26 Tex. Admin. Code § 263.107 - HHSC Review of LON
(a) HHSC may review
a recommended or assigned LON at any time to determine if it is appropriate. If
HHSC reviews an LON, documentation supporting the LON must be submitted to HHSC
in accordance with HHSC's request. HHSC may modify an LON and recoup or deny
payment based on its review.
(b)
Before assigning an LON, HHSC reviews documentation supporting the recommended
LON if:
(1) an LON is requested that is an
increase from the individual's current LON;
(2) an LON 9 is requested in accordance with
§
263.106(j) of
this subchapter (relating to LON Assignment);
(3) an LON is requested in accordance with
§
263.106(i) of
this subchapter; or
(4) an LON is
requested in accordance with §
263.106(k) and
(l) of this subchapter.
(c) Documentation supporting a recommended
LON described in subsection (b) of this section must be submitted to HHSC and
received by HHSC within seven calendar days after electronically submitting the
recommended LON.
(1) Within 21 calendar days
after receiving the supporting documentation, HHSC:
(A) requests additional
documentation;
(B) electronically
approves the recommended LON; or
(C) notifies the program provider and the
service coordinator in the HHSC data system that the recommended LON has been
denied.
(2) HHSC reviews
any additional documentation submitted in accordance with HHSC's request and:
(A) electronically approves the recommended
LON; or
(B) notifies the program
provider and the service coordinator in the HHSC data system that the
recommended LON has been denied.
Notes
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