Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 259 - COMMUNITY LIVING ASSISTANCE AND SUPPORT SERVICES (CLASS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
Subchapter D - TRANSFER, DENIAL, SUSPENSION, REDUCTION, AND TERMINATION OF SERVICES
Section 259.159 - Reduction of a CLASS Program Service or CFC Service
Current through Reg. 49, No. 38; September 20, 2024
(a) HHSC reduces a CLASS Program service or CFC service on an individual's IPC, based on a review described in § 259.79 of this chapter (relating to Renewal and Revision of an IPC) or § 259.83 of this chapter (relating to Utilization Review of an IPC by HHSC), if HHSC determines that the CLASS Program service or CFC service on the IPC does not meet the requirements described in §259.65(a)(1)(E)(iii) or (iv) and § 259.65(b) of this chapter (relating to Development of an Enrollment IPC).
(b) If HHSC proposes to reduce a CLASS Program service or CFC service on the individual's IPC, HHSC modifies the IPC and notifies the individual's CMA, in writing, of the proposed reduction.
(c) After receiving a written notice from HHSC proposing to reduce a CLASS Program service or CFC service, a CMA must:
(d) If the individual or LAR requests a fair hearing before the effective date of the reduction of a CLASS Program service or CFC service, as specified in the written notice, the modified IPC described in subsection (b) of this section may not be implemented and the DSA must provide the service to the individual in the amount authorized in the prior IPC while the appeal is pending.
(e) If an individual or LAR does not request a fair hearing before the effective date of the reduction of a CLASS Program service or CFC service, a CMA and DSA must:
