Overpayment The amount of benefits issued in excess of what should have been issued. Effective Month The first month benefits can be affected based on the monthly cutoff date or applicable policy for advance and adequate notice of adverse action. 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. The person's must have no vested interest in the household's situation. Identical Application One or more exact copies of an application previously submitted by an applicant. See Alternate Payee. Intentionally purchasing products originally purchased with SNAP benefits in exchange for cash or consideration other than eligible food. If you are just looking for support services and want to be contacted by programs, you need to create an account. This is done by intentionally reselling the product purchased with SNAP benefits in exchange for cash or consideration other than eligible food. Non-Traditional Retailer A food retailer who operates in a farmer's market or as a roadside vendor. Copyright 2016-2023. The certificate is a requirement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and is sent to denied recipients by the Texas Department of State Health Services (DSHS). Seecase modeandinterview mode. These items include housing, utilities, deposits for housing or utilities, food, clothing, and incidentals. Second Parent This is the parent who is not the caretaker. temporary quarters in another person's residence for 90 days or less. Permissible Purpose A federal requirement that allows staff to legally request a credit report from the Data Broker system for the sole purpose of determining eligibility. Case All the persons living together, and alien sponsors, who are related by Eligibility Determination Group (EDG) affiliation. A request for an administrative review must be submitted in writing within 30 calendar days from the date of the hearing officer's decision. Citizenship and Immigration Services [USCIS] Form I-864 or I-864-A) on or after Dec. 19, 1997, agreeing to support an alien as a condition of the alien's entry into the U.S. To find out if you might be eligible for Medicaid in Texas, visit yourtexasbenefits.com Payments to Civilians Relocated During Wartime Payments made to Aleuts or people of Japanese ancestry or their heirs who were relocated during World War II. This includes, mineral rights, patents or copyrights. Grandparent Payment System (GPS) An electronic, web-based data system used to inquire about the issuance of archived TANF one-time Grandparent Payments. See Alternate Payee. They are also subject to disciplinary action from the Texas Health and Human Services Commission (HHSC). is the guardian of a victim of a violent crime. Emergency Medicaid All types of emergency Medicaid coverage programs for people who are nonimmigrants, undocumented aliens or certain legal permanent resident aliens who have emergency medical conditions and who, except for alien status, would be Medicaid-eligible. Temporary Assistance for Needy Families (TANF) proration is based on the number of days between the begin date of eligibility and the end of the first month of eligibility. File Clearance compares the individual's demographic information against databases for potential matches. hold out to the public that they are a married couple. Type of Assistance (TOA) The specific aid for one or more people in an Eligibility Determination Group (EDG). The Veterans Crisis Line has a new number: Dial 988 then Press 1. 24/7, confidential support is always available. Alternate Payee A person who receives the benefits for the EDG when people on the EDG are unable or ineligible to receive them. BENDEX (Beneficiary and Earnings Data Exchange) A computer tape match from the Social Security Administration that provides Social Security and Medicare information about Texas Health and Human Services Commission (HHSC) recipients. General Equivalency Diploma (GED) A high school equivalency certificate issued after a person completes a State Board of Education-approved high school equivalency program. The notices and forms processed in this functional area are also called correspondence and linked to a specific case. SeeDetail Page. They will become lawful permanent residents (LPRs) upon the removal of their conditions by the Department of Homeland Security (DHS). Reinstatement Process of providing Transitional Medical Assistance (TMA) to a household denied because of failure to return a complete Medicaid Report. Retroactive Benefits Initial benefits issued for a month before the application is certified. Capital Goods The accumulated possessions (property, goods and products) used to produce income or other goods. The amount the employer pays is counted as part of the person's gross income. This information is used in the EDBC process to build Eligibility Determination Groups (EDGs) and determine eligibility for programs and types of assistance. Temporary Assistance for Needy Families (TANF) A child who lives with either one or both parents, or a parent and step-parent, and one or both parents or step-parent do not receive TANF benefits. To start a new session, you must close the browser window. All system-generated correspondence is scheduled for batch printing although it can be retrieved from Pending Correspondence and printed locally. Parent A person with either a natural, biological, adopted or stepchild. notifying the applicant and the eligibility system when spend down is met. Electronic Benefit Transfer (EBT) System A system HHSC staff with security access use to issue and replace Lone Star Cards. When an individual is added, File Clearance can be processed in Application Registration. Failure to report a required Texas Health and Human Services Commission (HHSC) program change in conjunction with one or more of these acts may be considered a basis to commit fraud. That means bringing some manufacturing back home, or "reshoring" and moving some of it . Participation Status The designation of