26 Tex. Admin. Code § 306.329

Current through Reg. 49, No. 49; December 6, 2024
Section 306.329 - Medicaid Provider Participation Requirements
(a) Qualifications. To become a Medicaid provider of MH rehabilitative services, an entity must:
(1) be established as a community mental health center in accordance with Texas Health and Safety Code, § 534.001, that:
(A) provides services comparable to MH rehabilitative services and the services described in the Texas Health and Safety Code, § 534.053(a)(1) - (7);
(B) is in compliance with Chapter 412, Subchapter G of this title (relating to Mental Health Community Services Standards);
(C) conducts criminal history clearances on all contractors delivering MH rehabilitative services and all employees and applicants of the Medicaid provider to whom an offer of employment is made and ensures that individuals do not come in contact with and are not provided services by an employee or contractor of the Medicaid provider (or employee or contractor of contractors delivering MH rehabilitative services under a contract with the Medicaid provider) who has a conviction for any of the criminal offenses listed in Texas Health and Safety Code, § 250.006, or for any criminal offense that the Medicaid provider has determined to be a contraindication to employment; and
(D) has a Medicaid provider agreement with the department to provide MH rehabilitative services; or
(2) be a corporation incorporated or registered to do business in the State of Texas that:
(A) has completed an application evidencing that it:
(i) provides services comparable to MH rehabilitative services and the services described in the Texas Health and Safety Code, § 534.053(a)(1) - (7);
(ii) is in compliance with Chapter 412, Subchapter G, of this title;
(iii) has demonstrated a history of providing, as well as the capacity to continue to provide, services to individuals required to submit to mental health treatment:
(I) under the Texas Code of Criminal Procedure, Article 17.032 (relating to Release on Personal Bond of Certain Mentally Ill Defendants), or Article 42.12 § 11(d) (relating to Community Supervision); and
(II) under the Texas Health and Safety Code, Chapter 573 (relating to Emergency Detention) and Chapter 574 (relating to Court-Ordered Mental Health Services); and
(iv) conducts criminal history clearances on all contractors delivering MH rehabilitative services and all employees and applicants of the corporation to whom an offer of employment is made and ensures that individuals do not come in contact with and are not provided services by an employee or contractor of the corporation (or employee or contractor of contractors delivering MH rehabilitative services under a contract with the corporation) who has a conviction for any of the criminal offenses listed in Texas Health and Safety Code, § 250.006, or for any criminal offense that the corporation has determined to be a contraindication to employment;
(B) has had its application information confirmed by an on-site visit by the department;
(C) has had its application approved by the department; and
(D) has signed a Medicaid provider agreement with the department to provide MH rehabilitative services.
(b) Compliance. A Medicaid provider must:
(1) comply with all applicable federal and state laws, rules, and regulations, and any Medicaid provider manuals and policy clarification letters promulgated by the department;
(2) document and bill for reimbursement of MH rehabilitative services in the manner and format prescribed by the department;
(3) allow the department access to all individuals and individuals' records;
(4) maintain capacity to provide those services that are described in Texas Health and Safety Code, § 534.053(a)(1) - (7); and
(5) maintain capacity to provide services to individuals required to submit to mental health treatment:
(A) under the Texas Code of Criminal Procedure, Article 17.032 (relating to Release on Personal Bond of Certain Mentally Ill Defendants), or Article 42.12 § 11(d) (relating to Community Supervision); and
(B) under the Texas Health and Safety Code, Chapter 573 (relating to Emergency Detention) and Chapter 574 (relating to Court-Ordered Mental Health Services).

26 Tex. Admin. Code § 306.329

Adopted to be effective January 22, 2014, 39 TexReg 299; Transferred from Title 25, § 416.15 by Texas Register, Volume 45, Number 08, February 21, 2020, TexReg 1239, eff. 3/15/2020