26 Tex. Admin. Code § 365.9

Current through Register Vol. 49, No. 48, November 29, 2024

Section 365.9 - Rights and Responsibilities

(a) An applicant and client have the right to:

(1) apply for eligibility determination;

(2) choose providers subject to program limitations;

(3) be notified of the program's decisions relating to modifications, suspensions, denials, or terminations; and

(4) appeal the program's decisions and receive a response within the deadline as described in §61.11 of this title (relating to Rights of Appeal).

(b) A provider has the right to:

(1) be notified of the program's decision relating to modifications, suspensions, denials, or terminations; and

(2) appeal the program's decisions and receive a response within the deadline as described in §61.11 of this title.

(c) A client has the responsibility to:

(1) provide accurate medical information to providers and notify providers of program eligibility prior to delivery of services;

(2) abide by program rules and policies; and

(3) notify the program of any lawsuit(s) contemplated or filed concerning the cause of the medical condition for which the program has made payment.

(d) An enrolled provider has the responsibility to:

(1) abide by program rules and policies;

(2) not discriminate against applicants or clients based on source of payment; and

(3) notify the program of any lawsuit(s) contemplated or filed concerning the cause of the medical condition for which the program has made payment.

(e) An authorized entity has the responsibility to:

(1) abide by program rules and policies; and

(2) not discriminate against applicants or clients.

26 Tex. Admin. Code § 365.9

The provisions of this §365.9 adopted to be effective February 18, 2010, 35 TexReg 1220; amended to be effective March 27, 2016, 41 TexReg 2170; transferred effective January 15, 2022, as published in the December 31, 2021 issue of the Texas Register, 46 TexReg 9421