SECTION 46.23. Financial Errors

Financial errors include the errors described in this section.

(1) The facility is reimbursed for services, but the daily census documentation and the daily service delivery documentation are missing for the period for which services are reimbursed. The Department of Aging and Disability Services (DADS) applies the error to the total number of units reimbursed for the billing period for which forms are missing.

(2) The facility is reimbursed for units that exceed the units recorded on daily census documentation and daily service delivery documentation. DADS applies the error to the total number of units reimbursed in excess of units recorded.

(3) The facility is reimbursed for units of service and the client did not receive services. DADS applies the error to the total number of units reimbursed for the days the client did not receive services.

(4) The facility is reimbursed for units of service and the client was Medicaid ineligible. DADS applies the error to the total number of units reimbursed for the days the client was Medicaid ineligible. This does not apply to the Community Care for Aged and Disabled (CCAD) Residential Care (RC) program.

Source Note: The provisions of this §46.23 adopted to be effective September 1, 2003, 28 TexReg 6941; amended to be effective September 1, 2014, 39 TexReg 6634