Current through Reg. 49, No. 49; December 6, 2024
Section 261.206 - Application Process(a) The department will accept an application for enrollment: (1) from a provider applicant, if the department determines that new or existing ICF/MR Program beds authorized in the Long Term Care Plan for People with Mental Retardation and Related Conditions are available for allocation to a program provider for a new facility not to exceed a capacity of six;(2) from an assignee, if the department receives notice that a provider agreement is being assigned; or(3) from a provider applicant, if the provider applicant provides residential services funded with general revenue that have been authorized by the department to be refinanced as ICF/MR Program services.(b) The department will publish a notice in the Texas Register, an official publication of the Texas Office of the Secretary of State (http://www.sos.state.tx.us/texreg/index.html), if it is accepting applications for enrollment in accordance with subsection (a)(1) of this section.(c) A provider applicant must request an application for enrollment in accordance with the published notice and must submit the application according to the notice and the department's application instructions.(d) A provider applicant must complete all portions of the application for enrollment and provide information according to the department's application instructions, including but not limited to: (1) providing an operational or organizational plan that describes in detail how the provider applicant will ensure sufficient staff resources are available to provide all services required by the ICF/MR Program; and(2) providing the resume or curriculum vita of the provider applicant's employee or contractor who will manage and oversee the provision of ICF/MR Program services, which: (A) demonstrates that the employee or contractor has a minimum of three years verifiable work experience in planning and providing direct services to people with mental retardation or other developmental disabilities; and(B) is accompanied by letter(s) of reference verifying the work experience in subparagraph (A) of this paragraph.(e) The department may reject an application for enrollment for good cause, including but not limited to: (1) the application is incomplete in any aspect;(2) the application is not submitted in accordance with the department's application instructions or published notice;(3) the application was submitted under the circumstances described in subsection (a)(1) of this section and requests a capacity exceeding six;(4) the application contains false information;(5) the application does not contain original signatures and dates;(6) the department has terminated a contract with the provider applicant or its affiliate during the three years prior to the application date;(7) the provider applicant or its affiliate has been excluded or debarred;(8) another state or federal agency has terminated a contract, licensure, or certification of the provider applicant or its affiliate during the three years prior to the application date;(9) the provider applicant or its affiliate has an outstanding Medicaid program audit exception or other unresolved financial liability owed to the State of Texas;(10) the provider applicant or its affiliate is ineligible to enroll as a Medicaid provider for reasons relating to criminal history records as set forth in department rules; or(11) the provider applicant or its affiliate terminated a provider agreement in a federal health care program, as defined in 42 USC, § 1302a - 7b(f), while an adverse action or sanction was in effect.(f) The department will review an application for enrollment received by the department and provide written notice to the provider applicant stating whether the application was approved or rejected.(g) The department will not enter into a provider agreement with a provider applicant whose application for enrollment is rejected.(h) If a provider applicant's application for enrollment is approved: (1) the department will notify the state survey agency of the application approval; and(2) the provider applicant must contact the state survey agency to initiate licensure and certification action.26 Tex. Admin. Code § 261.206
Adopted to be effective January 1, 2001, 25 TexReg 12790; Transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; Transferred from Title 40, § 9.206 by Texas Register, Volume 45, Number 35, August 28, 2020, TexReg 6127, eff. 10/1/2020