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RULE §380.301Client Rights and Responsibilities

(a) Recipient Rights.

  (1) Nondiscrimination. The recipient has a right to receive services in compliance with Title VI of the Civil Rights Act of 1964, 42 U.S.C.A. §§2000d, et seq.; §504 of the Rehabilitation Act of 1973, 29 U.S.C.A. §794; the Americans with Disabilities Act of 1990, 42 U.S.C.A. §12101, et seq;. and all amendments to each, and all requirements imposed by the regulations issued pursuant to these Acts, in particular 45 CFR Part 80 (relating to race, color, national origin), 45 CFR Part 84 (relating to handicap), 45 CFR Part 86 (relating to sex), and 45 CFR Part 91 (relating to age).

  (2) Abuse report. Recipients should report verbal or physical abuse or sexual harassment committed by other recipients or passengers, contractor employees, or Health and Human Services Commission (HHSC) staff to Regional MTP staff or Regional Management staff upon arrival at the recipient's destination.

  (3) Denial notification. If a service is denied, Regional MTP staff shall notify the recipient in accordance with Chapter 357, Subchapter A of this title (relating to Uniform Fair Hearing Rules). This recipient notification does not apply to transportation services under §380.209 of this title (relating to Program Exclusions).

  (4) Appeal request. A recipient whose services have been denied may request an administrative review by the Regional MTP Manager. A second administrative review may be conducted by the MTP Program Director. If the recipient is still dissatisfied, the recipient may appeal the administrative review decision or the service denial by requesting a fair hearing. A request for a fair hearing must be in writing and mailed or hand-delivered to the appropriate Regional MTP office.

(b) Recipient Responsibilities.

  (1) When a recipient or responsible adult requests transportation, he/she must provide Regional MTP staff with the following information:

    (A) recipient name, address, and, if available, the telephone number;

    (B) Medicaid, Transportation for Indigent Cancer Patients Program or Children with Special Health Care Needs recipient identification number (if applicable) or Social Security number, and date of birth;

    (C) name, address, and telephone number of health care provider and/or referring health-care provider;

    (D) purpose and date of trip and time of appointment;

    (E) affirmation that other means of transportation are unavailable;

    (F) special needs, including wheelchair lift or attendant(s);

    (G) medical necessity verified by the Health Care Provider's Statement of Need, if applicable; and

    (H) affirmation that advance funds are needed in order for the recipient to access health care services.

  (2) Recipients must reimburse HHSC for any advance funds, and any portion thereof, that are not used for the specific prior authorized service.

  (3) Recipients must refrain from verbal and/or physical abuse or sexual harassment toward another recipient or passenger, contractor's employees, or HHSC employees while requesting or receiving medical transportation services.

  (4) Recipients must safeguard all bus tickets and/or tokens from loss and theft and must return unused tickets or tokens to the Regional MTP office issuing the tickets or tokens.

  (5) Recipients who receive mass-transit bus tickets or tokens must complete HHSC's Verification of Travel to Health Care Services by Mass Transit, Form 3111. Recipients must return this verification form prior to their next request for tickets or tokens. A letter from the health care provider verifying delivery of services may be substituted for the disbursement of mass transit tickets or tokens verification form. Exceptions to this documentation may be granted by a Regional MTP Manager or supervisor when circumstances occur that are beyond the recipient's control. Exceptions will be documented in the recipient's record.

  (6) Recipients must not use authorized medical transportation for purposes other than travel to and from health care services.

  (7) If the recipient does not need to use the authorized transportation services, the recipient or the responsible adult should contact the Regional MTP staff to cancel the particular trip no less than four hours prior to the time of the authorized trip.

  (8) Recipients who receive advance funds for meals, lodging, and/or travel must return written documentation from the health care provider verifying services were provided, prior to receiving future advance funds.

  (9) Recipients must cancel requests for advance funds or lodging when not needed and must refund any disbursed advance funds to HHSC.

  (10) Recipients must provide appropriate receipts when seeking reimbursement for lodging.

Source Note: The provisions of this §380.301 adopted to be effective April 10, 2001, 26 TexReg 2720; amended to be effective May 11, 2003, 28 TexReg 3722; transferred effective March 1, 2004, as published in the Texas Register April 30, 2004, 29 TexReg 4267; amended to be effective August 6, 2013, 38 TexReg 4888

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