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 21:16:45 GMT
(a) The family's cost share amount is the lesser of the:(1) HHSC fee schedule amount; or(2) applicable deductible, copayment, and coinsurance amounts when the family has insurance that covers the ABA services.(b) If the parent disagrees with the contractor's determination of the family's ability to pay the cost share, the parent can:(1) request a review by the contractor's manager or program director;(2) file an informal or formal complaint with the contractor;(3) contact the HHS Office of the Ombudsman at 1-877-787-8999, for help resolving a problem or concern with the contractor; and(4) file a formal complaint with HHSC as noted in §105.509 of this chapter (relating to Complaint Process).