Current through Reg. 49, No. 38; September 20, 2024
(a) To purchase an
adaptive aid costing $500 or more for an individual, a CMA must:
(1) ensure that the individual or LAR
initiates a request for the adaptive aid by completing Part A of the HHSC
Request for Adaptive Aids, Medical Supplies and Minor Home Modifications form
described in the Community Living Assistance and Support Services
Provider Manual;
(2) send
the partially completed form to the DSA;
(3) ensure that the individual's service
planning team includes the cost of the specifications for the adaptive aid, as
described in §259.259 of this division (relating to Requirements for
Specifications for an Adaptive Aid), in:
(A)
the individual's proposed enrollment IPC, proposed renewal IPC, or proposed
revised IPC, as applicable; and
(B)
the individual's IPP; and
(4) no later than 14 calendar days after
completing the requirements described in paragraph (3) of this subsection,
submit to HHSC:
(A) the proposed enrollment
IPC, proposed renewal IPC, or proposed revised IPC described in paragraph
(3)(A) of this subsection, as applicable; and
(B) the individual's IPP described in
paragraph (3)(B) of this subsection.
(b) The cost of the specifications included
on an IPC and IPP as required by subsection (a)(3) of this section may not
exceed an amount equal to three units of service of behavioral support,
occupational therapy, physical therapy, or speech and language pathology, as
applicable.
(c) HHSC reviews the
documentation described in subsection (a)(4) of this section and determines
whether the proposed IPC is authorized in accordance with §
259.69 of this chapter (relating
to HHSC's Review of a Proposed Enrollment IPC) or §
259.79 of this chapter (relating
to Renewal and Revision of an IPC).
(d) HHSC notifies a DSA in MESAV of whether
the proposed IPC is authorized. HHSC notifies a CMA, in writing, of whether the
proposed IPC is authorized.
(e) If
HHSC approves the proposed IPC for payment of the specifications, the DSA must:
(1) no later than 30 calendar days after the
date HHSC approves the IPC, obtain the specifications regarding the adaptive
aid in accordance with §259.259 of this division and ensure that Part B of
the HHSC Request for Adaptive Aids, Medical Supplies and Minor Home
Modifications form is completed; and
(2) no later than 60 calendar days after
obtaining the specifications:
(A) obtain bids
from vendors in accordance with §259.261 of this division (relating to
Requirements for Bids of an Adaptive Aid);
(B) select a vendor from which to purchase
the adaptive aid; and
(C) complete
Part C of the HHSC Request for Adaptive Aids, Medical Supplies and Minor Home
Modifications form and send the form to the CMA.
(f) A CMA must, no later than 14 calendar
days after receipt of the form described in subsection (e)(2)(C) of this
section:
(1) complete Part D of the HHSC
Request for Adaptive Aids, Medical Supplies and Minor Home Modifications form,
evidencing that the criteria described in §
259.65(b) of this
chapter (relating to Development of an Enrollment IPC) are met;
(2) ensure that, in accordance with
Subchapter B of this chapter (relating to Eligibility, Enrollment, and Review),
the individual's service planning team includes the cost of the adaptive aid
in:
(A) the individual's proposed enrollment
IPC, proposed renewal IPC, or proposed revised IPC, as applicable; and
(B) the individual's IPP; and
(3) no later than 14
calendar days after completing the requirement described in paragraph (2) of
this subsection, submit to HHSC:
(A) the
completed HHSC Request for Adaptive Aids, Medical Supplies, and Minor Home
Modifications form;
(B) the
proposed enrollment IPC, proposed renewal IPC, or proposed revised IPC
described in paragraph (2)(A) of this subsection, as applicable;
(C) the individual's IPP described in
paragraph (2)(B) of this subsection; and
(D) documentation regarding bids required by
§259.261 of this division.
(g) HHSC reviews the documentation described
in subsection (f)(3) of this section and determines whether the proposed IPC is
authorized in accordance with §
259.69 or §
259.79 of this chapter.
(h) HHSC notifies a DSA, in the electronic
billing system, of whether the proposed IPC is authorized. HHSC notifies a CMA,
in writing, of whether the proposed IPC is authorized.
