Tex. Human Resources Code Section 32.04242
Payor of Last Resort


The executive commissioner shall adopt rules to ensure, to the extent allowed by federal law, that the Medicaid program:

(1)

is the payor of last resort; and

(2)

provides reimbursement for services, including long-term care services, only if, and to the extent, other adequate public or private sources of payment are not available.
Added by Acts 2011, 82nd Leg., R.S., Ch. 821 (H.B. 2722), Sec. 1, eff. June 17, 2011.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.119, eff. April 2, 2015.

Source: Section 32.04242 — Payor of Last Resort, https://statutes.­capitol.­texas.­gov/Docs/HR/htm/HR.­32.­htm#32.­04242 (accessed Mar. 23, 2024).

32.001
Purpose of Chapter
32.002
Construction of Chapter
32.003
Definitions
32.021
Administration of the Program
32.022
Medical and Hospital Care Advisory Committees
32.023
Cooperation with Other State Agencies
32.024
Authority and Scope of Program
32.025
Application for Medical Assistance
32.026
Certification of Eligibility and Need for Medical Assistance
32.027
Selection of Provider of Medical Assistance
32.028
Fees, Charges, and Rates
32.029
Methods of Payment
32.031
Receipt and Expenditure of Funds
32.032
Prevention and Detection of Fraud and Abuse
32.033
Subrogation
32.034
Contract Cancellation
32.035
Appeals
32.036
Program Payments Nonassignable and Exempt from Legal Process
32.038
Collection of Insurance Payments
32.039
Damages and Penalties
32.040
Identification of Husband or Alleged Father
32.043
Procurement Rules for Public Disproportionate Share Hospitals
32.044
Group Purchasing for Disproportionate Share Hospitals
32.045
Enhanced Reimbursement
32.046
Sanctions and Penalties Related to the Provision of Pharmacy Products
32.047
Prohibition of Certain Health Care Service Providers
32.048
Managed Care Information and Training Plan
32.049
Managed Care Contract Compliance
32.050
Dual Medicaid and Medicare Coverage
32.051
Misdirected Billing
32.052
Waiver Programs for Children with Disabilities or Special Health Care Needs
32.054
Dental Services
32.055
Catastrophic Case Management
32.056
Compliance with Texas Health Steps Comprehensive Care Program
32.057
Contracts for Disease Management Programs
32.058
Limitation on Medical Assistance in Certain Alternative Community-based Care Settings
32.059
Use of Respiratory Therapists for Respiratory Therapy Services
32.061
Community Attendant Services Program
32.062
Admissibility of Certain Evidence Relating to Nursing Institutions
32.063
Third-party Billing Vendors
32.064
Cost Sharing
32.067
Delivery of Comprehensive Care Services to Certain Recipients of Medical Assistance
32.068
In-person Evaluation Required for Certain Services
32.069
Chronic Kidney Disease Management Initiative
32.070
Audits of Providers
32.071
Recipient and Provider Education
32.072
Direct Access to Eye Health Care Services
32.073
Health Information Technology Standards
32.074
Access to Personal Emergency Response System
32.075
Employment Assistance and Supported Employment
32.076
Substitute Dentists
32.101
Definitions
32.102
Database of Medical Assistance Program Providers
32.103
Certain Fees Prohibited
32.104
Authority to Contract
32.105
Rules
32.201
Definitions
32.202
Electronic Communications
32.0211
Restrictions on Executive Commissioners, Former Members of a Board, Commissioners, and Their Business Partners
32.0212
Delivery of Medical Assistance
32.0213
Nursing Facility Bed Certification and Decertification
32.0214
Designations of Primary Care Provider by Certain Recipients
32.0215
Home or Community Care Providers: Civil Monetary Penalties
32.0231
Announcement of Funding or Program Change
32.0241
Review of Waiver Request
32.0242
Verification of Certain Information
