26 Tex. Admin. Code § 554.2604 - Vendor Payment Information
(a)
Vendor payment will be made based upon the nursing facility administrator's or
the administrative designee's approval of the Nursing Care Statement.
(b) Vendor payment will be made at periodic
intervals but not less than once per month for services rendered during the
previous billing period.
(c) The
vendor payment for an entire month will be in accordance with the number of
calendar days in the month.
(d)
Vendor payment for time periods of less than an entire calendar month shall be
made in accordance with the number of days care was provided beginning with the
effective date on the Notification of Recipient Medical Necessity Determination
and/or Vendor Payment Plan.
(e)
Days are defined as 24-hour periods extending from midnight to midnight.
Payment is computed in terms of whole days, even though the recipient may have
been in a nursing facility only a fractional part of the day of entrance. (See
§ 554.2601(e) of Title 40 (relating to Vendor Payment (Items and Services
Included)).
(f) Vendor payment will
be made in terms of daily rates.
(g) The recipient must have the status of a
certified recipient, must have been determined to be in need of nursing
facility care, and must be physically located in a Medicaid-certified bed of a
facility at the time the service is rendered in order for the facility to
receive payment for the service.
(h) The Texas Department of Human Services
(DHS) will owe the facility no interest on payments not made within the time
limits provided in these rules, the provider contract, or Chapter 2251 of the
Government Code when the delay is the result of a bona fide dispute between DHS
and the facility over compliance with the terms and conditions of the Medicaid
program or is the result of other rules, laws or contract terms authorizing the
withholding or nonpayment.
Notes
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