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 264.337 - Payment of Services

Universal Citation: 26 TX Admin Code § 264.337

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

(a) A CDSA must make payments in accordance with posted pay dates and required time frames unless delay is documented by the CDSA as being caused by an employer, DR, or service provider.

(b) A CDSA approves and pays for purchases through the CDS option only if:

(1) documentation provided is in accordance with § 41.239 of this chapter (relating to Documentation of Services Delivered) and § 41.335 of this chapter (relating to Documentation of Services Delivered); and

(2) services, goods, or items documented are included in the approved budget before purchase.

(c) A CDSA must pay only:

(1) the actual hours and minutes of service in accordance with the individual's program;

(2) the actual cost of the service or item, not to exceed the established budget unit rate or amount for the service;

(3) the budgeted employee benefits accrued based on hours worked by employees; and

(4) purchases of services and items if funds have been accrued based on units delivered.

(d) A CDSA must not request payment from DADS, and DADS does not pay, for services, goods, or items that:

(1) include finance charges, interest, or assessed late fees or charges;

(2) services, goods, or items that are delivered by a service provider who:
(A) was not approved in writing by the CDSA before service delivery, even if the CDSA determines later that the service provider was eligible to deliver the service; or

(B) was not eligible to provide the service at the time of delivery;

(3) are available through another service within the individual's program;

(4) are available through a non-program resource;

(5) are not included in an approved budget before purchase or delivery of the service or item; or

(6) the individual was not eligible for.

(e) A CDSA must bill accrued funds either at the time the funds are paid or deposited by the CDSA.

(f) A CDSA must make billing adjustments:

(1) for payments received that:
(A) have not been paid by the CDSA; and

(B) are not due from the CDSA; and

(2) when:
(A) the service plan period ends;

(B) the individual transfers to another CDSA; or

(C) the individual terminates the CDS option.

(g) A CDSA must ensure that payment of overtime pay for employees is calculated and paid in accordance with current state and federal laws and regulations for payment of overtime.

(h) A CDSA must receive a copy of the documentation of services delivered dated by the service provider and the employer or DR before issuing a subsequent payment to the employee when the previous payment was based on a time sheet received in an electronic format through e-mail.

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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