U.S. The caller must provide the head of households Social Security number (SSN) or the case number and date of birth of a household member to access information. Judicial Review A review of the fair hearing decision by a district court in Travis County to determine whether the agency decision is correct. Expenses of Reservists Federal income tax deductible expenses for National Guard and military reserve members who traveled more than 100 miles from home for service. Immigrant An alien who abandons residence in a foreign country to live in the U.S. as a permanent resident, for example a lawful permanent resident (LPR). Texas Health & Human Services Commission. These include Form H1010, Texas Works Application for Assistance Your Texas Benefits, or Form H1205, Texas Streamlined Application. Falsified DocumentForm H1010, Texas Works Application for Assistance Your Texas Benefits;Form H1019, Report of Change; or another signed and dated document that does not report all current income or circumstances. Managed Care A health care delivery system with the aim of controlling costs. Managing Conservator A person designated by a court to have daily legal responsibility for a child. During this step, information from electronic data sources is automatically requested, reasonable compatibility is run when income verification is required and correspondence is sent to the recipient. Temporary Assistance for Needy Families (TANF) An adult whose needs are included in a TANF grant because the adult is within the required degree of relationship and is financially eligible according to TANF policy. 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. Unauthorized access to this site and misuse of its information assets may be prosecuted under Texas State statutes regarding the use of individually identifiable personal health information (PHI) and The United States regulations and laws regarding the use of individually identifiable personal health information (PHI). It is a medical condition (including emergency labor and delivery) manifesting itself by acute symptoms of sufficient severity (including severe pain) that the absence of immediate medical attention could reasonably have been expected to result in: Employable Household Member A person whose earnings are countable and who: Employer-Paid Taxes Taxes that are paid by the employer on behalf of the employee rather than deducting the tax amount from the employee's wages. A child who will not graduate until after the month of their 19th birthday is not considered a dependent child after the month of their 18th birthday. Communal Dining A public or non-profit establishment approved by Food and Nutrition Services (FNS) that prepares and serves meals to elderly people or those who receive Supplemental Security Income (SSI) and their spouses. Domicile A home maintained or being established, as shown by continuation of responsibility for day-to-day care of the child, by the relative who the child lives. Type of Assistance (TOA) The specific aid for one or more people in an Eligibility Determination Group (EDG). Correspondence The functional area in which system and user-generated notices and forms are processed and stored. 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. 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. Non-Employment and Training (E&T) Counties Those Texas counties where the Texas Workforce Commission (TWC) determines it does not have enough offices to assist people who are mandatory work registrants. Override A Texas Integrated Eligibility Redesign System (TIERS) procedure that allows the user to make a change to the system-determined Eligibility Determination Group (EDG) results. Periodic Income Check (PIC) The process to determine whether electronic data indicates that there has been a change in the Modified Adjusted Gross Income (MAGI) household income that could make the recipient ineligible for certain Medical Programs. Colonias Unincorporated and unregulated settlements (neighborhoods) along the U.S. and Mexico border. are intended for expenses other than room and board. Based on the criteria, TIERS generates a sample list. Only a personal representative may authorize the use or disclosure of individually identifiable health information or obtain individually identifiable health information for a person. Data Broker An online portal used to obtain financial and other background information about applicants and recipients. It must take place before the person receives a seventh warrant. Print Mode Indicates where historical correspondence was printed. Overrides always require Second Level Review before they can be disposed. This is a toll-free number (2-1-1 or 877-541-7905) that allows people to inquire on the status of their case, their next appointment time, or to determine if Texas Health and Human Services Commission (HHSC) received information. Disqualified Person Someone who is normally considered a participating member of a household but whose needs are not considered because they failed to meet or comply with a program requirement. The system generates an alert when the SSA Benefit amount on file does not match the information on the BENDEX file. Electronic Benefit Transfer (EBT) System A system HHSC staff with security access use to issue and replace Lone Star Cards. Presumptive Eligibility (PE) Short-term Medicaid coverage provided to people determined potentially eligible for regular Medicaid by a qualified hospital or a qualified entity. Payments: Indian Tribal Household A household in which at least one household member is recognized as a tribal member by any Indian tribe. This coverage is providedtemporarily while the Texas Health and Human Services Commission (HHSC) determines eligibility for regular Medicaid. Four Months Post-Medical Medicaid coverage extended for a maximum of four months after denial of a case because of spousal support income. Third-Party Resource A source of payment of medical expenses other than the recipient or the Texas Health and Human Services Commission (HHSC). This category also includes Amerasians admitted under Section 584 of the Foreign Operations, Export Financing and Related Programs Appropriation Act of 1988. 