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TITLE 1ADMINISTRATION
PART 15TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 380MEDICAL TRANSPORTATION PROGRAM
SUBCHAPTER BELIGIBILITY, PROGRAM SERVICES, PROCESSES, ADDITIONAL TRANSPORTATION CONNECTED WITH AN AUTHORIZED TRIP, LIMITATIONS, AND EXCLUSIONS
RULE §380.207Program Limitations

In the following circumstances clients are not eligible to receive transportation services:

  (1) transportation to and from a day activity, a personal care home or state institution, or a facility participating in another Title XIX program for which the reimbursement rate structure includes transportation funds;

  (2) the intended destination is a nursing facility, except as specified in §380.202(5) of this subchapter (relating to Program Services);

  (3) the client is an inpatient in a health care facility, except as specified in §380.202(5) of this subchapter;

  (4) the client is under 15 years of age and:

    (A) the client's parent, guardian, or another adult authorized by the parent or guardian does not accompany the client as required by §354.1133 of this title (relating to Parental Accompaniment Requirement); and

    (B) the parent or guardian, if authorizing another adult to accompany the client, has not provided written authorization on a form prescribed by the Health and Human Services Commission, which will allow for the designation of one authorized adult and one alternate authorized adult;

  (5) the client is 15 through 17 years of age and not accompanied, unless one of the following conditions exists:

    (A) the client presents the parent's or legal guardian's signed, written consent for the transportation services to Medical Transportation Program staff, or a transportation provider; and/or

    (B) the treatment to which the minor is being transported is such that the law extends confidentiality to the minor for this treatment;

  (6) the client or another person or entity providing care for the client receives direct payment of worker's compensation benefits, U.S. Department of Veterans Affairs benefits, or other third-party resources for transportation to health care services on the client's behalf;

  (7) the client is on limited status, unless the provider has made the referral or the client requests family planning services;

  (8) TICP diagnostic visits and/or cancer or cancer-related treatments that are provided out-of-state;

  (9) the client and/or attendant intentionally, knowingly, or recklessly boards the vehicle carrying an illegal knife, a club, handgun or other weapon, as defined in Penal Code, §46.01, on or about his or her person;

  (10) a third-party, such as a lodging establishment, provides transportation, meals, and/or lodging at no charge for a client and attendant, for a particular appointment; or

  (11) an attendant does not accompany the client on the MTP-requested trip when a Health Care Provider's Statement of Need, Form 3113 or equivalent, is on file stating the client requires an attendant(s).


Source Note: The provisions of this §380.207 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 September 13, 2004, 29 TexReg 8796; amended to be effective January 1, 2013, 37 TexReg 10192; amended to be effective September 1, 2014, 39 TexReg 5731

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