Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 358 - MEDICAID ELIGIBILITY FOR THE ELDERLY AND PEOPLE WITH DISABILITIES
Subchapter C - FINANCIAL REQUIREMENTS
Division 3 - INCOME
Section 358.386 - Reduction of Pension and Benefit Checks for Recoupment of Overpayments
Universal Citation: 1 TX Admin Code ยง 358.386
Current through Reg. 49, No. 38; September 20, 2024
If a person's pension or benefit checks are reduced because of recovery of overpayments, the following apply:
(1) All overpayments except Retirement, Survivors, and Disability Insurance (RSDI).
(A) If a person was receiving Supplemental
Security Income (SSI) or assistance under a Medicaid-funded program for the
elderly and people with disabilities (MEPD) at the time of overpayment, the
Texas Health and Human Services Commission (HHSC) disregards as income the
amount being recovered. HHSC counts the net amount of the benefit (that is, the
gross benefit minus the amount being recouped) for the purpose of determining
eligibility and calculating a co-payment.
(B) If a person was not receiving SSI or
assistance under MEPD at the time of overpayment, HHSC counts the recovered
amount as income. HHSC counts the gross amount of the benefit for the purpose
of determining eligibility and calculating a co-payment.
(2) RSDI overpayments.
(A) If a person receives an overpayment of
Social Security (RSDI or Title II) benefits, recoupment is not voluntary. HHSC
counts the net amount of the RSDI benefit (that is, the gross RSDI minus the
amount being recouped) for the purpose of determining eligibility and
calculating a co-payment.
(B) If a
person receives an overpayment of SSI benefits and the person is still eligible
for SSI, the recoupment is voluntary. HHSC determines if the person signed a
voluntary agreement for recoupment. If there is a signed agreement, HHSC counts
the gross RSDI for the purpose of determining eligibility and calculating a
co-payment. If there is no signed agreement, there should be no recoupment from
RSDI benefits.
(C) If a person
receives an overpayment of SSI benefits and the person is no longer eligible
for SSI, recoupment of any RSDI or Title II benefits is not voluntary. HHSC
counts the net amount of the RSDI benefit (that is, the gross RSDI minus the
amount being recouped) for the purpose of determining eligibility and
calculating a co-payment.
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