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TITLE 26 - HEALTH AND HUMAN SERVICES
PART 1 - HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 554 - NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION
SUBCHAPTER E - RESIDENT RIGHTS
SECTION/RULE §554.410 - Refunds in Medicaid-certified Facilities
Chapter Review Date 03/11/2024

(a) The nursing facility must refund private funds paid to the facility for periods covered by Medicaid, including retroactive periods of Medicaid coverage, when:(1) the Medicaid vendor payment has been accepted by the nursing facility; or(2) the nursing facility has been notified by HHSC about an individual's eligibility for Medicaid.(b) The nursing facility must make the refund within 30 days of:(1) notification of eligibility for nursing home coverage;(2) notification of correction of applied income; or(3) receipt of any vendor payment from HHSC for any covered period.(c) When the facility becomes aware of the need for a refund as indicated in subsection (a) of this section, facility staff must write to the resident or resident representative, notifying the resident about the right to a refund and the amount due.

Source Note: The provisions of this §554.410 adopted to be effective May 1, 1995, 20 TexReg 2393; amended to be effective March 24, 2020, 45 TexReg 2025; transferred effective January 15, 2021, as published in the Texas Register December 11, 2020, 45 TexReg 8871.

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