SECTION 380.205. Program Processes

The following processes must be followed in order to ensure safe, efficient, and cost-effective delivery of transportation services:

(1) a request for routine medical transportation must be received at least two working days in advance of the client's health care service appointment;

(2) a request for a long distance trip must be received at least five working days in advance of the client's health care service appointment;

(3) exceptions to paragraphs (1) and (2) of this section may be granted when the circumstances have been determined to be beyond the client's control. The exception will be documented in the client's record;

(4) clients with recurring visits to a health care provider may receive multiple mass transit tickets or may have more than one transportation appointment authorized in advance;

(5) a certification period for Transportation for Indigent Cancer Patients Program (TICP) clients may be retroactive to the date of the initial request for transportation services if all eligibility requirements are met, and all forms are completed and returned to HHSC. The duration of the certification period is a maximum of 12 consecutive months and minimum of 60 days;

(6) specific certification periods apply to the following applicants of the TICP Program:

(A) applicants on unearned fixed income such as Social Security, workers' compensation, unemployment or U.S. Department of Veterans Affairs benefits can be certified for a 12 month period if there are no anticipated changes in household income;

(B) applicants with earned income can be certified up to an eight month period if there are no anticipated changes in household income;

(C) applicants whose unearned or earned household income is within 10% of the federal poverty guideline can be certified up to a six month period at a time if there are no anticipated changes in household income; or

(D) applicants who have zero income can be certified up to two months at a time. Zero income requires written verification from family members or advocates who can attest that the household receives no monthly earned or unearned income.

(7) transportation providers must report any accidents with injuries to HHSC within one hour and must report any other accidents within 24 hours; and

(8) transportation providers must attempt to contract with significant traditional providers.

Source Note: The provisions of this §380.205 adopted to be effective April 10, 2001, 26 TexReg 2720; amended to be effective May 11, 2003, 28 TexReg 3722; transferred effective March 1, 2004, as published in the Texas Register April 30, 2004, 29 TexReg 4267; amended to be effective August 6, 2013, 38 TexReg 4888; amended to be effective September 1, 2014, 39 TexReg 5731