Medical Assistance Program

Subchapter A. General Provisions

32.001 Purpose of Chapter 32.002 Construction of Chapter 32.003 Definitions

Subchapter B. Administrative Provisions

32.021 Administration of the Program 32.0211 Restrictions on Executive Commissioners, Former Members of a Board, Commissioners, and Their Business Partners 32.0212 Delivery of Medical Assistance 32.0213 Nursing Facility Bed Certification and Decertification 32.0214 Designations of Primary Care Provider by Certain Recipients 32.0215 Home or Community Care Providers: Civil Monetary Penalties 32.022 Medical and Hospital Care Advisory Committees 32.023 Cooperation with Other State Agencies 32.0231 Announcement of Funding or Program Change 32.024 Authority and Scope of Program; Eligibility 32.0241 Review of Waiver Request 32.0242 Verification of Certain Information 32.0243 Periodic Review of Eligibility for Certain Recipients 32.0244 Nursing Facility Beds in Certain Counties 32.0245 Nursing Facility Beds for Certain Facilities Treating Alzheimer's Disease 32.02451 Additional Personal Needs Allowance for Guardianship Expenses of Certain Recipients 32.0246 Medical Assistance Reimbursement for Certain Behavioral Health and Physical Health Services 32.0247 Medical Assistance for Certain Persons Making Transition from Foster Care to Independent Living 32.02471 Medical Assistance for Certain Former Foster Care Adolescents Enrolled in Higher Education 32.024715 Streamlined Eligibility Determination Process for Certain Former Foster Care Youth 32.02482 Medical Assistance Reimbursement for Lactation Consultation Services 32.0249 Mental Health Screenings in Texas Health Steps Program 32.025 Application for Medical Assistance 32.0251 Eligibility Notification and Review for Certain Children 32.0255 Transitional Medical Assistance 32.0256 Continuation of Medical Assistance for Certain Individuals 32.026 Certification of Eligibility and Need for Medical Assistance 32.0261 Continuous Eligibility 32.026101 Determination of Eligibility by Health Care Exchanges Prohibited 32.02611 Exclusion of Assets in Prepaid Tuition Programs and Higher Education Savings Plans 32.02613 Life Insurance Assets; Life Insurance Policy Conversion 32.0262 Eligibility Transition 32.0263 Health Care Orientation 32.0264 Suspension and Reinstatement of Eligibility for Children in Juvenile Facilities 32.0265 Notice of Certain Placements in Juvenile Facilities 32.0266 Suspension, Termination, and Automatic Reinstatement of Eligibility for Individuals Confined in County Jails 32.027 Selection of Provider of Medical Assistance 32.0275 Military Medical Treatment Facilities and Affiliated Health Care Providers; Reimbursement 32.028 Fees, Charges, and Rates 32.0281 Rules and Notice Relating to Payment Rates 32.0282 Public Hearing on Rates 32.0284 Calculation of Payments under Certain Supplemental Hospital Payment Programs 32.0285 Calculation of Medical Education Add-on for Reimbursement of Teaching Hospitals That Provide Behavioral Health and Physical Health Services 32.0286 Annual Patient Care Expense Ratio for Reimbursement of Certain Nursing Facility Providers 32.0287 Prescribed Pediatric Extended Care Center Reimbursement 32.029 Methods of Payment 32.0291 Prepayment Reviews and Payment Holds 32.031 Receipt and Expenditure of Funds 32.0311 Drug Reimbursement under Certain Programs 32.03115 Reimbursement for Medication-Assisted Treatment for Opioid or Substance Use Disorder 32.03117 Reimbursement for Non-Opioid Treatments 32.0312 Reimbursement for Services Associated with Preventable Adverse Events 32.03126 Reimbursement for Childhood Cranial Remolding Orthosis 32.0313 Induced Deliveries or Cesarean Sections Before 39TH Week 32.0314 Reimbursement for Durable Medical Equipment and Supplies 32.03141 Authority of Advanced Practice Registered Nurses and Physician Assistants Regarding Durable Medical Equipment and Supplies 