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TITLE 40SOCIAL SERVICES AND ASSISTANCE
PART 2DEPARTMENT OF ASSISTIVE AND REHABILITATIVE SERVICES
CHAPTER 108EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER NFAMILY COST SHARE SYSTEM
RULE §108.1419Private Insurance

(a) The contractor must obtain written parental consent to bill and to release personally identifiable information to private insurance.

(b) The contractor must obtain written parental consent when initially seeking to use their private insurance and subsequently each time the contractor obtains written parental consent due to an increase (in frequency, length, duration, or intensity) in the provision of services in the IFSP.

(c) If private insurance denies payment of the claim, the contractor must bill the family up to their maximum charge, based on their placement on the sliding fee scale.

(d) The contractor must adjust the amount billed to the family if the contractor or parent successfully disputes a denied claim.

(e) The contractor must not deny or delay a child's services if:

  (1) the family does not have private insurance; or

  (2) the parent does not give consent to bill or to release personally identifiable information to their private insurance. If the parent does not give consent, the contractor bills the family up to their maximum charge, based on their placement on the sliding fee scale.

(f) A family with private insurance will not be charged disproportionately more than a family without private insurance.


Source Note: The provisions of this §108.1419 adopted to be effective May 1, 2014, 39 TexReg 3449

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