Sec. 161.082. LONG-TERM CARE MEDICAID WAIVER PROGRAMS: UTILIZATION REVIEW. (a) In this section, "Section 1915(c) waiver program" has the meaning assigned by Section 531.001, Government Code.
(b) The department shall perform a utilization review of services in all Section 1915(c) waiver programs. The utilization review must include, at a minimum, reviewing program recipients' levels of care and any plans of care for those recipients that exceed service level thresholds established in the applicable waiver program guidelines.
Added by Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7), Sec. 1.06(b), eff. September 28, 2011.
Structure Texas Statutes
Title 11 - Aging, Community-Based, and Long-Term Care Services
Chapter 161 - Department of Aging and Disability Services
Subchapter D. Powers and Duties of Department
Section 161.071. General Powers and Duties of Department
Section 161.074. Competitive Grant Program
Section 161.075. Immunity for Area Agencies on Aging and Agency Employees and Volunteers
Section 161.076. On-Site Surveys of Certain Providers
Section 161.077. Investigation Database
Section 161.078. Eligibility for Deaf-Blind With Multiple Disabilities Waiver Program
Section 161.079. Informal Caregiver Services
Section 161.080. Contracts for Services for Individuals With Developmental Disabilities
Section 161.081. Long-Term Care Medicaid Waiver Programs: Streamlining and Uniformity
Section 161.082. Long-Term Care Medicaid Waiver Programs: Utilization Review
Section 161.083. Corrections Medication Aides
Section 161.084. Medicaid Service Options Public Education Initiative
Section 161.085. Interest List Reporting
Section 161.086. Electronic Visit Verification System
Section 161.087. Gifts and Grants
Section 161.088. Trauma-Informed Care Training
Section 161.089. Administrative Penalties