| (a) For each employee, contractor, or vendor, an FMSA
must:
(1) obtain from the employer, DR, or service provider
a copy of a renewed license or certificate, if required by the individual's
program, within 30 calendar days after the expiration date of the
current document on file required to maintain qualifications;
(2) notify the employer or DR to send required documentation
to the FMSA, if not received within the 30 days;
(3) notify the employer or DR in writing within three
working days after receipt of all required documentation if the service
provider is not qualified to continue service delivery; and
(4) retain the documentation on file.
(b) The FMSA must obtain and retain documentation on
file that the service provider continues to meet qualifications as
required by the individual's program rules, policies, and manuals,
and other state and federal regulations including:
(1) an annual check of DADS Nurse Aide Registry and
Employee Misconduct Registry; and
(2) a monthly check of the Texas Health and Human Services
Commission (HHSC) - Office of Inspector General (OIG) List of Excluded
Individuals/Entities and the United States Department of Health and
Human Services (HHS) - OIG Excluded Individuals/Entities Search online
searchable databases.
(c) The FMSA must notify the employer or DR in writing
to immediately terminate a service provider if the person is:
(1) listed as revoked in the Nurse Aide Registry;
(2) listed as unemployable in the Employee Misconduct
Registry; or
(3) is listed on the HHSC or HHS List of Excluded Individuals
and Entities.
(d) To comply with the Centers for Medicare and Medicaid
Services reporting requirements and 42 Code of Federal Regulations §1003.102(a)(2)),
an FMSA must immediately report any Medicaid exclusion findings to
HHSC-OIG using the self-reporting mechanism located on the HHSC-OIG
website.
(e) The FMSA must obtain an updated criminal conviction
history check for an employee, if requested by the employer or DR.
If the results of the updated check indicate the person has been convicted
of a crime listed in Texas Health and Safety Code (THSC), §250.006(a),
or an offense listed in THSC, §250.006(b) within the previous
five years, the FMSA must notify the employer or DR that the person
must be terminated immediately as an employee.
(f) The FMSA must not pay for services delivered by
a service provider if the FMSA has not documented continuing qualifications
for service delivery to the employer or DR, even if the service provider
is determined later by the FMSA to be qualified.
(g) The FMSA must pay, and not claim reimbursement
through DADS, for services delivered by a service provider if the
FMSA had notified the employer or DR in error that the service provider
was qualified.
(h) The FMSA must not pay, and must not claim reimbursement
from DADS, for services delivered on dates that the service provider
was not eligible.
|
