tx-August212026-56: 1 TAC §§373.101, 373.103, 373.105 — Medicaid Estate Recovery Program

Adopted Rules Title 1 TITLE 1. ADMINISTRATION PART 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION CHAPTER 373. MEDICAID ESTATE RECOVERY PROGRAM The executive commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Office of Inspector General (OIG), adopts in the Texas Administrative Code Title 1, Part 15, Chapter 373, Subchapter A, amendments to §§373.101, 373.103, 373.105, 373.201, 373.203, 373.205, 373.207, 373.209, 373.211, 373.213, 373.215, 373.217, and 373.219; and Subchapter C, amendments to §§373.301, 373.303, 373.305, and 373.307. Sections 373.101, 373.103, 373.105, 373.201, 373.203, 373.205, 373.207, 373.209, 373.211, 373.213, 373.215, 373.217, 373.219, 373.301, 373.303, 373.305, and 373.307 are adopted without changes to the proposed text as published in the March 20, 2026, issue of the Texas Register (51 TexReg 1777). These rules will not be republished. BACKGROUND AND JUSTIFICATION The amendments are necessary to clarify provisions in the Medicaid Estate Recovery Program (MERP) rules, consistent with applicable federal law at 42 U.S.C. §1396p(b)(1). HHSC, as the State Medicaid Agency, is required to operate a MERP and recover the costs of Medicaid long-term care benefits received by certain Medicaid recipients. HHSC submitted a proposed State Plan Amendment (SPA) to the Centers for Medicare & Medicaid Services seeking approval to send MERP notices to the last known address of the Medicaid recipient upon their death to ensure the decedent's heirs are aware of a possible MERP claim. The SPA was approved on July 31, 2026, with an effective date of July 2, 2026. The amendments also implement House Bill 4611, 88th Legislature, Regular Session, 2023, which makes non-substantive amendments to the Texas Government Code that make the statute more accessible, understandable, and usable. COMMENTS The 31-day comment period ended April 20,2026. During this period, HHSC did not receive any comments regarding the proposed rules. SUBCHAPTER A. GENERAL 1 TAC §§373.101, 373.103, 373.105 STATUTORY AUTHORITY The amendments are adopted under Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services system, and Texas Government Code §546.0403, which requires the executive commissioner to ensure Medicaid implements 42 United States Code §1396p(b)(1), Adjustments or recovery of medical assistance correctly paid under a State Plan, which has been done with the Medicaid Estate Recovery Program. The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority. Filed with the Office of the Secretary of State on August 7, 2026. TRD-202603326 Karen Ray Chief Counsel Texas Health and Human Services Commission Effective date: August 27, 2026 Proposal publication date: March 20, 2026 For further information, please call: (512) 221-7320 SUBCHAPTER B. RECOVERY CLAIMS 1 TAC §§373.201, 373.203, 373.205, 373.207, 373.209, 373.211, 373.213, 373.215, 373.217, 373.219 STATUTORY AUTHORITY The amendments are adopted under Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services system, and Texas Government Code §546.0403, which requires the executive commissioner to ensure Medicaid implements 42 United States Code §1396p(b)(1), Adjustments or recovery of medical assistance correctly paid under a State Plan, which has been done with the Medicaid Estate Recovery Program. The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority. Filed with the Office of the Secretary of State on August 7, 2026. TRD-202603327 Karen Ray Chief Counsel Texas Health and Human Services Commission Effective date: August 27, 2026 Proposal publication date: March 20, 2026 For further information, please call: (512) 221-7320 SUBCHAPTER C. NOTICE 1 TAC §§373.301, 373.303, 373.305, 373.307 STATUTORY AUTHORITY The amendments are adopted under Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services system, and Texas Government Code §546.0403, which requires the executive commissioner to ensure Medicaid implements 42 United States Code §1396p(b)(1), Adjustments or recovery of medical assistance correctly paid under a State Plan, which has been done with the Medicaid Estate Recovery Program. The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority. Filed with the Office of the Secretary of State on August 7, 2026. TRD-202603328 Karen Ray Chief Counsel Texas Health and Human Services Commission Effective date: August 27, 2026 Proposal publication date: March 20, 2026 For further information, please call: (512) 221-7320 CHAPTER 392. PURCHASE OF GOODS AND SERVICES FOR SPECIFIC HEALTH AND HUMAN SERVICES COMMISSION PROGRAMS SUBCHAPTER C. AUTISM PROGRAM 1 TAC §§392.201, 392.203, 392.205, 392.207 The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts the repeal of §392.201, concerning Definitions; §392.203, concerning Staff Qualifications; §392.205, concerning Criminal Background Checks; and §392.207, concerning Safety. Sections 392.201, 392.203, 392.205, and 392.207 are adopted without changes to the proposed text as published in the May 1, 2026, issue of the Texas Register (51 TexReg 2855). These rules will not be republished. BACKGROUND AND JUSTIFICATION The Children's Autism Program rules were located in two Titles in the Texas Administrative Code (TAC). The adopted repeals remove duplicative rules from 1 TAC Chapter 392, Subchapter C, Autism Program. The Children's Autism program rules were consolidated in 26 TAC Chapter 358, published elsewhere in this issue of the Texas Register. COMMENTS The 31-day comment period ended June 1, 2026. HHSC did not receive any comments regarding the proposed rules. STATUTORY AUTHORITY The repeals are adopted under Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services system and Texas Government Code §524.0005, which provides the executive commissioner of HHSC with broad rulemaking authority. In addition, Texas Human Resources Code §117.082 requires HHSC to adopt rules for the children's autism program, and Texas Human Resources Code Chapter 114 directs HHSC to perform the duties and functions of the Texas Council on Autism and Pervasive Developmental Disorders. The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority. Filed with the Office of the Secretary of State on August 5, 2026. TRD-202603314 Karen Ray Chief Counsel Texas Health and Human Services Commission Effective date: August 25, 2026 Proposal publication date: May 1, 2026 For further information, please call: (512) 815-6272