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The program reimburses the policy holder for private health insurance payroll deductions for Medicaid-eligible persons when HHSC determines that it is cost-effective. ), osteopathic medical physician (D.O. Bona Fide Agent A person who is familiar with an applicant and knowledgeable of the person's financial affairs. To continue working, click on Stay on page. Account Transfer The way an applicants information moves between the Marketplace and the Texas Health and Human Services Commission (HHSC) when a person applies for health insurance or medical programs. notifying the applicant and the eligibility system when spend down is met. Modified Adjusted Gross Income (MAGI) Household Composition The people whose income and needs are considered when determining eligibility for an applicant or recipient for certain Medical Programs based on tax status, tax relationships, living arrangement, and family relationships. (FPL). Activity Fee An additional cost incurred by the household associated with a structured dependent care program. Three Months Prior The three-month period before the Medicaid application month. Based on the criteria, TIERS generates a sample list. Temporary Assistance for Needy Families (TANF) A child who meets the definition of deprivation and who lives with a relative who meets the relationship requirement. 1-877-541-7905. Examples of batch processing include schedule system-generated correspondence to be printed at and mailed from a central site, mail out review packets at scheduled intervals from the central mail facility, and gathering information and share it through interfaces with other agencies. Unauthorized access to this site and its information assets is prohibited. With this type of access, a person can view and change an application created under their username. generate a manual issuance of benefits outside the normal eligibility process. When you're done, you can create an account to apply for benefits and send your info to support services to be contacted by programs. This includes falsifying a document or a statement, or providing false information in an interview, with the intent to commit fraud. These include construction of real property or lease, rental, license, sale, exchange, or other disposition of personal property, computer software, sound recordings, produced films, produced electricity, natural gas, or potable water. Proration Portion of total monthly benefits a household is entitled to receive. Your case number is a 10-digit number that HHSC uses to bundle and process benefits you receive through their agency. Child A child is an adoptive, step, or natural child who is under 19. Child Support A payment made from a biological or adoptive parent to a biological or adoptive child. Apply for benefits online at Unemployment Benefits Services by logging on and selecting Apply for Benefits, or call a Texas Workforce Commission . A household member may be charged with an IPV even if the person has not actually received benefits to which they are not entitled. Also known as a pre-need plan or prepaid funeral agreement. Grandparent Payment System (GPS) An electronic, web-based data system used to inquire about the issuance of archived TANF one-time Grandparent Payments. Military Member Aperson in the U.S. Armed Forces/Reserves (Army, Marine Corps, Navy, Air Force or Coast Guard), National Guard (Army, Marine Corps, Navy, Air Force, Coast Guard or Reserve Guard) or the State Military Forces/Texas State Guard. Special Immigrant Conditional Permanent Resident (SI CPRs) Qualified noncitizens granted special immigrant status. to file a federal income tax return for the taxable year in which Medical Program eligibility is requested; if married, to file a joint federal income tax return for the taxable year in which Medical Program eligibility is requested; that no other taxpayer will be able to claim the person or the couple as a tax dependent on a federal income tax return for the taxable year in which Medical Program eligibility is requested; or. ), dentist (D.D.S. Run EDBC (Eligibility Determination Benefit Calculation) A process in the Wrap Up eligibility management group used to determine eligibility of the Eligibility Determination Group (EDG). Interview Mode A designation in TIERS Data Collection that queues the driver flow through appropriate pages according to the type of action. Your Medicaid number also known as a recipient number or individual number is a 9-digit number than can be found on the 'Your Texas Benefits' card. We recommend creating an account so you can: Get alerts about updates to your application. Housing and Urban Development (HUD) U.S. Department of Housing and Urban Development. For example, a user can: User Guide A Texas Integrated Eligibility Redesign System (TIERS) help tool accessed by clicking on the Help icon in the upper right corner of TIERS pages. Automated Renewal Process The first step in an administrative renewal. Hearing The functional area where individual appeals are recorded and tracked. Qualified Health Professional A person who provides care under the supervision of a licensed practitioner or a medical or dental practice that is state regulated. Summer P-EBT (June-August 2022) is a one-time benefit of $391 for each eligible child. These items include housing, utilities, deposits for housing or utilities, food, clothing, and incidentals. For your convenience, the Help Center will open in a new window. Continuing Scheme A situation in which a recipient commits two or more acts. SDX information can be used as a source of verification and is available in the Texas