(a) An LON for a person must be requested from the
department by electronically transmitting a completed MR/RC Assessment,
indicating the recommended LON, and submitting any supporting documentation
required by §419.242 of this title (relating to Supporting Documentation
for Level of Need). The electronically transmitted MR/RC Assessment
must contain information identical to the information on the signed
MR/RC Assessment described in subsection (c) of this section.
(b) Supporting documentation must be received by the
department within seven days after the completed MR/RC Assessment
is electronically transmitted to the department.
(c) A paper copy of the person's signed MR/RC Assessment
and the supporting documentation must be maintained in the person's
record.
(d) The department will assign an LON 1, LON 5, LON
6, LON 8, or LON 9, to a person in accordance with the criteria described
in §419.241 of this title (relating to Level of Need Criteria).
(e) The department will assign an LON to a person based
on the department's review of information reported on the person's
MR/RC Assessment, including the ICAP service level score, and any
supporting documentation required by §419.242 of this title (relating
to Supporting Documentation for Level of Need).
(f) Within 21 days after receiving an MR/RC Assessment
and any supporting documentation, the department will request additional
documentation, electronically approve the recommended LON, or send
written notification to the requestor that the recommended LON has
been denied.
(g) If additional documentation is requested, the department
will review any additional documentation submitted in accordance with
its request and electronically approve the recommended LON or send
written notification to the requestor that the recommended LON has
been denied.
(h) The department may review a recommended or assigned
LON at any time to determine if it is appropriate. If the department
reviews a recommended or assigned LON, documentation supporting the
LON must be submitted to the department in accordance with the department's
request. The department may modify an LON and recoup or deny payment
based on its review.
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Source Note: The provisions of this §261.240 adopted to be effective September 1, 2001, 26 TexReg 5384; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; transferred effective October 1, 2020, as published in the Texas Register August 28, 2020, 45 TexReg 6127 |