26 Tex. Admin. Code § 264.241 - Payment of Services

(a) Only the employer or DR may approve the documentation of services delivered described in § 41.239 of this chapter (relating to Documentation of Services Delivered).

(b) An employer or DR must submit to the CDSA approved documentation of services delivered for payment on or before the due date established by the CDSA.

(c) Unless using an EVV system as required by Chapter 68 of this title (relating to Electronic Visit Verification (EVV) System), an employer or DR must obtain a correction and submit the corrected and approved documentation of services delivered to the CDSA within three calendar days after receiving a request for corrected documentation of services delivered from the CDSA.

(d) The CDSA does not pay for services delivered until receipt of approved documentation.

(e) Overtime pay for employees must be calculated and paid in accordance with current state or federal laws and regulations for payment of overtime.

(f) DADS does not pay, and the CDSA must not pay, for purchases or services that:

(1) are not in an approved budget at time of purchase;

(2) do not meet requirements for payment through the individual's program or this chapter;

(3) are provided by a service provider:

(A) before the CDSA provides written approval of the service provider's eligibility to deliver the service, even if the CDSA determines later that the service provider was eligible to deliver the service;

(B) while the service provider was not eligible to deliver services because the service provider did not have a valid license, certificate, or other formal permission to provide the service or failed to meet other qualifications for service delivery; or

(C) when the service provider's relationship to the employer, individual, or DR is prohibited for service delivery;

(4) are delivered when the individual receiving services is not eligible for services at the time of service delivery;

(5) are available through a non-program resource;

(6) are available through another service within the individual's program;

(7) do not meet:

(A) the needs of the individual;

(B) the employment-related requirements; or

(C) the employer-related responsibilities; or

(8) exceed the rate or amount approved for the service.

(g) If the employer or DR does not meet an employer responsibility or due date, DADS does not pay and the CDSA must not pay related finance charges, interest, and fees.

Notes

26 Tex. Admin. Code § 264.241

Transferred from 40 TAC § 41.241 Texas Register, Volume 49, Number 28, July 12, 2024, TexReg 4433, eff. 9/1/2024