Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 354 - MEDICAID HEALTH SERVICES
Subchapter A - PURCHASED HEALTH SERVICES
Division 11 - GENERAL ADMINISTRATION
Section 354.1133 - Parental Accompaniment Requirement
Universal Citation: 1 TX Admin Code ยง 354.1133
Current through Reg. 49, No. 38; September 20, 2024
(a) Scope. This section applies to a service provided or furnished pursuant to 25 TAC Chapter 33 (relating to Early and Periodic Screening, Diagnosis, and Treatment) or Chapter 380 of this title (relating to Medical Transportation Program).
(b) Definitions. For the purposes of this section, the following terms have the following meanings.
(1) Affiliate--Except for an individual
listed in §32.001(a)(1) - (3) of the Family Code, a person who is employed
by, contracts with, or volunteers with:
(A) a
provider or an entity contracted with a provider;
(B) an organization established by a provider
or group of providers; or
(C) an
entity that is associated with or related to a provider and that receives at
least 25 percent of its financial support from:
(i) a provider;
(ii) a group of providers; or
(iii) an organization related to a provider
or a group of providers.
(2) Provider--An individual, facility,
agency, institution, organization, group, or other entity enrolled with the
State of Texas to provide services under the Texas Medicaid program.
(3) Service--
(A) A service provided or furnished at an
Early and Periodic Screening, Diagnosis, and Treatment visit or screening;
or
(B) A benefit or service
provided under the Medical Transportation Program.
(c) Parental accompaniment.
(1) Except as provided in paragraph (2) of
this subsection, as a condition of eligibility for reimbursement for the cost
of a service, a child younger than 15 years of age must be accompanied by at
least one of the following:
(A) the child's
parent or guardian; or
(B) another
adult authorized by the parent or guardian, including an individual who is
enumerated in §
RSA
32.001(a) of the Family
Code.
(2) An adult
authorized to accompany a child cannot be the provider of a service for which
reimbursement is sought or an affiliate.
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