SECTION 355.11. Limitations and Benefits Provided

(a) Benefits provided by the Epilepsy Program are outlined in the contract with each provider and may include the following:

(1) diagnosis and treatment of epilepsy;

(2) management of continuity of care;

(3) integration of the personal, social, and vocational support services into the treatment plan; and

(4) epilepsy education.

(b) The Epilepsy Program benefits are limited to services received in Texas from a contracted provider.

(c) Depending on the recipient's eligibility status, services will be provided based upon:

(1) available funds;

(2) any contract between the department and the recipient's service provider; and

(3) any third-party liability.

(d) The Epilepsy Program is the payor of last resort. Benefits are payable only after all third parties or government entities (e.g., private/group insurance or the Veterans Administration) have met their liability.

Source Note: The provisions of this §355.11 adopted to be effective March 17, 2002, 27 TexReg 1791; amended to be effective October 8, 2006, 31 TexReg 8237; amended to be effective November 4, 2010, 35 TexReg 9738; amended to be effective July 2, 2015, 40 TexReg 4215; transferred effective March 15, 2022, as published in the February 25, 2022 issue of the Texas Register, 47 TexReg 981