WebTEXAS MEDICAID ESTATE RECOVERY PROGRAM (MERP) AUTHORIZATION AND MERP CERTIFICATION SECTION 1: Authorization to Obtain MERP Claim Information (To be Completed by Heirs/Beneficiaries or Estate Representative) Irving, Texas 75038 Phone: 1-800-641-9356 Fax: 214-560-3918 MERP Certification and Authorization Form – Revised … WebThe request form and documentation should be sent to MERP, Hardship Waiver Request, P.O. Box 13247, Austin, Texas 78711. (d) The Notice of Intent to File a Claim will state the date that MERP received notification of the death of a Medicaid recipient and the source of the death notification of the Medicaid recipient.
Forms Index for the Texas Probate System (4th ed.) - Texas …
WebAUTHORIZATION AND MERP* CERTIFICATION *Texas Medicaid Estate Recovery Program TO: Texas Medicaid Recovery Program (MERP) c/o Health Management Systems Attention: Mr. Jason W. Malmberg, Attorney 5615 High Point Drive, Suite 100 Irving, Texas 75038 PHONE: (214) 453-3057 FAX: (214) 560-3918 FROM: WebTexas Administrative Code. TITLE 1. ADMINISTRATION. PART 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION. CHAPTER 373. MEDICAID ESTATE RECOVERY PROGRAM. christopher hilley brewster ma
Texas Medicaid Estate Recovery Program - Sheehan Law PLLC
WebComplete every fillable area. Make sure the data you fill in Merp Form 8001 is updated and correct. Indicate the date to the template with the Date option. Select the Sign button and … WebFurnished Form 17 Texas Medicaid Estate Recovery Program (MERP) Authorization and MERP Certification FORMS Form 1 Probate Information List Form 2 Authorization Form 3 … WebTexas Administrative Code: TITLE 1: ADMINISTRATION: PART 15: TEXAS HEALTH AND HUMAN SERVICES COMMISSION: ... Basis for Claims §373.203: Claims Procedures §373.205: Medicaid Estate Recovery Program (MERP) Claim §373.207: Exemptions from Claims §373.209: Undue Hardship Waivers §373.211: Right to a Review of an Undue … christopher hillenbrand obituary