Integrated Eligibility Redesign System (TIERS). Qualified Hospital (QH) A Medicaid provider that notifies HHSC of its intent to make presumptive eligibility determinations and agrees to make PE determinations per HHSC policies and procedures. determining if a medical bill can be counted for spend down; corresponding with the applicant about eligible and ineligible medical bills; determining if and when the applicant meets spend down; and. These are benefits issued and accessed by EBT cards, card numbers and PINs, or by manual voucher and signature. Continuous Eligibility A period where a person remains eligible during a continuous eligibility period regardless of any change in circumstances, except for: Convertible Bond A bond that can be converted to cash according to program policy. SeeEDBC. Customs and Border Protection is responsible for border security functions. The Marketplace is also known as the Exchange, Health Insurance Marketplace, and Federally Facilitated Marketplace (FFM). Electronic Benefit Transfer (EBT) Site Coordinator An HHSC employee designated to ensure local offices comply with guidelines on security and accountability operations. To login again, click on either "Forgot user name" or "Forgot password" in the login box. Expedited Service Special, faster processing of SNAP applicants who qualify for an emergency food allotment, for active duty military members and their dependents applying for medical coverage and for pregnant women applicants who qualify for current or ongoing medical coverage. Trafficking Supplemental Nutrition Assistance Program (SNAP) . Essential Person The need for a particular member of a household to be in the home on a continuous basis because another member has a (certified) mental or physical impairment. Type Program (TP) 08, Parents and Caretaker Relatives Medicaid A person who supervises and cares for a dependent child. Seebatch processing,pending correspondence,print mode,print type,system-generatedanduser-generated. The Marketplace in Texas is operated by the U.S. Department of Health and Human Services. Practitioner A person who holds a license to practice medicine, including a physician (M.D. Electronic Benefit Transfer (EBT) Regional Coordinator An HHSC employee designated to oversee, monitor, lead regional planning and act as a point of contact for EBT security procedures. Personal Identification Number (PIN) Security Actions cardholders should take to prevent others from gaining access to their PIN and Electronic Benefit Transfer (EBT) account. Third-Party Resource A source of payment of medical expenses other than the recipient or the Texas Health and Human Services Commission (HHSC). These include a county holding facility for juveniles or a facility that a government unit exercises final administrative authority. Doctors and pharmacies use this number for billing. Explore health plans for you and your family, including short-term gap coverage and more. a supervised shelter that provides temporary living quarters; a place not intended for regular sleeping quarters; or. Unemployment Benefits Services allows individuals to submit new applications for unemployment benefits, submit payment requests, get claim and payment status information, change their benefit payment option, update their address or phone number, view IRS 1099-G information, and respond to work search log requests. This is also called a timely recertification or redetermination. This is done by intentionally reselling the product purchased with SNAP benefits in exchange for cash or consideration other than eligible food. Waiver Counties Texas counties with an unemployment rate over 10 percent. placing the patient's health in serious jeopardy; seriously impairing the patient's bodily functions; or. They are also subject to disciplinary action from the Texas Health and Human Services Commission (HHSC). Non-Traditional Retailer A food retailer who operates in a farmer's market or as a roadside vendor. The qualified hospital may choose to make PE determinations for pregnant women, children under 19, parents and caretaker relatives of dependent children under 19, and former foster care children. Temporary Assistance for Needy Families (TANF) A child who lives with either one or both parents, or a parent and step-parent, and one or both parents or step-parent do not receive TANF benefits. Employment Services Program (ESP) ESP consists of two programs. The intention is to get cash by purposely discarding the product and returning the container for the deposit amount. Tip Income Income earned along with wages paid by patrons to people employed in service-related occupations. One program is the Choices program for TANF recipients, and the other is the SNAP Employment and Training (E&T) program for SNAP recipients. Some people qualify for both Medicare and Medicaid. Batch is correspondence managed by batch processing and printed at a central mail facility. Benefit Issuance The functional area that supports the issuance and tracking of benefits calculated in the Eligibility Determination Benefit Calculation (EDBC) and authorized in disposition. A same-sex marriage that occurred on or after June 26, 2015, is considered valid on the date it occurred. Pick or change your PIN. The two levels of service are: Claim An amount owed by a person for an overpayment of benefits. Only a personal representative may authorize the use or disclosure of individually identifiable health information or obtain individually identifiable health information for a person. Overrides always require Second Level Review before they can be disposed. Ongoing Benefits Benefits issued for months after the