Current through Reg. 49, No. 38; September 20, 2024
(a) Except as
provided for a medical supply described in subsection (c) of this section, for
an adaptive aid costing less than $500 and authorized by HHSC, a DSA must
ensure that an individual receives the adaptive aid no later than 14 business
days after one of the following dates, whichever is later:
(1) the date HHSC approves the individual's
proposed IPC that includes the recommended adaptive aid; or
(2) the effective date of the individual's
proposed IPC as determined by the service planning team.
(b) Except as provided for a medical supply
as described in subsection (c) of this section, for an adaptive aid costing
$500 or more and authorized by HHSC, a DSA must ensure that an individual
receives the adaptive aid no later than 30 business days after one of the
following dates, whichever is later:
(1) the
date HHSC approves the individual's proposed IPC that includes the recommended
adaptive aid; or
(2) the effective
date of the individual's proposed IPC as determined by the service planning
team.
(c) For an adaptive
aid that is a medical supply, as listed in the Community Living
Assistance and Support Services Provider Manual, a DSA must ensure
that an individual receives the medical supply as follows:
(1) for a medical supply that is not
immediately needed by the individual, no later than five business days after
one of the following dates, whichever is later:
(A) the date HHSC approves the individual's
proposed IPC that includes the recommended adaptive aid; or
(B) the effective date of the individual's
proposed IPC as determined by the service planning team; and
(2) for a medical supply that is
immediately needed by the individual, no later than two business days after the
date HHSC approves the individual's proposed IPC that includes the recommended
adaptive aid.
(d) If a
DSA cannot provide an adaptive aid in the time frame described in subsections
(a), (b), or (c)(1) of this section, the DSA must comply with this subsection.
(1) Other than for a medical supply, for an
adaptive aid costing less than $500, the DSA must notify the individual and the
individual's case manager, orally or in writing, before the 14-day time frame
described in subsection (a) of this section expires:
(A) that the adaptive aid will not be
provided within the 14-day time frame; and
(B) of a new proposed date for provision of
the adaptive aid.
(2)
Other than for a medical supply, for an adaptive aid costing $500 or more, the
DSA must notify the individual and the individual's case manager, orally or in
writing, before the 30-day time frame described in subsection (b) of this
section expires:
(A) that the adaptive aid
will not be provided within the 30-day time frame; and
(B) of a new proposed date for provision of
the adaptive aid.
(3) For
an adaptive aid that is a medical supply and not immediately needed by the
individual, the DSA must notify the individual and the individual's case
manager, orally or in writing, before the five-day time frame described in
subsection (c)(1) of this section expires:
(A) that the adaptive aid will not be
provided within the five-day time frame;
(B) the reasons why the medical supply will
not be provided within the five-day time frame; and
(C) of a new proposed date for provision of
the medical supply.
