Eligibility Systems and Payment Systems
Service Authorization System Online (SASO) identifies the recipient as Service Group 1 and allows vendor payment when:
an active recipient with coverage Code R (either Long Term Care or Texas Works) enters a nursing facility; and
has a valid medical necessity and facility admission.
The system also automatically assigns a Code 60 (authorization for unlimited medications). This allows all medications to be paid through the vendor drug benefit.
If the nursing facility stay is temporary and the recipient returns home before being transferred to institutional Medicaid, no action is required. Retroactive coverage code changes are not needed.