Providers must:
(1) operate in accordance with the laws, rules, regulations,
and standards of care relating to the practice of their respective
license(s); ensure that their case managers are operating within the
laws, rules, regulations, and standards of care relating to the practice
of their respective license(s); and ensure that their case managers
operate only within the scope of their respective license(s);
(2) provide services according to policies and procedures
as published in the TMPPM and Medicaid bulletins, and in accordance
with the policies and procedures of the department;
(3) cease providing services and notify the department
if the professional license of a provider is suspended or revoked,
with such notification to be provided to the department no later than
seven calendar days after the date that the suspension or revocation
is imposed;
(4) assure that case managers attend required trainings
provided by the department;
(5) develop and maintain a quality management system
for the provision of services with the primary goal of assisting clients
in accessing necessary medical, social, educational, and other services
related to their health condition/health risk or high-risk condition;
(6) ensure that outreach activities do not impede freedom
of client choice, and that they comply with 1 TAC §371.27 (relating
to Prohibition against Solicitation of Medicaid or CHIP Recipients);
and
(7) ensure that clients are given choice of providers
for case management.
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