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TITLE 40SOCIAL SERVICES AND ASSISTANCE
PART 1DEPARTMENT OF AGING AND DISABILITY SERVICES
CHAPTER 48COMMUNITY CARE FOR AGED AND DISABLED
SUBCHAPTER JCOMMUNITY BASED ALTERNATIVES (CBA) PROGRAM
RULE §48.6021Delay of Pre-Enrollment Home Health Assessment

(a) A home and community support services agency (HCSSA) must complete the pre-enrollment home health assessment within the time period described in §48.6020 of this chapter (relating to Pre-Enrollment Home Health Assessment), unless:

  (1) the decision to initiate Medicare home health services is pending; or

  (2) there is a delay in getting the medical necessity and level of care assessment signed by the physician.

(b) The HCSSA must notify the case manager of a delay in obtaining the physician's signature which would prevent the HCSSA from meeting the time frame for completion of the pre-enrollment home health assessment as follows:

  (1) For priority referrals, the HCSSA must orally notify the case manager no later than 24 hours before the negotiated assessment completion date of the delay in obtaining the physician's signature and submit a Case Information form to the case manager within two working days after the oral notification, documenting the reason for the delay.

  (2) For routine referrals, the HCSSA must submit the Case Information form documenting the reason for the delay to the case manager no later than 24 hours before the end of the 14-day time frame allowed.


Source Note: The provisions of this §48.6021 adopted to be effective November 1, 1999, 24 TexReg 9310; amended to be effective September 1, 2008, 33 TexReg 7288

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