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(a)The provider agency must: (1)deliver to the client the specific transition assistance service that the case manager authorized in writing; (2)purchase services for the client within the dollar amount that the case manager authorizes; and (3)submit a claim for reimbursement to the Texas Department of Human Services only after the purchased services have been delivered to the client. (b)The provider agency must complete the delivery of services to the client at least two days before the client's nursing facility discharge date. (c)The provider agency may fail to deliver authorized services to the client by the applicable due date described in subsection (b) of this section only if the reason for the delay is beyond the control of the provider agency, and only if the provider agency makes an ongoing effort to deliver the services. The provider agency must document any failure to deliver the authorized services by the applicable due date, including: (1)a description of the pending services; (2)the reason for the delay; (3)either the date the provider agency anticipates it will deliver the pending services or specific reasons why the provider agency cannot anticipate a delivery date; and (4)a description of the provider agency's ongoing efforts to deliver the services. (d)The provider agency must orally notify the case manager of any failure to deliver any of the authorized services before the applicable due date described in subsection (b) of this section. Oral notice means directly speaking with the case manager and does not include a message left by voice mail.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed
with the Office of the Secretary of State on August
10, 2004
TRD-200405064 Carey Smith
Deputy Commissioner, Legal Services
Texas Department of Human Services
Effective date: August 31, 2004
Proposal publication date: June 11, 2004
For further information, please call: (512) 438-3734
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