Section 261.248 - Lapsed Level of Care(a) The department will not pay a program provider for ICF/MR Program services provided during a period of time in which the individual's LOC lapsed unless the program provider requests and is granted a reinstatement of the LOC in accordance with this section.(b) To request reinstatement of an LOC, a program provider must electronically transmit to the department an MR/RC Assessment indicating: (1) a code "E" in the "Purpose" section; and(2) the beginning and ending dates of the period of time for which the individual's LOC lapsed.(c) The department will not grant a request for reinstatement of an LOC: (1) if the individual does not have a current LOC;(2) to establish program eligibility;(4) to obtain an LOC for a period of time for which an LOC has been denied;(6) for a period of time during which the individual is not eligible for Medicaid.(d) If the department grants a reinstatement, the reinstatement will be for a period of not more than 180 days prior to the date of electronic transmission of the MR/RC Assessment described in subsection (b) of this section.(e) A program provider must maintain a paper copy of the completed MR/RC Assessment with all necessary signatures in the individual's record. The signed MR/RC Assessment must contain information identical to the information on the electronically transmitted MR/RC Assessment.26 Tex. Admin. Code § 261.248
Adopted to be effective September 1, 2001, 26 TexReg 5384; Transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841; Transferred from Title 40, § 9.248 by Texas Register, Volume 45, Number 35, August 28, 2020, TexReg 6127, eff. 10/1/2020