| (a) Service initiation. A provider must initiate services:
(1) in the PHC Program and CAS Program:
(A) for routine referrals described in §47.43
of this chapter (relating to Referrals and Authorizations), within
seven days after the provider receives the authorization on HHSC's
Authorization for Community Care Services form; and
(B) for expedited referrals described in §47.43
of this chapter, on the date negotiated between the case worker and
provider; and
(2) in the FC Program, within 14 days after the following,
whichever is later:
(A) the authorization date on HHSC's Authorization
for Community Care Services form; or
(B) the date the provider receives the authorization
on HHSC's Authorization for Community Care Services form, unless the
provider fails to stamp the receipt date on the form, in which case
the authorization date is used to determine timeliness.
(b) Notification of service initiation. Within 14 days
after initiating services, the provider must send notice of service
initiation to the case worker.
(c) Delay in service initiation. A provider may delay
service initiation only for reasons not directly caused by the provider,
or reasons beyond its control, such as natural or other disasters.
The provider must continue efforts to initiate services and set a
date, if possible, for service initiation. The provider must document
any failure to initiate services by the applicable due date in subsection
(a) of this section, including:
(1) the reason for the delay;
(2) either the date the provider anticipates it will
initiate services, or specific reasons why the provider cannot anticipate
a service initiation date; and
(3) a description of the provider's ongoing efforts
to initiate services.
(d) Documentation of service initiation. The provider
must maintain documentation of service initiation in the individual's
file.
|
| Source Note: The provisions of this §47.61 adopted to be effective June 1, 2004, 29 TexReg 5113; amended to be effective June 1, 2009, 34 TexReg 2802; amended to be effective October 1, 2019, 44 TexReg 5138 |
