Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 354 - HEMOPHILIA ASSISTANCE PROGRAM
Section 354.13 - Rights and Responsibilities
Universal Citation: 26 TX Admin Code ยง 354.13
Current through Reg. 49, No. 12; March 22, 2024
(a) Client Rights. The applicant, client, or legally authorized representative have the right to:
(1) apply for eligibility
determination;
(2) choose providers
subject to program limitations;
(3)
choose a health plan, if applicable, subject to program limitations;
(4) be notified of program decisions relating
to modifications, suspensions, denials, or terminations;
(5) have all client files and other
information maintained in a confidential manner to the extent authorized by
law;
(6) appeal program decisions
and receive a response within the deadline as described in § 354.17 of
this title (relating to Right of Appeal); and
(7) reapply for the program when eligibility
for the program is denied or terminated.
(b) Provider Rights. The provider has the right to:
(1) apply and enroll as a
provider;
(2) be notified of
program decision relating to modifications, suspensions, denials, or
terminations;
(3) have
confidentiality of information in the manner and to the extent authorized by
law;
(4) appeal program decisions
and receive a response within the deadline as described in § 354.17 of
this title; and
(5) reapply for the
program when eligibility for the program is denied or terminated.
(c) Client Responsibilities. The applicant, client, or legally authorized representative have the responsibility to:
(1) provide accurate medical information
to providers and notify providers of program eligibility prior to delivery of
services;
(2) provide the program
with accurate information regarding any change of circumstance which might
affect eligibility and benefits within 30 days following such change;
and
(3) notify the program of any
lawsuit(s) contemplated or filed concerning the cause of the medical condition
for which the program has made payment.
(d) Provider Responsibilities. The provider has the responsibility to:
(1) enroll as a
program provider and submit a completed application to the program, including
all documents requested;
(2) abide
by the program rules and regulations;
(3) not discriminate against applicants or
clients based on source of payment; and
(4) notify the program of any lawsuit(s)
contemplated or filed concerning the cause of the medical condition for which
the program has made payment.
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