TITLE 1.ADMINISTRATION

Part 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION

Chapter 354. MEDICAID HEALTH SERVICES

Subchapter A. PURCHASED HEALTH SERVICES

1. MEDICAID PROCEDURES FOR PROVIDERS

1 TAC §354.1003

The Texas Health and Human Services Commission adopts an amendment to 1 TAC §354.1003, concerning Time Limits for Submitted Claims. The amendment is adopted without change to the proposed text as published in the January 24, 2003 issue of the Texas Register (28 TexReg 635). The text of the rule will not be republished.

The amendment is adopted as a change to Chapter 354, Medicaid Health Services. The purpose of the amendment is to allow providers who are waiting for the issuance of a Texas Provider Identifier (TPI) number more time to file claims. The amendment will allow providers who are awaiting the issuance of a TPI number 95 days from the date of service (or discharge) or 95 days from the date the TPI number is issued, whichever is later, to ensure that their claims are received by HHSC or its designee. The amendment will also eliminate claims being denied because the TPI number was not issued prior to the claims being received by HHSC or its designee.

No comments were received regarding adoption of the amendment.

The amendment is adopted under §531.033, Government Code, which provides the commissioner of HHSC with broad rulemaking authority; and the Human Resources Code §32.021 and the Texas Government Code §531.021(a), which provide the Health and Human Services Commission (HHSC) with the authority to administer the federal medical assistance (Medicaid) program in Texas.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on April 24, 2003.

TRD-200302621

Steve Aragon

General Counsel

Texas Health and Human Services Commission

Effective date: May 14, 2003

Proposal publication date: January 24, 2003

For further information, please call: (512) 424-6576