| (a) An ordering physician in an employment or contractual
relationship with a PPECC cannot provide the required physician's
order unless the physician has a therapeutic relationship with and
ongoing clinical knowledge of the participant.
(b) The ordering physician's responsibilities include:
(1) providing an examination or treatment to the participant
within 30 days before the start of PPECC services;
(2) providing a signed prescription or written, dated
physician’s order for PPECC services within 30 calendar days
before the participant’s start of services, which is valid through
the initial authorization period and complies with requirements contained
in the Texas Medicaid Provider Procedures Manual;
(3) providing a signed prescription or written, dated
physician’s order for each PPECC authorization period, once
the initial prescription or order is no longer valid;
(4) performing a face-to-face evaluation of the participant
each year;
(5) reviewing, approving, signing, and dating a plan
of care, and any other documentation required for service prior authorization,
including any updates or changes;
(6) affirming in writing that PPECC services are medically
necessary for the participant;
(7) affirming in writing that the participant's medical
condition is sufficiently stable to permit safe delivery of PPECC
services as described in the plan of care; and
(8) providing continuing care to and medical supervision
of the participant.
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