To claim for school health and related services (SHARS) provided
to Medicaid-enrolled students eligible for services provided under
the Individuals with Disabilities Education Act (IDEA), school districts
must:
(1) ensure that services are provided in a manner and
environment consistent with:
(A) the student's physical and mental condition;
(B) the overall goals and objectives of the student's
individual education program (IEP); and
(C) other services and schedules prescribed in the
student's IEP;
(2) ensure that services are provided by persons licensed,
accredited, or certified by the appropriate federal or state agency
or recognized professional organization to deliver the specific service(s);
(3) meet Texas Education Agency (TEA) standards for
the delivery of SHARS;
(4) abide by the rules and regulations of TEA related
to service delivery, record-keeping, documentation, client confidentiality,
and access to client records by other professionals involved in the
implementation of the student's IEP;
(5) comply with all applicable federal, state, and
local laws and regulations regarding the services provided;
(6) be enrolled and approved for participation in the
Texas Medical Assistance Program (Medicaid);
(7) sign a written provider agreement with the Texas
Health and Human Services Commission (the Commission) or its designee
agreeing to comply with the terms of the agreement and all requirements
of Medicaid, including regulations, rules, handbooks, standards, and
guidelines published by the Commission or its designee;
(8) bill for services reimbursable by Medicaid in the
manner and format prescribed by the Commission or its designee, at
the time services are delivered, including billing for each cost category
for which the district will seek reimbursement through the annual
cost report required by paragraph (11) of this section;
(9) participate in the Commission-administered time
study;
(10) certify each quarter the Total Computable Expenditure
(Total Computable Expenditure = amount paid (Federal share) + calculated
State/Local share); and
(11) submit an annual cost report, as described in §355.8443
of this title (relating to Reimbursement Methodology for School Health
and Related Services (SHARS)).
|
| Source Note: The provisions of this §354.1342 adopted to be effective April 30, 1991, 16 TexReg 2227; transferred effective September 1, 1993, as published in the Texas Register September 7, 1993, 18 TexReg 5978; transferred effective September 1, 2001, as published in the Texas Register May 24, 2002, 27 TexReg 4561; amended to be effective October 1, 2011, 36 TexReg 4651; amended to be effective July 14, 2016, 41 TexReg 5038 |
