TX HHS Form H1215. Report of Delay in Certification

The TX HHS Form H1215, Report of Delay in Certification, helps resolve issues related to delayed certification for Medicaid applicants. This form is typically used by MEPD Eligibility Specialists when an applicant's certification is pending beyond the initial 30-day period. The form is filled out to document the reason for the delay and provide a plan for resolving the issue.

The Report of Delay in Certification requires specific information, including the applicant's number, date, category, and reason for the delay. The form also includes conditions that must be met, such as providing documentation supporting medical necessity or disability determination. Additionally, the supervisor's decision and signature are required to approve or deny the certification.

Key features of this form include:

• The requirement to document a reason for delay in certification
• The need to provide specific information about the applicant and their situation
• The supervisor's responsibility to review and approve or deny the certification
• The use of this form as a tool for resolving delays in Medicaid certification