(a) Common waiver services. For nursing services provided
by a registered nurse (RN), nursing services provided by a licensed
vocational nurse (LVN), physical therapy, occupational therapy, speech/language
therapy, behavioral support services, audiology services, dietary
services, employment assistance, and supported employment, an allowable
cost per unit of service is calculated for each contracted provider
in accordance with §355.723 of this title (relating to Reimbursement
Methodology for Home and Community-Based Services (HCS) and Texas
Home Living (TxHmL) Programs). This adjusted allowable cost per unit
of service may be combined into an array with the allowable cost per
unit of service of similar services provided by other programs in
determining rates for these services in accordance with §355.502
of this title (relating to Reimbursement Methodology for Common Services
in Home and Community-Based Services Waivers).
(b) Requisition fees. Requisition fees are reimbursements
paid to the HCS and TxHmL contracted providers for their efforts in
acquiring adaptive aids, medical supplies, dental services, and minor
home modifications for HCS and TxHmL participants. Requisition fee
reimbursement for adaptive aids, medical supplies, dental services,
and minor home modifications will vary based on the actual cost of
the adaptive aid, medical supply, dental service, and minor home modification.
Reimbursements are determined using a method based on modeled projected
expenses which are developed by using data from surveys; cost report
data from similar programs; consultation with other service providers
and/or professionals experienced in delivering contracted services;
and/or other sources.
(c) Requisition fees unallowable costs. The actual
cost of adaptive aids, medical supplies, dental services, and home
modifications is not allowable for cost reporting purposes. Allowable
labor costs associated with acquiring adaptive aids, medical supplies,
dental services, and home modifications should be reported in the
cost report. Any item purchased for participants in this program and
reimbursed through a voucher payment system is unallowable. Refer
to §355.103(b)(20)(K) of this title (relating to Specifications
for Allowable and Unallowable Costs).
(d) Transition assistance services. The reimbursement
for transition assistance services will be determined in accordance
with §355.502(e) of this title.
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Source Note: The provisions of this §355.725 adopted to be effective September 1, 2009, 34 TexReg 5658; amended to be effective June 20, 2011, 36 TexReg 3707; amended to be effective December 1, 2014, 39 TexReg 8960 |