Current through Reg. 49, No. 38; September 20, 2024
(a) The department
will accept an application for enrollment:
(1) from a provider applicant, if the
department determines that new or existing ICF/MR Program beds authorized in
the Long Term Care Plan for People with Mental Retardation and Related
Conditions are available for allocation to a program provider for a
new facility not to exceed a capacity of six;
(2) from an assignee, if the department
receives notice that a provider agreement is being assigned; or
(3) from a provider applicant, if the
provider applicant provides residential services funded with general revenue
that have been authorized by the department to be refinanced as ICF/MR Program
services.
(b) The
department will publish a notice in the Texas Register, an
official publication of the Texas Office of the Secretary of State
(http://www.sos.state.tx.us/texreg/index.html), if it is accepting applications
for enrollment in accordance with subsection (a)(1) of this section.
(c) A provider applicant must request an
application for enrollment in accordance with the published notice and must
submit the application according to the notice and the department's application
instructions.
(d) A provider
applicant must complete all portions of the application for enrollment and
provide information according to the department's application instructions,
including but not limited to:
(1) providing
an operational or organizational plan that describes in detail how the provider
applicant will ensure sufficient staff resources are available to provide all
services required by the ICF/MR Program; and
(2) providing the resume or curriculum vita
of the provider applicant's employee or contractor who will manage and oversee
the provision of ICF/MR Program services, which:
(A) demonstrates that the employee or
contractor has a minimum of three years verifiable work experience in planning
and providing direct services to people with mental retardation or other
developmental disabilities; and
(B)
is accompanied by letter(s) of reference verifying the work experience in
subparagraph (A) of this paragraph.
(e) The department may reject an application
for enrollment for good cause, including but not limited to:
(1) the application is incomplete in any
aspect;
(2) the application is not
submitted in accordance with the department's application instructions or
published notice;
(3) the
application was submitted under the circumstances described in subsection
(a)(1) of this section and requests a capacity exceeding six;
(4) the application contains false
information;
(5) the application
does not contain original signatures and dates;
(6) the department has terminated a contract
with the provider applicant or its affiliate during the three years prior to
the application date;
(7) the
provider applicant or its affiliate has been excluded or debarred;
(8) another state or federal agency has
terminated a contract, licensure, or certification of the provider applicant or
its affiliate during the three years prior to the application date;
(9) the provider applicant or its affiliate
has an outstanding Medicaid program audit exception or other unresolved
financial liability owed to the State of Texas;
(10) the provider applicant or its affiliate
is ineligible to enroll as a Medicaid provider for reasons relating to criminal
history records as set forth in department rules; or
(11) the provider applicant or its affiliate
terminated a provider agreement in a federal health care program, as defined in
42 USC, § 1302a - 7b(f), while an
adverse action or sanction was in effect.
(f) The department will review an application
for enrollment received by the department and provide written notice to the
provider applicant stating whether the application was approved or
rejected.
(g) The department will
not enter into a provider agreement with a provider applicant whose application
for enrollment is rejected.
(h) If
a provider applicant's application for enrollment is approved:
(1) the department will notify the state
survey agency of the application approval; and
(2) the provider applicant must contact the
state survey agency to initiate licensure and certification action.
