1. (a) The Texas Health and Human Services Commission (HHSC) allows any office of a state health and human services agency to accept an initial application.
2. (b) HHSC contracts with third parties to accept applications from hospital districts (including state-owned teaching hospitals), federally qualified health centers, and county health departments.
3. (c) HHSC may conduct a personal interview with an initial applicant if HHSC has received conflicting information related to household membership, income, or assets that affects eligibility and the information cannot be verified through other means.
4. (d) HHSC reopens a denied initial application, so long as the household complies with the missed requirements within 60 days after the date the application was submitted. HHSC otherwise requires the household to file a new application.
5. (e) HHSC reopens a denied renewal application, so long as the household complies with the missed requirements within 30 days after the last benefit month. HHSC otherwise requires the household to file a new application.

6. (f) HHSC may reopen an application for three months prior coverage if:

   1. (1) within two years after the application was filed, the applicant requests that the application be reopened; and
   2. (2) a Medicaid eligibility determination was not previously made for the three-month prior period.

7. (g) For a pregnant applicant who is potentially eligible but unable to provide proof of eligibility, HHSC:

   1. (1) postpones verifications and provides Medicaid coverage to ensure access to medical care within 30 days after the application date;
   2. (2) continues the coverage of women who provide postponed verifications by the 30th day after the application date; and
   3. (3) denies the coverage of those who fail to meet the 30-day deadline.
8. (h) There are no conditions limiting the designation of an authorized representative.

Source Note:The provisions of this §366.811 adopted to be effective June 9, 2010, 35 TexReg 4661.