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40.3.1 Renal Dialysis
Medicaid coverage of renal dialysis clients who may have Medicare coverage begins with the original onset date of dialysis treatments and may continue for a period of three months. During this period, Medicare eligibility is investigated through HHSC. If HHSC establishes that the client is Medicare-eligible, Medicaid coverage begins with the original onset date and continues until Medicare coverage begins. If HHSC determines that the client is not eligible for Medicare, Medicaid coverage of eligible clients begins with the original onset date and continues as long as the dialysis treatments are medically necessary, and the client is eligible for Medicaid.
In the case of a client who participates in self-dialysis training before the beginning of the third month, the Medicare waiting period is waived. The waiver is for Medicaid clients who can reasonably be expected to complete the training Program and, upon completion, enter a self-dialysis setting.
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