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TITLE 26HEALTH AND HUMAN SERVICES
PART 1HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 350EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER NFAMILY COST SHARE SYSTEM
RULE §350.1435Suspension of Services for Nonpayment

(a) The contractor must suspend Individualized Family Service Plan (IFSP) services subject to an out-of-pocket payment as identified in §350.1413 of this subchapter (relating to IFSP Services Subject to Out-of-Pocket Payment from the Family) when the balance remains delinquent for 90 days. If the parent uses their public or private insurance, the 90-day time period begins the date the contractor receives notice that the claims are denied for reimbursement and all appeals are exhausted.

(b) Before suspending IFSP services, the contractor must inform the parent that:

  (1) he or she has the option to request a:

    (A) review of the family cost share agreement, as described in §350.1417 of this subchapter (relating to Family Cost Share Agreement); or

    (B) reconsideration and adjustment of the family cost share obligation, as described in §350.1437 of this subchapter (relating to Extraordinary Circumstances);

  (2) IFSP services subject to an out-of-pocket payment will be suspended when a balance is delinquent for 90 days; and

  (3) the contractor cannot guarantee the same schedule or the same individual service provider if IFSP services are later reinstated.

(c) Respite vouchers will be denied during a suspension period.

(d) A notation must be made on the family cost share agreement that IFSP services subject to an out-of-pocket payment have been suspended due to non-payment.

(e) The contractor must reinstate suspended IFSP services when the family's account is paid in full or the family negotiates an acceptable payment plan with the contractor. The IFSP team must reassess the appropriateness of the IFSP before reinstating IFSP services if IFSP services are suspended for more than six months. The contractor must document the reinstatement of IFSP services date on the IFSP and the family cost share agreement.

(f) The contractor must maintain written local policy for collecting delinquent family cost share accounts. Documentation must reflect all reasonable attempts to collect unpaid balances. Reasonable attempts include multiple attempts at written notification, phone notification, and e-mail.


Source Note: The provisions of this §350.1435 adopted to be effective May 1, 2014, 39 TexReg 3449; transferred effective March 1, 2021, as published in the Texas Register February 5, 2021, 46 TexReg 941; amended to be effective March 17, 2022, 47 TexReg 1277

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