Aging and Disability Services Council Sharon Swift Butterworth ...

(2) the regulatory reference, if applicable; and
(3) the individual's right to request a fair hearing in accordance with §48.6010 of this
subchapter (relating to Individual's Right to Appeal).
(c) If the individual submits a request for a fair hearing, the CBA provider is not required to
provide the denied CBA services to the individual while the appeal is pending.
§48.6110. Reduction of a CBA Program Service.
(a) The DADS case manager reduces the amount of a CBA Program service if the DADS case
manager determines:
(1) as a result of utilization review, that the amount of the service does not meet the
requirements described in §48.6006(d)(1)-(5) of this subchapter (relating to Individual Service
Plan); or
(2) that providing the service in excess of a service limit described in §48.6084(a)(2)(A)-
(G) of this subchapter (relating to Service Limits and Claim Limits) is not necessary to meet the
requirements described in §48.6006(d)(1)-(5) of this subchapter (relating to Individual Service
Plan).
(c) If the DADS case manager reduces the services, the DADS case manager provides written
notice to the individual and CBA provider not later than 12 DADS workdays before the effective
date of the reduction identified in the written notice. The written notice must specify:
(1) the reason for reduction;
(2) the effective date of reduction;
(3) the regulatory reference; and
(4) the individual's right to request a fair hearing in accordance with §48.6010 of this
subchapter (relating to Individual's Right to Appeal).
(d) If the individual submits a request for a fair hearing, the CBA provider agency must
continue to provide the service at the current authorized level while the appeal is pending. [end
addition]
This agency hereby certifies that the proposal has been reviewed by legal counsel and found to
be within the agency's legal authority to adopt.
Issued in Austin, Texas, on .
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