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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 §48.6100Circumstances Requiring Termination of Services and Medicaid Eligibility Without Advance Notice

(a) If one or more circumstances specified in paragraphs (1) - (6) of this subsection occur, the DADS case manager terminates CBA services without advance notice.

  (1) DADS or its designee has factual information confirming the death of the individual;

  (2) DADS or its designee receives a clear written statement signed by the individual that:

    (A) the individual no longer wishes services; or

    (B) gives information that requires termination and indicates that the individual understands that this must be the result of supplying that information;

  (3) The individual's whereabouts are unknown and the post office returns agency or designee mail directed to the individual indicating no forwarding address;

  (4) The CBA provider or its designee establishes the fact that the individual has been accepted for Medicaid services by another state;

  (5) A change in the level of medical care is prescribed by the individual's physician; or

  (6) The notice involves an adverse determination made with regard to the preadmission screening requirements.

(b) Within one DADS workday after becoming aware that a situation described in subsection (a) of this section exists, the CBA provider must notify the DADS case manager by phone of the reason for termination and follow up with written documentation on the case information form within two DADS workdays of the phone notification.

(c) The CBA provider is not required to continue to provide CBA services to the individual.


Source Note: The provisions of this §48.6100 adopted to be effective May 23, 1999, 24 TexReg 3864; amended to be effective December 1, 2011, 36 TexReg 8061

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