Texas § GV.532.0257 - HEALTH CARE PROVIDER COMPLIANCE

§ GV.532.0257. HEALTH CARE PROVIDER COMPLIANCE

HEALTH CARE PROVIDER COMPLIANCE. A health care provider that provides to recipients personal care services, attendant care services, or other services the commission identifies shall: (1) use the electronic visit verification system or a proprietary system the commission allows as provided by Section 532.0258 to document the provision of those services; (2) comply with all documentation requirements the commission establishes; (3) comply with federal and state laws regarding confidentiality of recipients' information; (4) ensure that the commission or the Medicaid managed care organization with which a claim for reimbursement for a service is filed may review electronic visit verification system documentation related to the claim or obtain a copy of that documentation at no charge to the commission or the organization; and (5) at any time, allow the commission or a Medicaid managed care organization with which a health care provider contracts to provide health care services to recipients enrolled in the organization's managed care plan to have direct, on-site access to the electronic visit verification system in use by the health care provider. Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611 ), Sec. 1.01, eff. April 1, 2025.