26 Tex. Admin. Code § 554.410 - Refunds in Medicaid-Certified Facilities
(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.
Notes
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