commissioner, or the manager of the department unit having responsibility for oversight of the primary health care services program, if so authorized by the commissioner, may waive enforcement of this section concerning individual applicants if enforcement of this section would deny services to a class of otherwise eligible individuals because of conflicting federal, state, or local laws or regulations.

Source Note: The provisions of this §364.13 adopted to be effective May 28, 2006, 31 TexReg 4218; amended to be effective February 14, 2013, 38 TexReg 645; amended to be effective September 1, 2013, 38 TexReg 5505; transferred effective March 1, 2022, as published in the Texas Register February 11, 2022, 47 TexReg 674