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4.3.2.4 Duration of Limited Status
The Limited Program duration of limited status is the following:
• Initial limited status period-minimum of 36 months.
•Second limited status period-additional 60 months.
•Third limited status period-will be for the duration of eligibility and all subsequent periods of eligibility.
•Clients arrested, indicted, or convicted of a nonfelony crime related to Medicaid fraud will be assigned limited status for 60 months or the duration of eligibility and subsequent periods of eligibility up to or equal to 60 months.
HHSC uses the same time frames for clients whose LIMITED Form H3087 includes a special message.
Clients are removed from limited status at the end of the specified limitation period if their use of medical services no longer meets the criteria for limited status. A medical review also may be initiated at the client's or provider's request. Clients or providers call the Limited Program at 1-800-436-6184 to request this review.
Providers may request to no longer serve as a client's designated provider at any time during the limited period by calling the Limited Program. Providers are asked to serve or refer the client until another arrangement is made. New arrangements are made as quickly as possible.
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