SECTION 275.35. Service Plan and Co-payment Disagreements

(a) Service plan disagreements. If a provider and individual disagree on the number of hours of service or service tasks to be on the individual's service plan:

(1) the provider must offer the individual orally and in writing an informal dispute resolution (IDR) process through a meeting of the individual's IDT; and

(2) if the individual disagrees with the provider's decision after going through the IDR process, the individual may request a fair hearing as provided in §44.503 of this chapter (relating to Fair Hearing).

(b) Co-payment disagreements. If a provider and individual disagree on the amount of the individual's co-payment:

(1) the provider must offer the individual orally and in writing an IDR process through a meeting of the individual's IDT; and

(2) if the individual disagrees with the provider's decision after going through the IDR process, the individual may request a fair hearing as provided in §44.503 of this chapter.

Source Note: The provisions of this §275.35 adopted to be effective October 1, 2013, 38 TexReg 6606; transferred effective August 1, 2022, as published in the Texas Register July 8, 2022, 47 TexReg 3983