(a) Referrals in the PHC Program and CAS Program. HHSC
makes a referral to a provider to begin pre-initiation activities
in the PHC Program and CAS Program.
(1) Methods of referral.
(A) If an individual's needs require that a provider
complete pre-initiation activities in less than 14 days after a referral,
the case worker makes an expedited referral by oral notice and on
HHSC's Authorization for Community Care Services form.
(B) If an individual's needs do not require that a
provider complete pre-initiation activities in less than 14 days after
a referral, the case worker makes a routine referral on HHSC's Authorization
for Community Care Services form.
(2) A provider must accept all referrals.
(3) After a provider receives a referral, the provider
must conduct the pre-initiation activities as described in §47.45
of this subchapter (relating to Pre-Initiation Activities).
(b) Authorizations in the PHC Program and CAS Program.
After a provider completes the pre-initiation activities, HHSC makes
an authorization determination and notifies the provider that services
are authorized by sending the provider an HHSC Authorization for Community
Care Services form.
(c) Authorizations in the FC Program. HHSC does not
make a referral to a provider before authorizing services in the FC
Program.
(1) HHSC authorizes services for an individual in the
FC Program by sending a provider an HHSC Authorization for Community
Care Services form.
(2) A provider must accept all authorizations.
(3) After a provider receives an authorization, the
provider must conduct the pre-initiation activities as described in §47.45
of this subchapter.
|