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Get Form H3038 P 2012-2024

TENDING PRACTITIONER (or other Practitioner familiar with this patient’s case): The Texas Health and Human Services Commission (HHSC) provides Medicaid coverage for emergency services to patients who are non-immigrants, undocumented aliens and certain legal permanent resident aliens. Your certification that the patient was treated for an emergency condition (as defined below) and a statement of the dates the patient was treated are required before HHSC can process the patient’s application. .

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