26 Tex. Admin. Code § 277.61 - Service Initiation

(a) Service initiation. A provider must initiate services:

(1) in the PHC Program and CAS Program:

(A) for routine referrals described in § 47.43 of this chapter (relating to Referrals and Authorizations), within seven days after the provider receives the authorization on HHSC's Authorization for Community Care Services form; and

(B) for expedited referrals described in § 47.43 of this chapter, on the date negotiated between the case worker and provider; and

(2) in the FC Program, within 14 days after the following, whichever is later:

(A) the authorization date on HHSC's Authorization for Community Care Services form; or

(B) the date the provider receives the authorization on HHSC's Authorization for Community Care Services form, unless the provider fails to stamp the receipt date on the form, in which case the authorization date is used to determine timeliness.

(b) Notification of service initiation. Within 14 days after initiating services, the provider must send notice of service initiation to the case worker.

(c) Delay in service initiation. A provider may delay service initiation only for reasons not directly caused by the provider, or reasons beyond its control, such as natural or other disasters. The provider must continue efforts to initiate services and set a date, if possible, for service initiation. The provider must document any failure to initiate services by the applicable due date in subsection (a) of this section, including:

(1) the reason for the delay ;

(2) either the date the provider anticipates it will initiate services, or specific reasons why the provider cannot anticipate a service initiation date; and

(3) a description of the provider's ongoing efforts to initiate services.

(d) Documentation of service initiation. The provider must maintain documentation of service initiation in the individual's file.

Notes

26 Tex. Admin. Code § 277.61

Transferred from 40 TAC § 47.61 Texas Register, Volume 49, Number 24, June 14, 2024, TexReg 4436, eff. 7/1/2024