| (a) The department will accept an application for enrollment:
(1) from a provider applicant, if the department determines
that new or existing ICF/MR Program beds authorized in the Long Term Care Plan for People with Mental Retardation
and Related Conditions are available for allocation to a
program provider for a new facility not to exceed a capacity of six;
(2) from an assignee, if the department receives notice
that a provider agreement is being assigned; or
(3) from a provider applicant, if the provider applicant
provides residential services funded with general revenue that have
been authorized by the department to be refinanced as ICF/MR Program
services.
(b) The department will publish a notice in the Texas Register , an official publication
of the Texas Office of the Secretary of State (http://www.sos.state.tx.us/texreg/index.html),
if it is accepting applications for enrollment in accordance with
subsection (a)(1) of this section.
(c) A provider applicant must request an application
for enrollment in accordance with the published notice and must submit
the application according to the notice and the department's application
instructions.
(d) A provider applicant must complete all portions
of the application for enrollment and provide information according
to the department's application instructions, including but not limited
to:
(1) providing an operational or organizational plan
that describes in detail how the provider applicant will ensure sufficient
staff resources are available to provide all services required by
the ICF/MR Program; and
(2) providing the resume or curriculum vita of the
provider applicant's employee or contractor who will manage and oversee
the provision of ICF/MR Program services, which:
(A) demonstrates that the employee or contractor has
a minimum of three years verifiable work experience in planning and
providing direct services to people with mental retardation or other
developmental disabilities; and
(B) is accompanied by letter(s) of reference verifying
the work experience in subparagraph (A) of this paragraph.
(e) The department may reject an application for enrollment
for good cause, including but not limited to:
(1) the application is incomplete in any aspect;
(2) the application is not submitted in accordance
with the department's application instructions or published notice;
(3) the application was submitted under the circumstances
described in subsection (a)(1) of this section and requests a capacity
exceeding six;
(4) the application contains false information;
(5) the application does not contain original signatures
and dates;
(6) the department has terminated a contract with
the provider applicant or its affiliate during the three years prior
to the application date;
(7) the provider applicant or its affiliate has been
excluded or debarred;
(8) another state or federal agency has terminated
a contract, licensure, or certification of the provider applicant
or its affiliate during the three years prior to the application date;
(9) the provider applicant or its affiliate has an
outstanding Medicaid program audit exception or other unresolved financial
liability owed to the State of Texas;
(10) the provider applicant or its affiliate is ineligible
to enroll as a Medicaid provider for reasons relating to criminal
history records as set forth in department rules; or
(11) the provider applicant or its affiliate terminated
a provider agreement in a federal health care program, as defined
in 42 USC, §1302a-7b(f), while an adverse action or sanction
was in effect.
(f) The department will review an application for enrollment
received by the department and provide written notice to the provider
applicant stating whether the application was approved or rejected.
(g) The department will not enter into a provider agreement
with a provider applicant whose application for enrollment is rejected.
(h) If a provider applicant's application for enrollment
is approved:
(1) the department will notify the state survey agency
of the application approval; and
(2) the provider applicant must contact the state survey
agency to initiate licensure and certification action.
|
| Source Note: The provisions of this §261.206 adopted to be effective January 1, 2001, 25 TexReg 12790; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective October 1, 2020, as published in the Texas Register August 28, 2020, 45 TexReg 6127 |