an Eligibility Determination Group (EDG) member as an eligible or ineligible member of the certified group. The notice contains programmed information based on the program, type of assistance, and eligibility result. Be ready to answer questions abouteveryone applying such as: Check the status of your benefits ormanage your benefits. Standard of Need Basic needs of Temporary Assistance for Needy Families (TANF) families represented by a figure predetermined by the state of Texas per the number of certified people in the group. To learn more about Texas Works, please visit Texas Workforce Commission website. a supervised shelter that provides temporary living quarters; a place not intended for regular sleeping quarters; or. Residents of a publicly operated community residence are potentially eligible for Temporary Assistance for Needy Families (TANF) and Medicaid. See Alternate Payee. Standard Utility Allowance (SUA) A standard deduction for the cost of utilities. The goal of ESP is to prepare recipients for employment and help them find and keep a job. The mortgage company uses money in the account to pay annual property taxes, home insurance premiums and sometimes homeowner association fees on behalf of the homeowner. Make payments to the surviving spouse, children, parents, grandchildren or grandparents when the affected person is deceased. Click here to re-activate your account. Feb 17, 2022 Knowledge Article The Food and Nutrition Service (FNS) number is the 7-digit number printed on the Supplemental Nutrition Assistance Program (SNAP) permit sent to you when you became authorized to participate in SNAP. Individual Number A unique nine-digit number that identifies any person known to the Texas Integrated Eligibility Redesign System (TIERS). In this system, patients go to their primary care physician to obtain other health services such as specialty medical care, surgery or physical therapy. Eligibility staff access BVS as a source to verify age, relationship and citizenship. These plans are offered through the Health Insurance Marketplace, or the Exchange, where individuals can research, compare, and purchase health plans. ITIN holders pay taxes. Interview Mode A designation in TIERS Data Collection that queues the driver flow through appropriate pages according to the type of action. These households may bypass the income and resources tests and are deemed financially eligible. The employer does not match the money contributed by the employee until the defined period of time ends. Lawful Permanent Resident (LPR) A person lawfully admitted for legal permanent residence in the U.S. 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. EDGs denied because of new or increased earnings will receive a maximum of 12 months of coverage. The notice of adverse action expires in 13 days. Reactivation Date The effective date to reinstate benefits for an Eligibility Determination Group (EDG). Standby List Applicants who are awaiting an interview without a specific appointment. There are three types of benefit accounts: The person or their representative uses the Lone Star Card and a personal identification number (PIN) to access benefits in the account. Supplemental Nutrition Assistance Program (SNAP) applicants and people in these counties are still subject to E&T work registration requirements with TWC, but are exempt from E&T participation and are not subject to SNAP federal time limits. Health Insurance Premium Payment (HIPP) A reimbursement program administered by the Texas Health and Human Services Commissions (HHSCs) Third-Party Resource Unit, which pays for the cost of premiums, coinsurance, and deductibles. Priority Supplemental Nutrition Assistance Program (SNAP) Issuances Expedited SNAP benefits, benefits issued on or after the 25th day from the date of application, and issuances ordered by a hearing officer decision that must be made available in order to meet fair hearing timeliness requirements. intended to result in physical harm, bodily injury or assault, or that is a threat that reasonably places the member in fear of imminent physical harm or bodily injury or assault, not including defensive measures to protect oneself; or. Medicaid is also known as the medical assistance program. Clearinghouse A centrally located site that processes medical bills submitted by applicants for Medically Needy with Spend Down. Certified Group The members in an Eligibility Determination Group (EDG) who are eligible for a given program. SeeCarryover Standby List. The user reaches the end of the driver flow at the Case Assignment page and must use the Left Navigation to return to specific pages in Data Collection. Illegally Present Alien A non-citizen living in the U.S. without proper approval from the U.S. Child support may be: Child Support Disregard The first $75 of the total child support collected in a month that is subtracted before determining TANF eligibility or benefits. Customs and Border Protection is responsible for border security functions. IDAs are generally matched dollar-for-dollar with funds from private citizens, corporations, banks, communities, or charitable organizations. SeeCase. produces reports that meet Texas Health and Human Services Commission (HHSC), state and federal reporting requirements. For more information, including who is eligible, click HERE. Carryover Standby List Applicants from a previous day's standby list who have not been interviewed. These benefits are accessed by: card and personal identification numbers (PINs); or, Attempting to buy, sell, steal, or otherwise effect an exchange of SNAP benefits and using them for cash or something other than eligible food, either directly, indirectly, in complicity or collusion with others, or acting alone. HHSC expunges these benefits at the end of each state fiscal year (Aug. 31). Logical Unit of Work (LUW) A set of Texas Integrated Eligibility Redesign System (TIERS) pages that must be completed before the