SECTION 263.303. HHSC Review of an IPC

(a) HHSC may review an IPC to determine if the type and amount of HCS Program services and CFC services specified in the IPC meet the requirements described in §263.301(c) of this subchapter (relating to IPC Requirements).

(1) If an IPC submitted to HHSC exceeds 100 percent of the estimated annualized average per capita cost for ICF/IID Program services, a LIDDA or program provider must immediately submit documentation supporting the IPC to HHSC, including a copy of the signed and dated IPC, the PDP, the implementation plans for the services on the IPC, and assessments. A LIDDA or program provider must submit additional documentation as requested by HHSC.

(2) If requested by HHSC for an IPC other than one described in paragraph (1) of this subsection:

(A) a LIDDA must submit documentation supporting an initial IPC to HHSC; and

(B) a LIDDA or program provider must submit documentation supporting a renewal or revised IPC to HHSC.

(b) HHSC considers a service coordinator's agreement or disagreement that a renewal or revised IPC meets the requirements described in §263.301(c) of this subchapter, as required by §263.302(e)(3) of this subchapter (relating to Renewal and Revision of an IPC), in its review of an IPC.

(c) Based on a review of an IPC, HHSC may deny or reduce an HCS Program service or a CFC service in accordance with §263.704 of this chapter (relating to Denial of HCS Program Services or CFC Services) and §263.706 of this chapter (relating to Reduction of HCS Program Services or CFC Services).

Source Note: The provisions of this §263.303 adopted to be effective March 1, 2023, 48 TexReg 1080