26 Tex. Admin. Code § 554.2606 - Supplementation of Vendor Payments
(a)
Facilities must abide by Public Law 95-142 related to Medicare/Medicaid
antifraud and abuse amendments.
(b)
Participation will be limited to providers of services who accept, as payment
in full, the amounts paid in accordance with the fee structure approved by the
Texas Department of Human Services (DHS).
(c) Providers who have a contract with DHS
and who solicit contributions, donations, or gifts from Medicaid recipients or
family members will be in noncompliance with federal requirements.
(d) The facility must inform Medicaid
recipients and their families that their right to nursing facility services is
not contingent upon contributions. The facility must give copies of this notice
to the recipient, and either the responsible party or family
representative.
(e) If a recipient,
family member, guardian, or other interested party does make a free-will
contribution, the nursing facility administrator executes a statement for
signature by both the contributor and the administrator. It will state that the
services provided to any Medicaid recipient in the nursing facility are not
predicated upon contributions and that the gifts are free-will
contributions.
(f) When a provider
accepts federal and/or state funds for items or services delivered which are
not reimbursed within the per diem, the facility must document:
(1) that the type of item or service is
ordered by the physician;
(2) that
the item or service has not been billed to more than one payor source;
and
(3) that the recipient actually
received the item or service.
Notes
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