Aging and Disability Services Council Sharon Swift Butterworth ...

TITLE 40 SOCIAL SERVICES AND ASSISTANCE
PART 1 DEPARTMENT OF AGING AND DISABILITY SERVICES
CHAPTER 45 COMMUNITY LIVING ASSISTANCE AND SUPPORT SERVICES
SUBCHAPTER I FISCAL MONITORING
RULE §45.901, §45.902
Proposed action:
X Amendment
STATUTORY AUTHORITY
The amendments are proposed under Texas Government Code, §531.0055, which provides that
the HHSC executive commissioner shall adopt rules for the operation and provision of services
by the health and human services agencies, including DADS; Texas Human Resources Code,
§161.021, which provides that the Aging and Disability Services Council shall study and make
recommendations to the HHSC executive commissioner and the DADS commissioner regarding
rules governing the delivery of services to persons who are served or regulated by DADS; and
Texas Government Code, §531.021, which provides HHSC with the authority to administer
federal funds and plan and direct the Medicaid program in each agency that operates a portion of
the Medicaid program.
The amendments affect Texas Government Code, §531.0055 and §531.021, and Texas Human
Resources Code, §161.021.
§45.901. Administrative Errors.
A recoupment of 12 percent of the paid unit rate is the administrative error exception for services
billed. It represents the administrative portion of the rate. Administrative errors are applied to the
documentation reviewed and are not extrapolated. Administrative errors include, but are not
limited to, the items in paragraph (1)-(2) of this section:
(1) Administrative errors on documentation of services delivered form or the facsimile:
(A) The program provider leaves the month and year of service blank. DADS applies the
error to the total number of units documented on the time sheet.
(B) The timekeeper fails to enter a date of signature to certify the total number of hours the
habilitation service provider, nurse, or therapist worked. DADS applies the error to the total
number of units documented on the time sheet.
(C) The timekeeper corrects the date of signature but fails to initial the correction. DADS
applies the error to the number of units reimbursed after the earliest signature date.
(D) The timekeeper enters an illegible date of signature or makes an illegible correction to
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