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. These plans are offered through the Health Insurance Marketplace, or the Exchange, where individuals can research, compare, and purchase health plans. Boarder A person paying reasonable compensation for room and meals. a supervised shelter that provides temporary living quarters; a place not intended for regular sleeping quarters; or. Treat an untimely reapplication the same as an initial application. Special Review A procedure to explore one or more areas of eligibility. Penalty on Early WithdrawalA federal income tax deduction for people who withdrew money from a time-deposit savings account before the certificate maturing and who were charged a penalty for early withdrawal. Mastectomy surgery is a significant life event for many people. Authorized Representative (AR) A person or organization designated by an applicant or recipient to take the following actions on the applicants behalf: Automated Income Check Process The first step in a periodic income check (PIC). The account transfer from the Marketplace to HHSC, and from HHSC to the Marketplace, includes the information the applicant submitted through the original application in addition to information from verifications performed by either the Marketplace or HHSC. These databases contain information for individuals who are currently on assistance and for individuals who have applied for or received assistance in the past. These are benefits issued and accessed by EBT cards, card numbers and PINs, or by manual voucher and signature. Administrative Renewal The method used to redetermine eligibility for most Medical Programs, including Medicaid for the Elderly and People with Disabilities (MEPD) and the Childrens Health Insurance Program (CHIP). Newborn Child A child receiving Type Program (TP) 45, Medical Assistance for Newborn Children, because the child's mother was eligible for and received Medicaid coverage at time of the child's birth or whose mother was eligible for and received Medicaid coverage retroactively for the time of the child's birth. Temporary Assistance for Needy Families Non-Cash (TANF-NC) Consists of services for: Temporary Assistance for Needy Families (TANF) Redirect A Texas Works message to TANF applicants delivered up front by Texas Health and Human Services Commission (HHSC) staff before the application process begins, explaining that: Temporary Assistance for Needy Families State Program (TANF-SP) Cash assistance for families with a dependent child and at least two adults. Participation Status The designation of an Eligibility Determination Group (EDG) member as an eligible or ineligible member of the certified group. Streamlined Reporting (SR) Households where all adults are exempt from the 18-50 work requirements due to: Note: These households receive a six-month certification period. Radiation Exposure Payments A program to compensate a person for injury or death from exposure to radiation from nuclear testing and uranium mining. Electronic Benefit Transfer (EBT) Vendor A company that performs EBT-related services for the state of Texas. Dispose To authorize an Eligibility Determination Group (EDG) so eligibility is established or denied. The Medicaid phone number is 800-252-8263, 2-1-1, or 1-877-541-2190; you can speak with a representative who will assist you in obtaining the answers and services you require. Quality Control The functional area that supports the state's approach to quality control and allows authorized staff to enter sample selection criteria. Each state has its own rules about who's eligible, and what Medicaid covers. 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. Children's Health Insurance Program (CHIP) Medical coverage for children under 19 whose family income exceeds the limits for Children's Medicaid. Parolee A person paroled into the U.S. under section 212(d)(5) of the INA for at least one year. Also covers medicines ordered by doctors and dentists. SeeCase Mode. The automated process uses existing applicant information, electronic data source information and reasonable compatibility when income verification is required. Permissible purpose means the person whose credit report is requested must be: Staff who request credit information without permissible purpose are subject to fines, imprisonment, or both. Changes in income identified through this process may impact eligibility for other programs. Sibling Brother or sister, including legally adopted and half-brothers and half-sisters. The person's must have no vested interest in the household's situation. The last number in your TANF Eligibility Determination Group number tells what day you get your benefits. The participation status indicates whether the person is considered an adult or a child according to policy. If you are just looking for support services and want to be contacted by programs, you need to create an account. The Food and Nutrition Act of 2008 limits eligibility for SNAP benefits to U.S. citizens and certain lawfully present non-citizens. First Cousin Once Removed A person who is either one's first cousin's child or the parent's first cousin. 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. HHSC IEVS Staff HHSC eligibility field staff who process Automated System for Office of Inspector General (ASOIG) Match Texas Works Messages and MEPD Long Term Care (LTC) IEVS Matches. hold out to the public that they are a married couple. Personal Responsibility Agreement (PRA) A requirement for Temporary Assistance for Needy Families (TANF) that certain people must follow the conditions of the agreement. Independent Child A child who does not live with a parent and who is: Independent Living Payments Payments from Title IV-E funds that are distributed by Child Protective Services to certain people when they leave foster care. Authorized staff can correct months in this functional area. ITIN holders are not eligible for all of the tax benefits and public benefits that U.S. citizens and other taxpayers can receive. collects information from throughout the Texas Integrated Eligibility Redesign System (TIERS); and. Preschool Children Children who are under six. Taxable Year The 12-month period that a person uses to report income for federal income tax purposes. processeligibility determinations for multiple programs based on data provided through direct input and interfaces with other systems; assistusers in monitoring and managing workload; and. Apply online and make a Your Texas Benefitsaccount so you can start, save and go backto your online application at any time. It is also referred to as spousal support. State and federal government websites often end in .gov. Interfaces The functional area that exchanges information with other systems and agencies. Annulment A court order declaring a marriage invalid. For Type Program (TP) 08, Parents and Caretaker Relatives Medicaid A relative within the required degree of relationship, other than a legal parent, caring for a dependent child who meets the income limits for that program. One program is the Choices program for TANF recipients, and the other is the SNAP Employment and Training (E&T) program for SNAP recipients. EDGs denied because of new or increased spousal support income will receive a maximum of four months of coverage. Sufficient Employment Job earnings, other than seasonal work such as migrant or seasonal farm work, that would result in Temporary Assistance for Needy Families (TANF) ineligibility without including the 90 percent earned income disregard . Case Mode Status of a case that identifies that: Case Number A unique 10-digit number that identifies a group of Eligibility Determination Groups (EDGs).
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