Medicaid Reimbursement Process

If a Supplemental Security Income appellant becomes eligible for Medicaid while on indigent health care, the county might be eligible for reimbursement for costs incurred.

The state office can process claims for county-run programs to attempt to recover payments made to providers for CIHCP clients certified for retroactive Medicaid.

For HHSC to file the claim and reimburse the county for all Medicaid-paid claims, the following steps must be taken:

Download instructions here (PDF)

  1. County staff must sign and submit a Confidentiality Form to HHSC.
  2. County staff must have a potential SSI appellant sign a Form 113, which must also be signed by the provider. Claims paid before signatures are obtained won’t be eligible for reimbursement.
  3. Submit Form 112 with requested reimbursement costs and Medicaid approved claim forms (1500, UB-04 or pharmacy statement).

Required Forms: