|(a) If the individual or legally authorized representative
(LAR) has provided complete financial information and the person disagrees
with the fees assessed by the Texas Health and Human Services Commission
(HHSC), the individual or LAR may contact the reimbursement office
of the state hospital in which the individual would receive services
to request a reduction and review of charges by the state hospital
superintendent, or designee. The request must be made in writing within
10 business days of the date on the notification of charges letter.
The individual or LAR retains the right to formally appeal the charges
without using the rate review process at a state hospital.
(b) The individual or LAR will be notified of the rate
review process at the time of initial rate determination and upon
any subsequent rate determination.
(c) A request under this section will delay the deadline
under §910.8(c)(2) of this chapter (relating to Appeal Process)
for an appeal request to be submitted until a determination is made
regarding a review under this section.
(d) If HHSC requests more information for a review,
the request must be made within 7 business days of the original review
request. An individual must submit additionally requested information
within 15 business days. If the additional information is not received
within 15 days, the request under this section will be considered
withdrawn. If additional information is not received, HHSC must provide
a notice to the individual that the request under this section is
considered withdrawn and that the individual may proceed with an appeal
under §910.8 of this chapter.
(e) Once HHSC receives all necessary information, HHSC
must issue a review decision within seven business days and provide
notice of the decision to the individual or LAR.