MDCP Medicaid Fair Hearing Guide

Disability Rights Texas Handout

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MDCP Medicaid Fair Hearing Guide

Please use our MDCP Medicaid Fair Hearing Checklist with this guide.

Central Argument for Your Child’s MDCP Case

The most important question in your child’s case is whether he/she has nursing needs on a regular basis that would be provided by a nurse in a nursing facility if he or she had to reside there. The Medically Dependent Children Program (MDCP) is designed to provide services to help support caregivers in the community and prevent unnecessary institutionalization of medically dependent children like your child. Further, many children are receiving Medicaid because they meet medical necessity for MDCP. The question is whether your child meets criteria for MDCP, not whether your child’s nursing needs are being provided by you in the home. In other words, the question is: does your child meet criteria for a nursing facility at the time of the assessment. It’s simple—if your child has a need for nursing on a regular basis (and therefore meets the criteria for admission into a nursing facility), then your child meets the criteria for MDCP.

Before Your Child’s Fair Hearing

Putting Together a Hearing Packet for Your Child

Representing Your Child in the Medicaid Fair Hearing—What to Expect and What to Do


Created: November 9, 2017
Publication Code: HC16

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Disclaimer: Disability Rights Texas strives to update its materials on an annual basis, and this handout is based upon the law at the time it was written. The law changes frequently and is subject to various interpretations by different courts. Future changes in the law may make some information in this handout inaccurate.

The handout is not intended to and does not replace an attorney’s advice or assistance based on your particular situation.