| (a) The parent has the right to:
(1) receive certain early childhood intervention services
at no cost in accordance with 34 CFR §303.521(b);
(2) refuse any early childhood intervention services
they do not wish to receive;
(3) receive information about any method the contractor
may use to verify the family's allowable deductions;
(4) receive information about the contractor's process
for determining their maximum charge before signing the family cost
share agreement;
(5) not have their personally identifiable information
released for billing purposes without prior written consent; and
(6) not have their private insurance billed without
prior written consent.
(b) If the family has an inability to pay, all IDEA
Part C services are provided with no out-of-pocket charge to the parent.
The family's inability to pay for early childhood intervention services
will not result in the delay or denial of early childhood intervention
services to the child or the family.
(c) If the parent disagrees with the contractor's determination
of the family's ability to pay, the calculated adjusted income, or
the assigned maximum charge, the parent can:
(1) request a review by the contractor manager or program
director;
(2) file an informal or formal complaint with the contractor;
(3) contact the HHSC Office of the Ombudsman for help
resolving a problem or concern with the contractor;
(4) file a formal complaint with HHSC, in compliance
with 34 CFR §303.434;
(5) participate in mediation, in compliance with 34
CFR §303.431; and
(6) participate in a due process hearing, in compliance
with 34 CFR §303.436 or §303.441, whichever is applicable.
(d) The contractor must provide the parent a copy of
the ECI Family Cost Share publication before the contractor initially
bills the child's third-party payor to pay for early childhood intervention
services.
(e) The ECI Family Cost Share publication:
(1) explains the family cost share process;
(2) describes the parent's procedural safeguards and
related due process rights;
(3) notifies the parent that:
(A) parental consent must be obtained before the contractor
releases personally identifiable information to third-party payors;
(B) if the parent does not consent under 34 CFR §303.520(a)(2),
the contractor must still make available those Part C services on
the IFSP to which the parent has consented;
(C) the parent has the right to withdraw their consent
at any time;
(D) the parent may incur potential costs for co-pays
as a result of using their public insurance and potential costs such
as co-pays, co-insurance, or deductibles as a result of using their
private insurance to pay for early childhood intervention services;
and
(E) if the child has private insurance in addition
to Medicaid, the private insurance is the primary payor and must be
billed before filing a claim with Medicaid.
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| Source Note: The provisions of this §350.1409 adopted to be effective May 1, 2014, 39 TexReg 3449; amended to be effective June 30, 2019, 44 TexReg 3280; transferred effective March 1, 2021, as published in the Texas Register February 5, 2021, 46 TexReg 941 |