32.0315 Funds for Graduate Medical Education 32.0316 Electronic Transactions; Medicaid 32.0317 Reimbursement for Services Provided under School Health and Related Services Program 32.032 Prevention and Detection of Fraud and Abuse 32.0321 Surety Bond 32.0322 Criminal History Record Information; Enrollment of Providers 32.033 Subrogation 32.034 Contract Cancellation; Notice and Hearing 32.035 Appeals 32.036 Program Payments Nonassignable and Exempt from Legal Process 32.038 Collection of Insurance Payments 32.0381 Icf-Iid Payment Rates 32.039 Administrative Remedies 32.0391 Criminal Offense 32.040 Identification of Husband or Alleged Father 32.0421 Administrative Penalty for Failure to Provide Information 32.0422 Health Insurance Premium Payment Reimbursement Program for Medical Assistance Recipients 32.0423 Recovery of Reimbursements from Health Coverage Providers 32.0424 Requirements of Third-Party Health Insurers 32.04242 Payor of Last Resort 32.0425 Reimbursement for Wheeled Mobility Systems 32.043 Procurement Rules for Public Disproportionate Share Hospitals 32.044 Group Purchasing for Disproportionate Share Hospitals 32.045 Enhanced Reimbursement 32.046 Sanctions and Penalties Related to the Provision of Pharmacy Products 32.0461 Vendor Drug Program; Competitive Bidding 32.0462 Vendor Drug Program; Pricing Standard 32.0463 Medications and Medical Supplies 32.047 Prohibition of Certain Health Care Service Providers 32.048 Managed Care Information and Training Plan 32.049 Managed Care Contract Compliance 32.050 Dual Medicaid and Medicare Coverage 32.051 Misdirected Billing 32.052 Waiver Programs for Children with Disabilities or Special Health Care Needs 32.053 Program of All-Inclusive Care for the Elderly (pace) 32.0531 Pace Program Team 32.0532 Pace Program Reimbursement Methodology 32.0533 Data Collection: Pace and Star + Plus Medicaid Managed Care Programs 32.054 Dental Services 32.055 Catastrophic Case Management 32.0551 Optimization of Case Management Systems 32.056 Compliance with Texas Health Steps Comprehensive Care Program 32.0561 Maternal Depression Screening 32.057 Contracts for Disease Management Programs 32.058 Limitation on Medical Assistance in Certain Alternative Community-Based Care Settings 32.059 Use of Respiratory Therapists for Respiratory Therapy Services 32.061 Community Attendant Services Program 32.062 Admissibility of Certain Evidence Relating to Nursing Institutions 32.063 Third-Party Billing Vendors 32.0631 Annual Notice to Certain Providers Regarding Use of Medicaid Identification Numbers with Respect to Newborn Children 32.064 Cost Sharing 32.0641 Recipient Accountability Provisions; Cost-Sharing Requirement to Improve Appropriate Utilization of Services 32.067 Delivery of Comprehensive Care Services to Certain Recipients of Medical Assistance 32.068 In-Person Evaluation Required for Certain Services 32.069 Chronic Kidney Disease Management Initiative 32.070 Audits of Providers 32.0705 External Audits of Certain Medicaid Contractors Based on Risk 32.071 Recipient and Provider Education 32.072 Direct Access to Eye Health Care Services 32.073 Health Information Technology Standards 32.074 Access to Personal Emergency Response System 32.075 Employment Assistance and Supported Employment 32.0755 Prevocational Services under Certain Waiver Programs 32.076 Substitute Dentists

Subchapter C. Medical Assistance Program Provider Database

32.101 Definitions 32.102 Database of Medical Assistance Program Providers 32.103 Certain Fees Prohibited 32.104 Authority to Contract 32.105 Rules

Subchapter E. Electronic Communications

32.201 Definitions 32.202 Electronic Communications

Subchapter F. Partnership for Long-Term Care Program

32.251 Definitions 32.252 Partnership for Long-Term Care Program 32.253 Asset Disregard 32.254 Reciprocal Agreements 32.255 Training; Information and Technical Assistance 32.256 Rules