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Revision 20-4; Effective October 1, 2020
B-531 Medicaid Reinstatement for Children Certified for TP 44 Who Are Released from a Juvenile Facility
Revision 20-4; Effective October 1, 2020
TP 44
Upon receiving notification from the Texas Juvenile Justice Department (TJJD) or a Juvenile Probation Department (JPD) that a child whose Medicaid is suspended has been released and the child has months remaining on their original certification period:
- reinstate the child's eligibility effective the date of their release, and
- certify the child for any remaining months of the child’s original certification period.
Add the child back to any associated active TANF, SNAP, Medicaid, CHIP, or Medicaid for the Elderly and People with Disabilities (MEPD) EDGs if the child is a required member of the household.
The child's eligibility is reinstated even if the child is released to a household that is different than the one in which the child resided at the time of their placement.
If the child is not eligible for reinstatement but is released to a home in which a sibling is receiving Medicaid or CHIP, add the child to the sibling’s case.
| If the child is released to the same household and the case is… | Then… |
|---|---|
| Active or denied | The child's TP 44 eligibility is reinstated for the remainder of the child's original certification period on the same EDG. |
| If the child is released to a different household… | Then… |
|---|---|
| With an existing denied case | The child's TP 44 eligibility is reinstated for the remainder of the original certification period on a new EDG. |
| Without an existing case | The child's TP 44 eligibility is reinstated for the remainder of the child's original certification period on a new case. |
| For a child released to a different household, any changes to the child's circumstances should be addressed at the next scheduled renewal. A child released to a different household may not administratively renew. | |
| If the child is released as an independent child with… | Then… |
|---|---|
| An existing denied case | The child's TP 44 eligibility is reinstated for the remainder of the child's original certification period on a new EDG. |
| Without an existing case | The child's TP 44 eligibility is reinstated for the remainder of the child's original certification period on a new case. |
| For a child released as an independent child, any changes to the child's circumstances should be addressed at the next scheduled renewal. A child released to a different household may not administratively renew. | |
TIERS will automatically reinstate the child’s eligibility for the remainder of the certification period and add the child to any associated active EDGs upon notification from TJJD or a JPD. When an exception to the automated process occurs, CBS staff must manually process the reinstatement or add the child to an existing case following B-545, Notification of Actual Release.
Related Policy
Medicaid Suspension, B-520
Child Placed in a Secured Juvenile Facility, B-543
Child Placed in a Non-Secure Facility, B-544
Notification of Actual Release, B-545
B-532 Medicaid Reinstatement for Persons Released from Texas County Jails
Revision 20-4; Effective October 1, 2020
TA 82, TP 40, TP 44 and TP 70
When notified by any source that a person has been released from a Texas county jail, perform individual inquiry to determine if the person:
- has suspended or terminated health care coverage due to county jail confinement; and
- was included in the budget or certified group of any other EDGs at the time their health care coverage was suspended or terminated.
If inquiry shows that the person’s health care coverage was suspended at confinement, perform a County Jail Release - Search to determine if the person has an active suspension (months remaining on their original certification). If so, create a Process a County Jail Confinement/Release task for all active cases on which the person was included prior to suspension and enter the release information into TIERS on the County Jail Release - Details page.
When the health care coverage EDG is disposed:
- The person’s health care coverage is reinstated for the remaining months of the original certification period, effective the date the person is released from the county jail.
- The Individual - Medicaid History page is updated to indicate the person’s eligibility has been reinstated.
- A TF0001, Notice of Case Action, is generated notifying the person of reinstatement.
Reinstatement must occur within two business days of receiving the notification of the person’s release.
Consider the report of release as a change report for all other types of assistance and follow policy in B-641, Additions to the Household, to determine if the person needs to be added to the other types of assistance.
If inquiry shows that the person’s health care coverage was terminated at confinement or that the person’s original certification has ended and is not eligible for reinstatement, send an application to the person’s last known address.
Related Policy
Termination of Medical Coverage for People Confined in a Public Institution, B-510
Medicaid Suspension, B-520
Additions to the Household, B-641
General Policy, E-1010
Action on Changes, E-2220
General Policy, M-1010
Action on Changes, M-2220
B-533 Reasonable Opportunity After a Medicaid Suspension and Reinstatement
Revision 20-4; Effective October 1, 2020
TA 82, TP 40, TP 44 and TP 70
If a person’s reasonable opportunity period expires while their Medicaid is suspended, a new reasonable opportunity period is provided when their Medicaid coverage is reinstated. The new reasonable opportunity period is the earlier of the following:
- 95 days from the date the reinstatement is disposed; or
- the last day of their current certification period.
If the person’s Medicaid coverage is reinstated before the original reasonable opportunity period end date, their original reasonable opportunity due date is retained.
A TF0001, Notice of Case Action, is generated at reinstatement and will include the reasonable opportunity information to remind the person to submit documentation of citizenship or alien status.
Related Policy
Reasonable Opportunity, A-351.1