initial benefit month. See Taxpayer. The Texas Workforce Commission (TWC) administers unemployment benefits, which provide temporary relief for eligible Texans who find themselves out of work or dealing with severely reduced work hours. Functions of the clearinghouse include: Collateral Contact A person the advisor can contact to verify a person's information. Agriculturally Related Activities Employment: Aid A benefit, coverage or service in programs that HHSC administers. Convertible bonds are countable resources. You can use it at stores that accept EBT. TWC has designated all counties in Texas as Choices counties, and the Local Workforce Development Boards (LWDBs), after coordination with the Texas Health and Human Services Commission (HHSC) state office, assign a service level designation for each county depending upon services available in that county. Other-Related Temporary Assistance for Needy Families/Medical Program (TANF/MP) Child An eligible child living with a relative other than the child's legal parent. For example, if you are receiving disability benefits through the Social Security Administration, then your Social Security number is the individual number used by the state of Texas. Institution of Higher Education Any public or private college, community college, junior college, technical institute, or university that usually requires a high school diploma or equivalent certificate such as a general equivalency diploma (GED), to enter. You do not need to be enrolled in VA benefits or health care to connect. Also formally known as (adult) probation. Note: A licensed vocational nurse or licensed practical nurse does not meet the definition of practitioner. Lock-in A status created by the Texas Health and Human Services Commission (HHSC) for certain people to help contain Medicaid costs, which allows additional review of high Medicaid users. A calendar tax year is 12 consecutive months beginning Jan. 1 and ending Dec. 31. According to the IRS, in 2015, "4.4 million ITIN filers paid over $5.5 billion in payroll and Medicare taxes and $23.6 billion in total taxes.". Qualified entities that are also Breast and Cervical Cancer Services (BCCS) contractors with the DSHS may make presumptive eligibility determinations for Medicaid for Breast and Cervical Cancer (MBCC) applicants. Immigration and Customs Enforcement handles immigration enforcement; and. Certified Group The members in an Eligibility Determination Group (EDG) who are eligible for a given program. They cannot be used to schedule appointments using the Scheduling functional area. Untimely SNAP application filed after the 15th of the last certification month. Battered Alien A battered spouse, battered child or parent, or child of a battered person with a pending petition with the U.S. They can also change any case data for cases where they are the head of household, an adult member within the household, or an authorized representative. Modified Adjusted Gross Income (MAGI) Household Size The number of people in an applicants or recipients MAGI household composition, including the number of unborn children, if applicable. Medicaid Members: Continuous Medicaid coverage will end on March 31, 2023. Escrow An escrow account is an account a mortgage company sets up for the homeowner as part of their monthly mortgage payment. Adverse Action Any HHSC action resulting in denial, suspension, reduction or termination of assistance. The number is used to record covered wages, track Social Security benefits and for other identification purposes. In-Kind Contribution Any gain or benefit to a person that is not in the form of money paid directly to the person such as clothing, public housing or food. To ensure the information is saved in an LUW in Data Collection, the user can click on the Next button to advance to the next LUW or on the Previous button to return to the previous LUW. The PAN is not related to the persons Texas Health and Human Services Commission (HHSC) case number. The data broker vendor collects and combines information from many data sources. Driver Flow The logical sequence of data collection pages that appear as a case is completed or read. Homeless Household Households that have no regular nighttime residence or that live in: Hotline (TANF/SNAP Complaints) Toll-free number (877-787-8999) where staff receive complaints for Temporary Assistance for Needy Families (TANF) and Supplemental Nutrition Assistance Program (SNAP) cases. The house parent assumes responsibility and acts in lieu of the parent in meeting the childrens ongoing needs. the prevention and treatment of substance abuse; Women, Infants, and Children (WIC) nutrition. Make payments to the surviving spouse, children, parents, grandchildren or grandparents when the affected person is deceased. Married Minor An person, age 14-17, who is married. Failure to report a required Texas Health and Human Services Commission (HHSC) program change in conjunction with one or more of these acts may be considered a basis to commit fraud. The money contributed to these accounts is not subject to federal income tax at the time of deposit. 1-877-541-7905. Nonconvertible Bond A bond that cannot be converted to cash per program policy. Canceled Debts Debts that have been canceled, forgiven, or discharged. These benefits are accessed by: card and personal identification numbers (PINs); or, Attempting to buy, sell, steal, or otherwise effect an exchange of SNAP benefits and using them for cash or something other than eligible food, either directly, indirectly, in complicity or collusion with others, or acting alone.

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