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RULE §354.1133 Parental Accompaniment Requirement

Published: 2015

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(a) Scope. This section applies to a service provided
or furnished pursuant to 25 TAC Chapter 33 (relating to Early and
Periodic Screening, Diagnosis, and Treatment) or Chapter 380 of this
title (relating to Medical Transportation Program).
(b) Definitions. For the purposes of this section,
the following terms have the following meanings.
  (1) Affiliate--Except for an individual listed in §32.001(a)(1)
- (3) of the Family Code, a person who is employed by, contracts with,
or volunteers with:
    (A) a provider or an entity contracted with a provider;
    (B) an organization established by a provider or group
of providers; or
    (C) an entity that is associated with or related to
a provider and that receives at least 25 percent of its financial
support from:
      (i) a provider;
      (ii) a group of providers; or
      (iii) an organization related to a provider or a group
of providers.
  (2) Provider--An individual, facility, agency, institution,
organization, group, or other entity enrolled with the State of Texas
to provide services under the Texas Medicaid program.
  (3) Service--
    (A) A service provided or furnished at an Early and
Periodic Screening, Diagnosis, and Treatment visit or screening; or
    (B) A benefit or service provided under the Medical
Transportation Program.
(c) Parental accompaniment.
  (1) Except as provided in paragraph (2) of this subsection,
as a condition of eligibility for reimbursement for the cost of a
service, a child younger than 15 years of age must be accompanied
by at least one of the following:
    (A) the child's parent or guardian; or
    (B) another adult authorized by the parent or guardian,
including an individual who is enumerated in §32.001(a) of the
Family Code.
  (2) An adult authorized to accompany a child cannot
be the provider of a service for which reimbursement is sought or
an affiliate.

Source Note: The provisions of this §354.1133 adopted to be effective January 1, 2013, 37 TexReg 10185