information entered on these pages is saved. Able Bodied Adult Without Dependents (ABAWD) A person, 18 through 50 who: The ABAWD age criteria begins the month after the person turns 18 and ends the month the person turns 50. This calculation is based on family size and is used in the Temporary Assistance for Needy Families (TANF) 100 percent budgetary needs gross income test. Waiver of Continued Benefits An individual option to allow eligibility staff to process an adverse action during the individual's appeal process. Coordination of benefits (COB) allows plans that provide health and/or prescription coverage for a person with Medicare to determine their respective payment responsibilities (i.e., determine which insurance plan has the primary payment responsibility and the extent to which the other plans will contribute when an individual is covered by more Even if designed to serve up to 16 residents, the following facilities are not considered publicly operated community residences: Qualified Entity (QE) A Medicaid provider (in most instances but can also be an organization such as a school or clinic) that notifies HHSC of its election to make presumptive eligibility determinations and agrees to make presumptive eligibility determinations for pregnant women only, per HHSC policies and procedures. With this type of access, a person can view and change an application created under their username. To be eligible for Texas Medicaid, you must be a resident of the state of Texas, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income. An example of a publicly operated community residence that is not a public institution is a county homeless shelter with a capacity of up to 16 people. Supplemental Nutrition Assistance Program (SNAP) Past name was the Food Stamp Program. allthe EDGs in a case are denied (Ongoing). Disaster SNAP (D-SNAP) gives short-term food benefits to people recovering from a disaster. Non-Public Assistance (NPA) Household Supplemental Nutrition Assistance Program (SNAP) households where no one receives Temporary Assistance for Needy Families (TANF) or only some of the members receive TANF. SeePrint Mode. It compares an applicants statement of income against income provided by electronic data sources. createcorrespondence and reports based on system-requested and user-requested criteria. Expunged Benefits Benefits that are removed from an EBT account by the issuer of the benefits. perform initial self-screening to check for potential eligibility; view general benefit program information. Battered Alien A battered spouse, battered child or parent, or child of a battered person with a pending petition with the U.S. Common Law Marriage Relationship in which the two parties both 18 years or older: A minor child in Texas cannot legally enter a common law marriage unless the claim of common law marriage began before Sept. 1, 1997. This category also includes Amerasians admitted under Section 584 of the Foreign Operations, Export Financing and Related Programs Appropriation Act of 1988. Children's Health Insurance Program (CHIP) Medical coverage for children under 19 whose family income exceeds the limits for Children's Medicaid. Report Date The date information is reported to the Texas Health and Human Services Commission (HHSC). Conception occurs, but no fetus ever develops. Card Sleeve A durable paper envelope folded to the dimensions of the plastic EBT card. 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. Workforce Innovation and Opportunity Act A federal program to streamline state workforce development systems combining job training, adult education and literacy, and vocational rehabilitation. Reasonable Opportunity The 95-day period following the date a notice is sent to a person. reactivating an EDG without requiring a new application form. Your session has ended. This may or may not include the person or the persons spouse. Print Type Classification of historical correspondence as the original record or a reprint of the original. receives Supplemental Nutrition Assistance Program (SNAP) benefits; is physically and mentally able to work at least an average of 20 hours per week; is not a member of a SNAP Eligibility Determination Group (EDG) where a household member on the SNAP EDG is under 18; and is not pregnant. It gives Supplemental Security Income (SSI) and Medicaid information on Texas Health and Human Services Commission (HHSC) people. Deductible Part of Self-Employment Tax A federal income tax deduction for self-employed people paying self-employment taxes. Homeless Household Households that have no regular nighttime residence or that live in: Hotline (TANF/SNAP Complaints) Toll-free number (877-787-8999) where staff receive complaints for Temporary Assistance for Needy Families (TANF) and Supplemental Nutrition Assistance Program (SNAP) cases. HHSC The Texas Health and Human Services Commission. SeeCascade Logic,Rebuild EDG, andRun EDBC. Children's Medicaid Medical coverage for children whose family income is under the applicable income limit. placing the patient's health in serious jeopardy; seriously impairing the patient's bodily functions; or. Wrap Up The Texas Integrated Eligibility Redesign System (TIERS) program page in Data Collection where Eligibility Determination Groups (EDGs) are built and the Eligibility Determination Benefit Calculation (EDBC) is run to determine the highest level of eligibility or ineligibility. Qualified expenses include purchased books, supplies, equipment and other classroom materials. 