Revision 15-4; Effective October 1, 2015

All Programs

Individuals have a right to correct any information that HHSC has about the individual and any other individual on the individual's case.

Advisors follow policies in A-2300, Case Disposition; B-100, Processes and Processing Time Frames; and B-600, Changes, for the time frames and procedures to correct or update information when processing:

• applications,
• redeterminations, and
• other actions on active cases.

 

B—651 Correction Request

Revision 15-4; Effective October 1, 2015

All Programs

A request for correction must be in writing and:

• identify the individual asking for the correction;
• identify the disputed information about the individual;
• state why the information is wrong;
• include any proof that shows the information is wrong;
• state what correction is requested; and
• include a return address, telephone number, or email address at which HHSC can contact the individual.

During application, redetermination, and other actions on active EDGs, individuals are not required to request correction of incorrect information in writing. (Refer to B-116, Information Reported During Application Processing; B-124, Processing Untimely Redeterminations; and B-623, How to Report.)

 

 

B—652 Action on Denied EDGs or During the Last Month of Certification and the Client Has Not Reapplied

Revision 15-4; Effective October 1, 2015

All Programs

Advisors must respond according to the following chart:

When an individual requests that the agency correct their information ...	then ...
at application, redetermination, or anytime when an EDG is active,	follow policies in A-2300, Case Disposition; B-100, Processes and Processing Time Frames; and B-600, Changes.
on a denied EDG or during the last month of certification, and the individual has not reapplied,	review the request, contact third parties if necessary, and send the correct information for imaging.

The advisor notifies the individual in writing within 60 days (using current HHSC letterhead without the board members' names) that the information is corrected or will not be corrected and the reason. The advisor informs the individual if HHSC needs to extend the 60-day period by an additional 30 days to complete the correction process or obtain additional information.

If HHSC makes a correction to individually identifiable health information, the advisor must ask the individual for permission before sharing with third parties. HHSC will make a reasonable effort to share the correct information with persons who received the incorrect information from HHSC if they may have relied or could rely on it to the disadvantage of the individual. Advisors follow regional procedures to contact the HHSC privacy officer for a record of disclosures.

Note: Advisors follow procedures to establish a claim or restore benefits if an overissuance or underissuance occurred. Advisors make a referral to the Office of Inspector General for intentional program violation occurrences.

 

 

B—653 Different Review Process

Revision 15-4; Effective October 1, 2015

All Programs

Advisors must not follow procedures in B-600, Changes, when the accuracy of information provided by an individual is determined by another review process such as a:

• fair hearing,
• civil rights hearing, or
• other appeal process.

The decision in that review process is the decision on the request to correct information.