|(a) Payment rate determination. Payment rates are developed
based on payment rates determined for other programs that provide
similar services. If payment rates are not available from other programs
that provide similar services, payment rates are determined using
a pro-forma analysis in accordance with §355.105(h) of this chapter
(relating to General Reporting and Documentation Requirements, Methods,
(b) Related information. The information in §355.101
of this chapter (relating to Introduction) and §355.105(g) of
this chapter applies to this section.
(c) Reporting of cost. To gather adequate financial
and statistical information upon which to base reimbursement, HHSC
may require a contracted provider to submit a cost report for any
service provided through the Home and Community-Based Services - Adult
Mental Health (HCBS-AMH) program.
(1) If HHSC requires the provider to submit a cost
report, the provider must follow the cost reporting guidelines in §355.105
of this chapter and the guidelines for determining whether a cost
is allowable or unallowable in §355.102 of this chapter (relating
to General Principles of Allowable and Unallowable Costs) and §355.103
of this chapter (relating to Specifications for Allowable and Unallowable
(2) A provider is excused from the requirement to submit
a cost report if the provider meets one or more of the conditions
in §355.105(b)(4)(D) of this chapter.