26 Tex. Admin. Code § 257.15 - Provider Qualifications and Approval Process

(a) To be approved by HHSC as a provider, an applicant must:

(1) not be listed on the HHSC Office of Inspector General's Excluded Individual/Entities nor on the U.S. HHS Office of Inspector General List of Excluded Individuals/Entities (LEIE);

(2) complete:

(A) a pre-planning process with HHSC that includes a review of case manager qualifications listed in §257.19 of this subchapter (relating to Case Manager Qualifications) and an overview of case management activities as listed in §257.21 (Case Manager Responsibilities); and

(B) the HHSC standardized case management training provided by HHSC; and

(3) agree to:

(A) employ or contract with one or more case managers who each meet at least one of the qualifications listed in §257.19 of this subchapter (relating to Case Manager Qualifications); and

(B) comply with:

(i) the rules, policies, and procedures of HHSC relating to Case Management for Children and Pregnant Women; and

(ii) applicable state and federal laws governing participation of providers in the Medicaid program and enrollment as a state Medicaid provider.

(b) HHSC notifies an applicant that complies with subsection (a) of this section whether HHSC approves the applicant's enrollment to be a Medicaid provider of Case Management for Children and Pregnant Women services.

Notes

26 Tex. Admin. Code § 257.15

Adopted by Texas Register, Volume 50, Number 21, May 23, 2025, TexReg 3130, eff. 5/29/2025