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. Medical Support Health insurance that absent parents will be ordered to obtain for their children who receive Medicaid when it is available at reasonable cost. You need 4 numbers for your PIN. The Marketplace in Texas is operated by the U.S. Department of Health and Human Services. Payments: Indian Tribal Household A household in which at least one household member is recognized as a tribal member by any Indian tribe. Individual Retirement Account (IRA) An account in which a person contributes an amount of money to supplement retirement income, regardless of their participation in a group retirement plan. Deprivation Loss of parental support caused by death, incapacity, continued absence of one or both natural or adoptive parents, or because of unemployment or underemployment of both parents in a two-parent family. You'll get an email or text when there'sa form or notice available online in yourMessage Center. Texas's EBT customer service number is 1-800-777-7328. SeeEDBC. Point-of-Sale (POS) Transaction An electronic transaction using an Electronic Benefit Transfer (EBT) card to make a purchase, a cash withdrawal, or inquiry. Temporary Assistance for Needy Families (TANF) Certified Child A child who is included in a TANF grant. Vendor Payment Payment made directly to the individual's creditor or person providing the service by a person or organization outside the household. eligible for Medicaid because a responsible person who is not within the degree of relationship required for Temporary Assistance for Needy Families (TANF) applies on the child's behalf. Judicial Review A review of the fair hearing decision by a district court in Travis County to determine whether the agency decision is correct. Medicaid Report (Form H1146) A form completed by a transitional Medicaid household in the fourth, seventh and tenth months of medical coverage to report earnings and household composition changes. There are two types of categorically eligible households: Certificate of Coverage A certificate that serves as proof of a Medicaid recipient's most recent period of Medicaid 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 . Restored Benefits Full or partial months of benefits for a past month that are owed to a household due to an agency error. Management The way in which a household pays its expenses with available income. Type Program (TP) 08, Parents and Caretaker Relatives Medicaid A person who supervises and cares for a dependent child. Special Immigrant Iraqi and Afghan (SIV) A special immigrant status under 101(a)(27) of the INA may be granted to Iraqi and Afghan people who have worked on behalf of the U.S. government in Iraq or Afghanistan. Intentional Program Violation (IPV) The act of intentionally making a false or misleading statement, or misrepresenting, concealing or withholding facts for the purpose of receiving assistance under the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF) or Medicaid program. Applicants who meet eligibility requirements during any of the months in this period receive Medicaid benefits for the eligible month(s). Absent Parent A child's parent who is not living in the home. SeeInterview ModeandCase Mode. Recognizable Needs The maximum needs amount allowed by the Texas Health and Human Services Commission (HHSC) when determining eligibility. Blue Shield of Texas at 1-800-521-2227 or www.bcbstx.com or contact the Texas Department of Insurance, Consumer Protection at 1-800-252-3439 or www.tdi.texas.gov. Molar Pregnancy Also known as hydatidiform mole, a molar pregnancy is considered a degenerating pregnancy. Educational Expenses/Student Loan Interest A federal income tax deduction for people paying interest on student loans or for people with education expenses such as tuition, fees, room and board, books and other supplies. Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) Multiple people may be certified on a single EDG. Your case visibility account has been disabled because of inactivity. Each state has its own rules about who's eligible, and what Medicaid covers. Personal Responsibility Agreement (PRA) A requirement for Temporary Assistance for Needy Families (TANF) that certain people must follow the conditions of the agreement. Activity Fee An additional cost incurred by the household associated with a structured dependent care program. Supplemental Security Income (SSI) A needs-tested program administered by the Social Security Administration. Marketplace The governmental entity that makes qualified health plans available to qualified people, qualified employers or both. The number is used to record covered wages, track Social Security benefits and for other identification purposes. The PAN is not related to the persons Texas Health and Human Services Commission (HHSC) case number. Trade Adjustment Assistance Act Program (TAAP) A program for workers displaced by foreign workers. Changes in income identified through this process may impact eligibility for other programs. TWC is part of a local and state network dedicated to developing the workforce of Texas. Electronic Benefit Transfer (EBT) A system that uses electronic technology to complete some of a benefit program's functional requirements. Institution of Higher Education Any public or private college, community college, junior college, technical institute, or university that usually requires a high school diploma or equivalent certificate such as a general equivalency diploma (GED), to enter. Managed Care A health care delivery system with the aim of controlling costs. Refugee A person admitted to the U.S. under Section 207 of the INA. 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. It is also referred to as spousal support. Alerts A functional area on a navigation bar that allows eligibility staff to request alerts and view outstanding and processed alerts. 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. Welcome to UnitedHealthcare Individual Exchange plans, also referred to as Individual and Family plans. are received for a minimum of three months. The .gov means its official. an applicant or a certified Temporary Assistance for Needy Families (TANF); Supplemental Nutrition Assistance Program (SNAP)or Medical Program household member or a member who would be certified but is disqualified; or.

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