Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 364 - PRIMARY HEALTH CARE SERVICES PROGRAM
Subchapter A - PRIMARY HEALTH CARE SERVICES PROGRAM
Section 364.5 - General Program Requirements

Universal Citation: 26 TX Admin Code ยง 364.5

Current through Reg. 49, No. 38; September 20, 2024

(a) Because budgetary limitations exist, all program providers shall offer at least the following priority services:

(1) diagnosis and treatment;

(2) emergency medical services;

(3) family planning services;

(4) preventive health services;

(5) health education; and

(6) laboratory, x-ray, nuclear medicine, or other appropriate diagnostic services.

(b) The department, through approved providers, shall provide for the delivery of primary health care services to those populations that demonstrate unmet needs due to the inaccessibility and/or unavailability of primary health care services. Unmet needs may be determined by, but are not limited to, the following criteria:

(1) geographic area;

(2) demography;

(3) socioeconomic conditions;

(4) key health indicators identified by the department with the assistance of the community; and

(5) health resources available in the community.

(c) The department may deliver services directly to eligible individuals if existing private or public providers or other resources in the service area are unavailable or unable to provide those services, as evidenced by the applications received during the Request for Proposals process. The department shall make determinations that providers or resources are unavailable or unable to provide services in accordance with Health and Safety Code, § 31.005.

(d) Individuals eligible for prescription drug benefits under Medicare, Part D, who reside in areas of the state served by program providers that offer prescription drugs as a primary health care service shall receive prescription drug benefits according to Medicare regulations and procedures. Individuals who are not eligible for prescription drug benefits under Medicare, Part D, who reside in areas of the state served by program providers that offer prescription drugs as a primary health care service shall receive covered prescription drugs dispensed by pharmacy providers according to this chapter.

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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