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Form 1049 Home and Community Based Services (Hcs) or Texas Home Living (Txhml) Initial Documentation of Provider Choice - Texas
What Is Form 1049?
This is a legal form that was released by the Texas Health and Human Services - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form 1049?
A: Form 1049 is the initial documentation form for selecting Home and Community Based Services (HCS) or Texas Home Living (TxHmL) providers in Texas.
Q: What are Home and Community Based Services (HCS)?
A: Home and Community Based Services (HCS) are Medicaid waiver programs that provide assistance and support to individuals with disabilities in Texas.
Q: What is Texas Home Living (TxHmL) program?
A: Texas Home Living (TxHmL) is a Medicaid waiver program that provides services and supports to individuals with intellectual and developmental disabilities in Texas.
Q: What is the purpose of Form 1049?
A: The purpose of Form 1049 is to document the initial choice of providers for Home and Community Based Services or Texas Home Living programs.
Q: Who is required to complete Form 1049?
A: Individuals or their legally authorized representatives are required to complete Form 1049 when selecting providers for HCS or TxHmL.
Q: What information is needed on Form 1049?
A: Form 1049 requires information such as the individual's name, Medicaid number, provider choice, and signatures.
Form Details:
- Released on July 1, 2019;
- The latest edition provided by the Texas Health and Human Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form 1049 by clicking the link below or browse more documents and templates provided by the Texas Health and Human Services.
