The following words and terms, when used in this subchapter, have the following meanings unless the context clearly indicates otherwise.
(1) Abortion--As defined in Texas Health and Safety Code §245.002.
(2) Affiliate--
(A) An individual or entity that has a legal relationship with another entity, which relationship is created or governed by at least one written instrument that demonstrates:
(i) common ownership, management, or control;
(ii) a franchise; or
(iii) the granting or extension of a license or other agreement that authorizes the affiliate to use the other entity's brand name, trademark, service mark, or other registered identification mark.
(B) The written instruments referenced in subparagraph (A) of this definition may include a certificate of formation, a franchise agreement, standards of affiliation, bylaws, articles of incorporation or a license, but do not include agreements related to a physician's participation in a physician group practice, such as a hospital group agreement, staffing agreement, management agreement, or collaborative practice agreement.
(3) Applicant--A female applying to receive services in the HTW program, including a current client who is applying to renew.
(4) Budget group--Members of a household whose needs, income, resources, and expenses are considered in determining eligibility.
(5) CHIP--The Texas State Children's Health Insurance Program.
(6) Client--A female who is enrolled in the HTW program.
(7) Covered service--A service that is reimbursable under the HTW program, including HTW Plus services.
(8) Family planning services--Educational or comprehensive medical activities that enable individuals to determine freely the number and spacing of their children and to select the means by which this may be achieved.
(9) Federal poverty level--The household income guidelines issued annually and published in the Federal Register by the United States Department of Health and Human Services.
(10) HHSC--The Texas Health and Human Services Commission or its designee.
(11) HTW Plus--Healthy Texas Women Plus. An enhanced postpartum services package for women enrolled in the HTW program who are eligible for the services.
(12) HTW program--The Healthy Texas Women program. A program administered by HHSC as outlined in this subchapter.
(13) HTW provider--A provider that is enrolled in the Texas Medicaid program and is qualified to perform covered services in the HTW program. An HTW provider with a cost reimbursement contract with HHSC may be reimbursed for providing additional services as described in §382.21(a)(2) of this subchapter (relating to Reimbursement).
(14) Medicaid program--The Texas Medical Assistance Program, a joint federal and state program provided for in Texas Human Resources Code Chapter 32, and subject to Title XIX of the Social Security Act, 42 U.S.C. §§1396 et seq.
(15) Minor--In accordance with the Texas Family Code, a person under 18 years of age who has never been married and never been declared an adult by a court (emancipated).
(16) Third-party resource--A person or organization, other than HHSC or a person living with a female applicant or a client, who may be liable as a source of payment of the female applicant's or client's medical expenses, for example, a private health insurance company or liability insurance company.
(17) Unintended pregnancies--Pregnancies that a female reports as either mistimed or undesired at the time of conception.
(18) U.S.C.--United States Code.
Source Note: The provisions of this §382.5 adopted to be effective July 1, 2016, 41 TexReg 4623; amended to be effective May 16, 2024, 49 TexReg 3199