1. (a) If a health care provider and a governmental entity or hospital district cannot agree on a household's eligibility for assistance, the provider or the governmental entity or hospital district may submit the matter to the Health and Human Services Commission (commission) not later than the 90th day after the eligibility determination was issued.
2. (b) The health care provider and the governmental entity or hospital shall submit all relevant information to the commission in accordance with the internal procedures established by the commission.
3. (c) From the information submitted, the commission shall determine the household's eligibility for assistance.
4. (d) Not later than the 45th day after the receipt of the matter, the commission shall notify each governmental entity or hospital district and the health care provider of the decision and the reasons for the decision.

Source Note:The provisions of this §363.3 adopted to be effective April 1, 2004, 29 TexReg 3177; amended to be effective February 28, 2008, 33 TexReg 1549; transferred effective March 1, 2022, as published in the Texas Register February 11, 2022, 47 TexReg 673; amended to be effective September 18, 2024, 49 TexReg 7328.