SECTION 363.305. Provider Participation Requirements

(a) PDN services providers must be independently enrolled in the Texas Medicaid Program to be eligible to receive reimbursement for providing private duty nursing services through the Texas Health Steps Comprehensive Care Program.

(b) A PDN services provider must:

(1) be an RN, an LVN under the supervision of an RN, or a licensed HCSSA;

(2) be enrolled in the Texas Medicaid Program;

(3) comply with the terms of the Texas Medical Assistance Provider Agreement;

(4) agree to provide services in compliance with all applicable federal, state, and local laws and regulations, including the Texas Nursing Practice Act;

(5) comply with all applicable state and federal laws and regulations relating to the Texas Medicaid Program;

(6) comply with the requirements of the Texas Medicaid Provider Procedures Manual, including all updates and revisions published bimonthly in the Texas Medicaid Bulletin, and all handbooks, standards, and guidelines published by HHSC;

(7) comply with accepted professional standards and principles of nursing practice;

(8) comply with Texas Family Code Chapter 261 and Texas Human Resources Code Chapter 48, concerning mandatory reporting of suspected abuse and neglect of children and adults with disabilities; and

(9) maintain written policies and procedures for obtaining consent for medical treatment for clients in the absence of the responsible adult that meet the standards of Texas Family Code §32.001, relating to Consent by Non-Parent.

(c) Provider Notification of Termination of Services.

(1) Independently enrolled RNs must provide a recipient at least 30 days written notice of the intent to voluntarily terminate services, except in situations of a potential threat to the nurse's personal safety.

(2) An HCSSA must provide a recipient at least five days written notice of its intent to voluntarily terminate services, except as allowed by 40 TAC §97.295 (relating to Client Transfer or Discharge Notification Requirements).

Source Note: The provisions of this §363.305 adopted to be effective October 15, 2015, 40 TexReg 7056