(a) A contractor must have and maintain a license,
certification, accreditation, or other documentation required of an
applicant in §49.205 of this chapter (relating to License, Certification,
Accreditation, and Other Requirements), except:
(1) a contractor that has had a contract for the DBMD
Program continuously since September 1, 1999, and that does not provide
home health or personal assistance services is not required to have
a HCSSA license issued in accordance with Chapter 97 of this title
(relating to Licensing Standards for Home and Community Support Services
Agencies) for a contract in effect on September 1, 2014; and
(2) a contractor that has had a contract for AFC services
in a four-bed home continuously since January 15, 2009, and that has
an assisted living facility Type C license issued in accordance with
Chapter 92 of this title (relating to Licensing Standards for Assisted
Living Facilities) is not required to have an assisted living facility
Type A or Type B license issued in accordance with Chapter 92 of this
title.
(b) A contractor must complete any training required
by HHSC as stated on the HHSC website before HHSC places a contract
of the contractor on a choice list.
(c) A contractor must ensure that an employee, subcontractor,
or volunteer can effectively communicate with an individual or LAR
concerning service planning and the provision of services, which may
require the contractor to provide an interpreter for the individual.
(d) Except as provided in HHSC rules governing services
provided under the contract, a contractor must not allow an individual
to perform services under the contract or perform other work that
benefits the contractor.
(e) A contractor must comply with the terms of its
contract, which requires compliance with applicable federal and state
laws, rules, and regulations, including this chapter, rules governing
services provided under the contract, and applicable reimbursement
rules in 1 TAC Chapter 355 (relating to Reimbursement Rates).
(f) A contractor:
(1) must accept the reimbursement rate for a service
in effect at the time the service is provided as payment in full for
performance under the contract; and
(2) must not make an additional charge to the individual,
any member of the individual's family, or any other source for supplementation
for performance under the contract, unless specifically allowed by
federal or state law, rule, or regulation.
(g) A contractor must:
(1) subscribe to receive HHSC e-mail updates, using
the link provided at the HHSC website and, for its contract, select
the following categories:
(A) information letters; and
(B) provider alerts; and
(2) be informed of the content of the e-mail updates.
(h) A contractor must notify HHSC of a change of ownership
or change in legal entity in accordance with §49.210(a)(1) of
this chapter (relating to Contractor Change of Ownership or Legal
Entity).
(i) If there is a change to a contractor's physical,
mailing, or e-mail address, as stated on the contractor's contract
application packet or on a prior written notice of change to the information,
the contractor must notify HHSC of the change and provide the new
physical, mailing, or e-mail address:
(1) at least 30 days before the address changes; or
(2) if a natural or unforeseen disaster prevents compliance
with paragraph (1) of this subsection, within three days after the
change.
(j) If there is a change to the name of the signature
authority, the contractor must notify HHSC of the change within 30
days after the change by submitting a new, fully executed HHSC "Governing
Authority Resolution" form.
(k) If there is a change to the information regarding
the applicant or a controlling person of the applicant being confirmed
by DFPS or HHSC as having committed abuse, neglect, or exploitation,
as stated on the contractor's contract application packet or on a
prior written notice of change to the information, the contractor
must notify HHSC of the change within three business days after the
contractor or controlling person becomes aware of the change.
(l) If a controlling person of a contractor is convicted
of any crime listed in §49.206 of this chapter (relating to Ineligibility
Due to Criminal History), the contractor must notify HHSC within three
business days after the contractor or controlling person becomes aware
of the conviction.
(m) If a contractor files for bankruptcy, the contractor
must notify HHSC within 14 days after filing.
(n) If a contractor or controlling person of a contractor
is excluded in accordance with §§1128, 1128A, 1136, 1156,
or 1842(j)(2) of the Social Security Act, the contractor must notify
HHSC of the exclusion change within three business days after the
contractor or controlling person becomes aware of the exclusion.
(o) If a contractor or a controlling person of a contractor
becomes aware the contractor or controlling person is listed on any
of the following, the contractor must notify HHSC within three business
days after the contractor becomes aware of the listing:
(1) the HHSC employee misconduct registry as unemployable;
(2) the HHSC nurse aide registry as revoked or suspended;
(3) the United States System for Award Management maintained
by the General Services Administration;
(4) the LEIE maintained by the United States Department
of Health and Human Services, Office of Inspector General;
(5) the LEIE maintained by the HHSC Office of Inspector
General; or
(6) the Debarred Vendor List maintained by the Texas
Comptroller of Public Accounts.
(p) If there is a change to any of the information
on the contractor's contract application packet or on a prior written
notice of change to the information, other than the information referenced
in subsections (i) - (o) of this section, a contractor must notify
HHSC of the change and provide the new information within 14 days
after the information changes.
(q) For a notice that a contractor is required to send
to HHSC in accordance with this chapter, the contractor must ensure
that the notice is:
(1) in writing;
(2) signed by the signature authority; and
(3) sent to the HHSC mailing address or email address
identified on the form "Contract Approval Letter" issued to the contractor
when the contract was awarded.
(r) A contractor must allow HHSC and any authorized
federal or state agency access to:
(1) individuals;
(2) employees, subcontractors, or volunteers of the
contractor; and
(3) any premises controlled by the contractor.
(s) A contractor must not pay for any item or service
furnished, ordered, or prescribed by an individual listed on either
LEIE described in §49.304(f)(1) of this subchapter (relating
to Background Checks).
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