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RULE §382.17Health-Care Providers

(a) Procedures. An HTW provider must:

  (1) be enrolled as a Medicaid provider in accordance with Chapter 352 of this title (relating to Medicaid and Children's Health Insurance Program Provider Enrollment);

  (2) complete the HTW certification process as described in subsection (e) of this section; and

  (3) comply with the requirements set out in Chapter 354, Subchapter A, Division 1 of this title (relating to Medicaid Procedures for Providers).

(b) Requirements. An HTW provider must ensure that:

  (1) the HTW provider does not perform or promote elective abortions outside the scope of HTW and is not an affiliate of an entity that performs or promotes elective abortions; and

  (2) in offering or performing an HTW service, the HTW provider:

    (A) does not promote elective abortion within the scope of HTW;

    (B) maintains physical and financial separation between its HTW activities and any elective abortion-performing or abortion-promoting activity, as evidenced by the following:

      (i) physical separation of HTW services from any elective abortion activities, no matter what entity is responsible for the activities;

      (ii) a governing board or other body that controls the HTW provider has no board members who are also members of the governing board of an entity that performs or promotes elective abortions;

      (iii) accounting records that confirm that none of the funds used to pay for HTW services directly or indirectly support the performance or promotion of elective abortions by an affiliate; and

      (iv) display of signs and other media that identify HTW and the absence of signs or materials promoting elective abortion in the HTW provider's location or in the HTW provider's public electronic communications; and

    (C) does not use, display, or operate under a brand name, trademark, service mark, or registered identification mark of an organization that performs or promotes elective abortions.

(c) Defining "promote." For purposes of subsection (b) of this section, the term "promote" means advancing, furthering, advocating, or popularizing elective abortion by, for example:

  (1) taking affirmative action to secure elective abortion services for an HTW client (such as making an appointment, obtaining consent for the elective abortion, arranging for transportation, negotiating a reduction in an elective abortion health-care provider fee, or arranging or scheduling an elective abortion procedure); however, the term does not include providing upon the patient's request neutral, factual information and nondirective counseling, including the name, address, telephone number, and other relevant information about a health-care provider;

  (2) furnishing or displaying to an HTW client information that publicizes or advertises an elective abortion service or health-care provider; or

  (3) using, displaying, or operating under a brand name, trademark, service mark, or registered identification mark of an organization that performs or promotes elective abortions.

(d) Compliance information. Upon request, an HTW provider must provide HHSC with all information HHSC requires to determine the HTW provider's compliance with this section.

(e) Certification. Upon initial application for enrollment in HTW, a health-care provider must certify its compliance with subsection (b) of this section and any other requirement specified by HHSC. Each health-care provider enrolled in HTW must annually certify that the HTW provider complies with subsection (b) of this section.

(f) HTW provider disqualification. If HHSC determines that an HTW provider fails to comply with subsection (b) of this section, HHSC disqualifies the HTW provider from HTW.

(g) Client assistance and recoupment. If an HTW provider is disqualified, HHSC takes appropriate action to:

  (1) assist an HTW client to find an alternate HTW provider; and

  (2) recoup any funds paid to a disqualified HTW provider for HTW services performed during the period of disqualification.

(h) Exemption from initial certification. The initial application requirement of subsection (g) of this section does not apply to a health-care provider that certified and was determined to be in compliance with the requirements of the Texas Women's Health Program administered by HHSC pursuant to Texas Human Resources Code §32.024(c-1).

Source Note: The provisions of this §382.17 adopted to be effective July 1, 2016, 41 TexReg 4623

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