(a) Right of Medicaid-eligible individual to request
a fair hearing. Any Medicaid-eligible individual whose request for
eligibility for MH rehabilitative services is denied or is not acted
upon with reasonable promptness, or whose MH rehabilitative services
have been terminated, suspended, or reduced by the department is entitled
to a fair hearing in accordance with 1 TAC Chapter 357, Subchapter
A (relating to Uniform Fair Hearing Rules).
(b) Notice. The Medicaid provider must notify the department
or its designee if the provider has reason to believe that an individual's
MH rehabilitative services should be denied, reduced or terminated.
(c) Right of non-Medicaid eligible individual to request
a review. Any individual who has not applied for or is not eligible
for Medicaid whose request for eligibility for MH rehabilitative services
is not acted upon with reasonable promptness, or whose MH rehabilitative
services have been terminated, suspended, or reduced by a local mental
health authority or its contractor is entitled to the right of review
and notification in accordance with the department's rules concerning
such matters for non-Medicaid-eligible individuals.
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Source Note: The provisions of this §306.331 adopted to be effective January 22, 2014, 39 TexReg 299; transferred effective March 15, 2020, as published in the February 21, 2020 issue of the Texas Register, 45 TexReg 1239 |