| (a) The contractor must:
(1) enroll eligible children in HHSC Focused ABA services
in accordance with the eligibility criteria in §105.307 of this
subchapter (relating to Eligibility);
(2) provide written information to families regarding
the estimated maximum monthly cost of service and the estimated amount
of cost share that will be required for payment of services based
on the fee schedule and any applicable insurance deductible, co-insurance
and co-pay described in Subchapter F of this chapter (relating to
Cost Share);
(3) verify benefits for all children identified with
potential third-party payer coverage for services provided in the
Autism Program and maintain related documentation on file; and
(4) provide written notification of rights of the child
and parents or guardians noted in Subchapter E of this chapter (relating
to Autism Program Rights).
(b) An offer of enrollment into HHSC Focused ABA services
is based on the continued availability of funding and the contractor's
ability to serve more children.
(1) When a contractor is not immediately able to accept
an eligible child into the HHSC Children's Autism Program, and the
family is interested in enrolling in services, the contractor places
the family on an interest list. The interest list is reviewed every
six months to determine if families are still eligible and interested
in services.
(2) Children are removed from the interest list when
an opening for services is available, the child is no longer eligible
for the HHSC Children's Autism Program, or when the family indicates
they are no longer interested.
(3) Children who have received Focused Applied Behavior
Analysis (ABA) Services and have remaining months of eligibility are
given priority over children on the interest list who have not previously
received services when they apply for additional Focused ABA Services
if they continue to meet eligibility criteria and funds and staff
capacity are available.
|
| Source Note: The provisions of this §358.309 adopted to be effective September 1, 2014, 39 TexReg 6680; amended to be effective December 22, 2015, 40 TexReg 9307; amended to be effective September 4, 2018, 43 TexReg 5683; transferred effective August 1, 2021, as published in the July 9, 2021 issue of the Texas Register, 46 TexReg 4173 |
