DADS released two information letters:
HCS:
DADS notified these providers of the language included in the adoption proposal of HSC’s rule about an individual’s freedom of choice of direct service providers. An excerpt:
§9.177. Certification Principles: Staff Member and Service Provider Requirements.
(b) The program provider must employ or contract with a person or entity of the individual’s or Legally Authorized Representative’s (LARs) choice in accordance with this subsection.
(1) Except as provided by paragraph (2) of this subsection, the program provider must employ or contract with a person or entity of the individual’s or LAR’s choice to provide an HCS Program service to the individual if that person or entity:
(A) is qualified to provide the service;
(B) provides the service at or below the direct services portion of the applicable HCS Program rate; and
(C) is willing to contract with or be employed by the program provider to provide the service in accordance with this subchapter.
(2) The program provider may choose not to employ or contract with a person or entity of the individual’s or LAR’s choice in accordance with paragraph (1) of this subsection for good cause. The program provider must document the good cause.
(3) The requirement in paragraph (1)(B) of this subsection does not prohibit the program provider and the person or entity from agreeing to payment for the service in an amount that is more than the direct services portion of the applicable HCS Program rate.
DADS LTSS providers:
DADS emphasized the importance and usefulness of the TMHP Remittance and Status (R&S) Report. For instance, neglecting to reconcile R&S Reports may result in incorrect billing, which may lead to audits and penalties. (Letter)
