| supplies,
dental services, specialized therapies, and minor home modifications.
Reimbursements are determined using a method based on modeled projected
expenses which are developed by using data from surveys; cost report
data from similar programs; consultation with other service providers
and/or professionals experienced in delivering contracted services;
and/or other sources.
(f) Allowable and unallowable costs.
(1) Providers must follow the guidelines in determining
whether a cost is allowable or unallowable as specified in §355.102
and §355.103 of this title (relating to General Principles of
Allowable and Unallowable Costs, and Specifications for Allowable
and Unallowable Costs) as well as the following provisions.
(2) Participant room and board expenses are not allowable,
except for those related to respite care.
(3) The actual cost of adaptive aids, medical supplies,
dental services, and home modifications is not allowable for cost
reporting purposes. Allowable labor costs associated with acquiring
adaptive aids, medical supplies, dental services, and home modifications
should be reported in the cost report. Any item purchased for participants
in this program and reimbursed through a voucher payment system is
unallowable. Refer to §355.103(b)(20)(K) of this title (relating
to Specifications for Allowable and Unallowable Costs).
(g) Authority to determine reimbursement. The authority
to determine reimbursement is specified in §355.101 of this title
(relating to Introduction).
(h) Reporting revenue. Revenues must be reported on
the cost report in accordance with §355.104 of this title (relating
to Revenues).
(i) Reviews and field audits of cost reports. Desk
reviews or field audits are performed on all contracted providers'
cost reports. The frequency and nature of the field audits are determined
by HHSC to ensure the fiscal integrity of the program. Desk reviews
and field audits will be conducted in accordance with §355.106
of this title (relating to Basic Objectives and Criteria for Audit
and Desk Review of Cost Reports), and providers will be notified of
the results of a desk review or a field audit in accordance with §355.107
of this title (relating to Notification of Exclusions and Adjustments).
Providers may request an informal review and, if necessary, an administrative
hearing to dispute an action taken under §355.110 of this title
(relating to Informal Reviews and Formal Appeals).
(j) Reporting requirements. The program director's
full salary is to be reported on the line item of the cost report
designated for the director.
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| Source Note: The provisions of this §355.505 adopted to be effective September 1, 1996, 21 TexReg 7890; transferred effective September 1, 1997, as published in the Texas Register October 17, 1997, 22 TexReg 10311; amended to be effective June 21, 1998, 23 TexReg 6197; amended to be effective June 25, 2000, 25 TexReg 5867; amended to be effective September 1, 2001, 26 TexReg 6297; amended to be effective April 13, 2003, 28 TexReg 3047; amended to be effective September 1, 2004, 29 TexReg 7667; amended to be effective February 3, 2008, 33 TexReg 667; amended to beeffectiveSeptember 1, 2009, 34 TexReg 5654; amended to be effective June 20, 2011, 36 TexReg 3707; amended to be effective April 1, 2012, 37 TexReg 2068; amended to be effective November 25, 2012, 37 TexReg 9086; amended to be effective April 1, 2014, 39 TexReg 2062; amended to be effective January 1, 2015, 39 TexReg 9193 |
