Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 264 - CONSUMER DIRECTED SERVICES OPTION
Subchapter C - ENROLLMENT AND RESPONSIBILITIES OF FINANCIAL MANAGEMENT SERVICES AGENCIES (FMSAS)
Section 264.329 - Continued Eligibility of an Employee, Contractor, or Vendor

Universal Citation: 26 TX Admin Code § 264.329

Current through Reg. 50, No. 13; March 28, 2025

(a) For each employee, contractor, or vendor, an FMSA must:

(1) obtain from the employer, DR, or service provider a copy of a renewed license or certificate, if required by the individual's program, within 30 calendar days after the expiration date of the current document on file required to maintain qualifications;

(2) notify the employer or DR to send required documentation to the FMSA, if not received within the 30 days;

(3) notify the employer or DR in writing within three working days after receipt of all required documentation if the service provider is not qualified to continue service delivery; and

(4) retain the documentation on file.

(b) The FMSA must obtain and retain documentation on file that the service provider continues to meet qualifications as required by the individual's program rules, policies, and manuals, and other state and federal regulations including:

(1) an annual check of DADS Nurse Aide Registry and Employee Misconduct Registry; and

(2) a monthly check of the Texas Health and Human Services Commission (HHSC) - Office of Inspector General (OIG) List of Excluded Individuals/Entities and the United States Department of Health and Human Services (HHS) - OIG Excluded Individuals/Entities Search online searchable databases.

(1) listed as revoked in the Nurse Aide Registry;

(2) listed as unemployable in the Employee Misconduct Registry; or

(3) is listed on the HHSC or HHS List of Excluded Individuals and Entities.

(d) To comply with the Centers for Medicare and Medicaid Services reporting requirements and 42 Code of Federal Regulations §1003.102(a)(2)), an FMSA must immediately report any Medicaid exclusion findings to HHSC-OIG using the self-reporting mechanism located on the HHSC-OIG website.

(e) The FMSA must obtain an updated criminal conviction history check for an employee, if requested by the employer or DR. If the results of the updated check indicate the person has been convicted of a crime listed in Texas Health and Safety Code (THSC), §250.006(a), or an offense listed in THSC, §250.006(b) within the previous five years, the FMSA must notify the employer or DR that the person must be terminated immediately as an employee.

(f) The FMSA must not pay for services delivered by a service provider if the FMSA has not documented continuing qualifications for service delivery to the employer or DR, even if the service provider is determined later by the FMSA to be qualified.

(g) The FMSA must pay, and not claim reimbursement through DADS, for services delivered by a service provider if the FMSA had notified the employer or DR in error that the service provider was qualified.

(h) The FMSA must not pay, and must not claim reimbursement from DADS, for services delivered on dates that the service provider was not eligible.

Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.

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