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RULE §350.1409Parent Rights Related to the Family Cost Share System

(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.

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

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