Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 260 - DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
Subchapter B - ELIGIBILITY, ENROLLMENT, AND REVIEW
Division 3 - REVIEW
Section 260.75 - Utilization Review of an IPC by HHSC
Current through Reg. 49, No. 38; September 20, 2024
(a) HHSC conducts a utilization review of an IPC to determine if:
(b) If requested by HHSC, a program provider must submit documentation supporting an IPC to HHSC no later than 10 business days after the date of HHSC's request.
(c) If HHSC determines that an IPC does not meet the criteria described in § 260.51(a)(4) of this subchapter, HHSC notifies the program provider of such determination and sends written notice to the individual or LAR that the individual's DBMD Program services and CFC services are proposed for termination and includes in the notice the individual's right to request a fair hearing in accordance with § 260.111 of this subchapter (relating to Individual's Right to a Fair Hearing).
(d) If HHSC determines that an IPC meets the criteria described in § 260.51(a)(4) of this subchapter but one or more DBMD Program services or CFC services specified in the IPC do not meet the requirements described in § 260.67(a)(1) and (b) of this subchapter, HHSC:
(e) If HHSC notifies a program provider of the denial or reduction of a DBMD Program service or CFC service, and of the modification of the IPC in accordance with subsection (d) of this section, the program provider must send the individual or LAR written notice and provide services in accordance with:
