MHPM Appendices
Appendix I, Helpful Telephone Numbers
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CARE Form System (3618, 3619, and 3652) | 800-727-5436 |
Distribution (fax) | 512-438-3548 |
Facility Enrollment | 512-438-2630 |
Hospice Complaints | 800-458-9858 |
ICF/MR-RC Complaint Hotline | 800-458-9858 |
Medicaid Fraud | 888-752-4888 |
Medicaid Hospice | 512-438-3015 |
Nursing Home Hotline | 800-458-9858 |
Protective and Regulatory Hotline (PRS) | 800-252-5400 |
Provider Claims Services | 512-438-2200 |
Texas Medicaid and Healthcare Partnership-Long Term Care | 800-626-4117 |
Vendor Drug Hotline | 800-435-4165 |
Appendix II, Abbreviations Dictionary
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| Acronym | Definition |
|---|---|
| AI | Applied Income |
| CCAD | Community Care Aged and Disabled |
| CFR | Code of Federal Regulations |
| CM | Contract Management |
| CMS | Claims Management System |
| DME | Durable Medical Equipment |
| DSHS | Texas Department of State Health Services |
| HHSC | Texas Health and Human Services Commission |
| ICF-MR/RC | Intermediate Care Facilities for Persons with Mental Retardation and Related Conditions |
| MAO | Medical Assistance Only |
| MDS | Minimum Data Set |
| ME | Medicaid Eligibility |
| MED | Medicaid Eligibility Date |
| NF | Nursing Facility |
| PIN | Payee ID Number (14 digits) |
| RUG | Resource Utilization Group |
| SSA | Social Security Administration |
| SSI | Supplemental Security Income |
| TMHP | Texas Medicaid and Healthcare Partnership |
| UR | Utilization Review |
Appendix III, Directive to Physicians and Family or Surrogates
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Revision 05-1; Effective December 2, 2005
Visit the web site below for this information:
Appendix IV, Disclosure Statement for Medical Power of Attorney
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Revision 05-1; Effective December 2, 2005
Disclosure Statement for Medical Power of Attorney:
https://hhs.texas.gov/laws-regulations/forms/miscellaneous/mpoa-medical-power-attorney
Visit the web site below for additional information:
https://hhs.texas.gov/laws-regulations/forms/advance-directives
Appendix V, Out of Hospital Do Not Resuscitate Order
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Revision 05-1; Effective December 2, 2005
For information about the Texas Department of State Health Services Out of Hospital Do Not Resuscitate Program and forms, visit the web site at http://www.dshs.texas.gov/emstraumasystems/dnr.shtm.