In the following circumstances clients are not eligible to
receive transportation services:
(1) transportation to and from a day activity, a personal
care home or state institution, or a facility participating in another
Title XIX program for which the reimbursement rate structure includes
transportation funds;
(2) the intended destination is a nursing facility,
except as specified in §380.202(5) of this subchapter (relating
to Program Services);
(3) the client is an inpatient in a health care facility,
except as specified in §380.202(5) of this subchapter;
(4) the client is under 15 years of age and:
(A) the client's parent, guardian, or another adult
authorized by the parent or guardian does not accompany the client
as required by §354.1133 of this title (relating to Parental
Accompaniment Requirement); and
(B) the parent or guardian, if authorizing another
adult to accompany the client, has not provided written authorization
on a form prescribed by the Health and Human Services Commission,
which will allow for the designation of one authorized adult and one
alternate authorized adult;
(5) the client is 15 through 17 years of age and not
accompanied, unless one of the following conditions exists:
(A) the client presents the parent's or legal guardian's
signed, written consent for the transportation services to Medical
Transportation Program staff, or a transportation provider; and/or
(B) the treatment to which the minor is being transported
is such that the law extends confidentiality to the minor for this
treatment;
(6) the client or another person or entity providing
care for the client receives direct payment of worker's compensation
benefits, U.S. Department of Veterans Affairs benefits, or other third-party
resources for transportation to health care services on the client's
behalf;
(7) the client is on limited status, unless the provider
has made the referral or the client requests family planning services;
(8) TICP diagnostic visits and/or cancer or cancer-related
treatments that are provided out-of-state;
(9) the client and/or attendant intentionally, knowingly,
or recklessly boards the vehicle carrying an illegal knife, a club,
handgun or other weapon, as defined in Penal Code, §46.01, on
or about his or her person;
(10) a third-party, such as a lodging establishment,
provides transportation, meals, and/or lodging at no charge for a
client and attendant, for a particular appointment; or
(11) an attendant does not accompany the client on
the MTP-requested trip when a Health Care Provider's Statement of
Need, Form 3113 or equivalent, is on file stating the client requires
an attendant(s).
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| Source Note: The provisions of this §380.207 adopted to be effective April 10, 2001, 26 TexReg 2720; amended to be effective May 11, 2003, 28 TexReg 3722; transferred effective March 1, 2004, as published in the Texas Register April 30, 2004, 29 TexReg 4267; amended to be effective September 13, 2004, 29 TexReg 8796; amended to be effective January 1, 2013, 37 TexReg 10192; amended to be effective September 1, 2014, 39 TexReg 5731 |
