| (a) The provider agency must: (1) deliver to the client the specific transition assistance service that the case manager authorized in writing; (2) purchase services for the client within the dollar amount that the case manager authorizes; and (3) submit a claim for reimbursement to the Texas Department of Human Services only after the purchased services have been delivered to the client. (b) The provider agency must complete the delivery of services to the client at least two days before the client's nursing facility discharge date. (c) The provider agency may fail to deliver authorized services to the client by the applicable due date described in subsection (b) of this section only if the reason for the delay is beyond the control of the provider agency, and only if the provider agency makes an ongoing effort to deliver the services. The provider agency must document any failure to deliver the authorized services by the applicable due date, including: (1) a description of the pending services; (2) the reason for the delay; (3) either the date the provider agency anticipates it will deliver the pending services or specific reasons why the provider agency cannot anticipate a delivery date; and (4) a description of the provider agency's ongoing efforts to deliver the services. (d) The provider agency must orally notify the case manager of any failure to deliver any of the authorized services before the applicable due date described in subsection (b) of this section. Oral notice means directly speaking with the case manager and does not include a message left by voice mail. |
