Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 380 - MEDICAL TRANSPORTATION PROGRAM
Subchapter B - ELIGIBILITY, PROGRAM SERVICES, PROCESSES, ADDITIONAL TRANSPORTATION CONNECTED WITH AN AUTHORIZED TRIP, LIMITATIONS, AND EXCLUSIONS
Section 380.207 - Program Limitations
Current through Reg. 49, No. 38; September 20, 2024
In the following circumstances clients are not eligible to receive transportation services:
(1) transportation to and from a day activity, a personal care home or state institution, or a facility participating in another Title XIX program for which the reimbursement rate structure includes transportation funds;
(2) the intended destination is a nursing facility, except as specified in § 380.202(5) of this subchapter (relating to Program Services);
(3) the client is an inpatient in a health care facility, except as specified in § 380.202(5) of this subchapter;
(4) the client is under 15 years of age and:
(5) the client is 15 through 17 years of age and not accompanied, unless one of the following conditions exists:
(6) the client or another person or entity providing care for the client receives direct payment of worker's compensation benefits, U.S. Department of Veterans Affairs benefits, or other third-party resources for transportation to health care services on the client's behalf;
(7) the client is on limited status, unless the provider has made the referral or the client requests family planning services;
(8) TICP diagnostic visits and/or cancer or cancer-related treatments that are provided out-of-state;
(9) the client and/or attendant intentionally, knowingly, or recklessly boards the vehicle carrying an illegal knife, a club, handgun or other weapon, as defined in Penal Code, § RSA 46.01, on or about his or her person;
(10) a third-party, such as a lodging establishment, provides transportation, meals, and/or lodging at no charge for a client and attendant, for a particular appointment; or
(11) an attendant does not accompany the client on the MTP-requested trip when a Health Care Provider's Statement of Need, Form 3113 or equivalent, is on file stating the client requires an attendant(s).