This is a clone of the Texas Administrative Code (TAC) for educational purposes. It is not the official version and should not be used for legal purposes. Site created Wed, 21 May 2025 21:16:44 GMT
(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;(3) to renew an LOC;(4) to obtain an LOC for a period of time for which an LOC has been denied;(5) to revise an LON; or(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.