Texas Administrative Code › Title 1 - ADMINISTRATION › Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION › Chapter 354 - MEDICAID HEALTH SERVICES › Subchapter A - PURCHASED HEALTH SERVICES › Division 3 - MEDICAID HOME HEALTH SERVICES › Section 354.1033 - Provider Participation Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) Home Health Agencies. To participate in
					 the Texas Medical Assistance (Medicaid) Program, a home health agency must:
(1) be certified for participation as a home
					 health agency in the Medicare program;
(2) agree to operate and furnish services in
					 compliance with all federal, state, and local laws and regulations. This
					 includes holding a valid state license as a home and community support services
					 agency with the category of service of licensed and certified home health
					 services;
(3) be enrolled and
					 approved for participation in the Medicaid program;
(4) enter into and agree to comply with the
					 terms of the written Medicaid Provider Agreement;
(5) comply with all state and federal
					 regulations and rules relating to the Medicaid program;
(6) comply with the requirements of the Texas
					 Medicaid Provider Procedures Manual that is received upon enrollment, and all
					 revisions and updates of the manual, and all handbooks, standards, and
					 guidelines published by the department;
(7) comply with accepted professional
					 standards and principles that apply to health professionals providing services
					 for a home health agency;
(8)
					 submit claims for covered services in the manner and format prescribed by the
					 department; and
(9) maintain
					 written policies and procedures for informing all adult individuals of their
					 rights under state and federal law, in advance of their receiving care by or
					 through the home health agency. The policies and procedures must:
(A) contain procedures for providing written
					 information regarding the individual's right to refuse, withhold, or withdraw
					 medical treatment under the following state and federal common law and
					 statutes:
(i) the individual's right to self
					 determination in making health care decisions;
(ii) the individual's rights under the
					 Natural Death Act (Health and Safety Code, Chapter 672) to execute an advance
					 written Directive to Physicians, or to make a non-written directive regarding
					 their right to withhold or withdraw life sustaining procedures in the event of
					 a terminal condition;
(iii) the
					 individual's rights under Health and Safety Code, Chapter 674, concerning
					 written and non-written Out-of-Hospital Do-Not-Resuscitate Orders;
(iv) the individual's right to execute a
					 Durable Power of Attorney for Health Care under the Civil Practice and Remedies
					 Code, Chapter 135, regarding their right to appoint an agent to make medical
					 treatment decisions on their behalf; and
(v) the agency's policy regarding the
					 implementation of the individual's rights;
(B) ensure the agency's compliance with the
					 requirements of Texas laws relating to advance directives;
(C) document in the individual's medical
					 record whether or not the individual has executed an advance
					 directive;
(D) not condition giving
					 services or otherwise discriminate against an individual based on whether or
					 not the individual has or has not executed an advance directive; and
(E) educate staff (individually or with
					 others) and the community on issues concerning advance directives.