32.0243
Periodic Review of Eligibility for Certain Recipients
32.0244
Nursing Facility Beds in Certain Counties
32.0245
Nursing Facility Beds for Certain Facilities Treating Alzheimer’s Disease
32.0246
Medical Assistance Reimbursement for Certain Behavioral Health and Physical Health Services
32.0247
Medical Assistance for Certain Persons Making Transition from Foster Care to Independent Living
32.0249
Mental Health Screenings in Texas Health Steps Program
32.0251
Eligibility Notification and Review for Certain Children
32.251
Definitions
32.252
Partnership for Long-term Care Program
32.253
Asset Disregard
32.254
Reciprocal Agreements
32.0255
Transitional Medical Assistance
32.255
Training
32.0256
Continuation of Medical Assistance for Certain Individuals
32.256
Rules
32.0261
Continuous Eligibility
32.0262
Eligibility Transition
32.0263
Health Care Orientation
32.0264
Suspension and Reinstatement of Eligibility for Children in Juvenile Facilities
32.0265
Notice of Certain Placements in Juvenile Facilities
32.0266
Suspension, Termination, and Automatic Reinstatement of Eligibility for Individuals Confined in County Jails
32.0275
Military Medical Treatment Facilities and Affiliated Health Care Providers
32.0281
Rules and Notice Relating to Payment Rates
32.0282
Public Hearing on Rates
32.0284
Calculation of Payments Under Certain Supplemental Hospital Payment Programs
32.0285
Calculation of Medical Education Add-on for Reimbursement of Teaching Hospitals that Provide Behavioral Health and Physical Health Services
32.0287
Prescribed Pediatric Extended Care Center Reimbursement
32.0291
Prepayment Reviews and Payment Holds
32.0311
Drug Reimbursement Under Certain Programs
32.0312
Reimbursement for Services Associated with Preventable Adverse Events
32.0314
Reimbursement for Durable Medical Equipment and Supplies
32.0315
Funds for Graduate Medical Education
32.0316
Electronic Transactions
32.0317
Reimbursement for Services Provided Under School Health and Related Services Program
32.0321
Surety Bond
32.0322
Criminal History Record Information
32.0381
Icf-iid Payment Rates
32.0391
Criminal Offense
32.0421
Administrative Penalty for Failure to Provide Information
32.0422
Health Insurance Premium Payment Reimbursement Program for Medical Assistance Recipients
32.0423
Recovery of Reimbursements from Health Coverage Providers
32.0424
Requirements of Third-party Health Insurers
32.0425
Reimbursement for Wheeled Mobility Systems
32.0461
Vendor Drug Program
32.0462
Vendor Drug Program
32.0463
Medications and Medical Supplies
32.0531
Pace Program Team
32.0532
Pace Program Reimbursement Methodology
32.0551
Optimization of Case Management Systems
32.0561
Maternal Depression Screening
32.0641
Recipient Accountability Provisions
32.0705
External Audits of Certain Medicaid Contractors Based on Risk
32.0755
Prevocational Services Under Certain Waiver Programs
32.02451
Additional Personal Needs Allowance for Guardianship Expenses of Certain Recipients
32.02471
Medical Assistance for Certain Former Foster Care Adolescents Enrolled in Higher Education
32.02611
Exclusion of Assets in Prepaid Tuition Programs and Higher Education Savings Plans
32.02613
Life Insurance Assets
32.03115
Reimbursement for Medication-assisted Treatment for Opioid or Substance Use Disorder
32.03117
Reimbursement for Non-opioid Treatments
32.03141
Authority of Advanced Practice Registered Nurses and Physician Assistants Regarding Durable Medical Equipment and Supplies
32.04242
Payor of Last Resort
32.024715
Streamlined Eligibility Determination Process for Certain Former Foster Care Youth
32.026101
Determination of Eligibility by Health Care Exchanges Prohibited

Accessed:
Mar. 23, 2024

§ 32.04242’s source at texas​.gov