SECTION 357.595. Obligation of Health Care Practitioners and Providers

(a) Each provider is responsible for ensuring that items or services furnished personally by, at the medical direction of, or on the prescription or order of an excluded physician are not billed to the Titles XIX and XX programs after dates specified in this subchapter.

(b) Providers must not bill recipients for services or items specified in subsection (a) unless:

(1) the recipient is informed, before delivery of the item or service, that those services are not reimbursed by the department; and

(2) the provider obtains and retains before delivery of the item or service, a signed consent from the recipient indicating that the recipient understands he is responsible for the payment of these services and that he still requests the service.

(c) Providers who violate department rules by billing recipients are subject to all applicable administrative sanctions described in Subchapter V of this chapter (relating to Fraud and Abuse).

Source Note: The provisions of this §357.595 adopted to be effective December 15, 1988, 13 TexReg 5828; transferred effective September 1, 2004, as published in the Texas Register September 17, 2004, 29 TexReg 9013