Texas Register, Volume 30, Number 41, Pages 6499-6834, October 14, 2005 Page: 6,535
6499-6834 p. ; 28 cm.View a full description of this periodical.
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(2) The child had health insurance coverage provided by
ERS, or CHIP in another state;
(3) The child's health insurance coverage costs more than
10 percent of the Budget Group's [budget gmup's] gross monthly in-
come;
(4) The child has access to group-based health insurance
[benefits plan] coverage and will participate in the premium payment
reimbursement program administered by the Commission; or
(5) The Commission grants an exception to the waiting pe-
riod under subsection (d) of this section.
(d) [(e)] The Commission may grant an exception to the
90-day waiting period by this section if it determines good
cause exists to grant an exception and either:
(1) An Applicant [applicant] requests an exception:
(A) Prior to submission of an Application [application];
(B) At the time of Application [application]; or
(C) As part of a request for review or reconsideration of
a denial of eligibility under sections 370.52 or 370.54 of this chapter;
or
(2) The Commission reaches a determination that good
cause exists based either on information provided by an Applicant
[applicant] or information otherwise obtained by the Commission.
370.49. Medicaid Referrals for Pregnant CHIP Members.
Pregnant CHIP members may be referred for a Medicaid for eligi-
bility determination. Those pregnant CHIP members who are deter-
mined to be Medicaid eligible will be disenrolled from CHIP. Medicaid
coverage will be coordinated to begin when CHIP enrollment ends to
avoid gaps in health care coverage. In the event HHSC or its designee
remains unaware of a member's pregnancy until delivery, the deliv-
ery will be covered by CHIP. HHSC or it's designee will suspend the
member's eligibility expiration date after notification of the delivery is
received. HHSC or its designee will reinstate the mother's eligibility
expiration date and set the mother's eligibility expiration date at the
later of
(1) the end of the second month following the month of
the baby's birth or
(2) the date when the mother's eligibility would have ex-
pired. [If a Texare applicant chid is referred to Medicaid and subse-
uently determined ineligible for Medicaid Medicaid denies eligibility
and may deem the ehild eligible for CHIP ased on the budget group's
income andlr assets or the child's citizenship o1r immigration status.]
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal author-
ity to adopt.
Filed with the Office of the Secretary of State on October 3, 2005.
TRD-200504462
Steve Arag6n
Chief Counsel
Texas Health and Human Services Commission
Earliest possible date of adoption: November 13, 2005
For further information, please call: (512) 424-6900
1 TAC 370.48(Editor's note: The text of the following section proposed for repeal
will not be published. The section may be examined in the offices of the
Texas Health and Human Services Commission or in the Texas Register
office, Room 245, James Earl Rudder Building, 1019 Brazos Street,
Austin.)
Statutory Authority (CHIP)
The repeal is proposed under the authority granted to HHSC
by Government Code, 531.033, which authorizes the Commis-
sioner of HHSC to adopt rules necessary to implement HHSC's
duties and the Texas Health and Safety Code, 62.051(d), which
directs HHSC to adopt rules as necessary to implement the Chil-
dren's Health Insurance Program.
The proposed repeal affects the Texas Health and Safety Code,
Chapter 62, and the Texas Government Code, Chapter 531. No
other statutes, articles, or codes are affected by these proposed
repeal.
370.48. Completion of Application Process.
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal author-
ity to adopt.
Filed with the Office of the Secretary of State on October 3, 2005.
TRD-200504463
Steve Arag6n
Chief Counsel
Texas Health and Human Services Commission
Earliest possible date of adoption: November 13, 2005
For further information, please call: (512) 424-6900
DIVISION 5. REVIEW AND RECONSID-
ERATION OF ELIGIBILITY DENIALS AND
TEMPORARY ENROLLMENT
1 TAC 370.50 - 370.54
Statutory Authority (CHIP)
The amendments are proposed under the authority granted
to HHSC by Government Code, 531.033, which authorizes
the Commissioner of HHSC to adopt rules necessary to imple-
ment HHSC's duties and the Texas Health and Safety Code,
62.051 (d), which directs HHSC to adopt rules as necessary to
implement the Children's Health Insurance Program.
The proposed amendments affect the Texas Health and Safety
Code, Chapter 62, and the Texas Government Code, Chapter
531. No other statutes, articles, or codes are affected by these
proposed amendments.
370.50. Matters subject to review [and reconsideration ofEligibility
denials and Temporary Enrollment].
[(a)] An applicant may request review of an action. [that is
dissatisfied or disagrees with certain decisions made by or on behalf of
the GHIP pro].am may request:]
[(1-) a review of the initiall d cisino. and]
[(2) if the applicant is dissatisfied with the outeeme of the
review, a reconsideration of the review of the decision.]
[(b) An applicant may request a review andlor reconsideration
of the following decisions:]PROPOSED RULES October 14, 2005 30 TexReg 6535
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Texas. Secretary of State. Texas Register, Volume 30, Number 41, Pages 6499-6834, October 14, 2005, periodical, October 14, 2005; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth97314/m1/34/: accessed July 17, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.