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H.3.3 Requirements for TVFC Providers
By enrolling, public and private providers agree to:
• Determine TVFC eligibility before administering vaccines obtained through TVFC. The Patient Eligibility Screening Form will be provided to the parent or guardian to declare each child's eligibility.
•Maintain records of the parent, guardian, or authorized representative's responses on the Patient Eligibility Screening Form for at least three years. If requested, the provider will make such records available to DSHS, the local health department authority, or the U.S. Department of Health and Human Services (HHS).
•Comply with the appropriate vaccination schedule, dosage, and contraindications, as established by ACIP, unless (a) in making a medical judgment in accordance with accepted medical practice, the provider deems such compliance to be medically inappropriate, or (b) the particular requirement is not in compliance with Texas law, including laws relating to religious and medical exemptions.
•Provide VISs to the responsible adult, parent, or guardian and maintain records in accordance with the NCVIA. (Signatures are not required for the VISs but are recommended.)
•Not charge for vaccines supplied by DSHS and administered to a child who is eligible for TVFC.
•Charge a vaccine administration fee to the Texas Medicaid Program, but not impose a charge for the administration of the vaccine in any amount higher than the maximum administration fee established by DSHS (providers may charge a vaccine administration fee to Medicaid, but not a fee for the vaccine). Medicaid patients cannot be charged any out-of-pocket expense for the vaccine, administration of the vaccine, or an office visit associated with Medicaid services.
•Not deny administration of a TVFC vaccine to a child because of the inability of the child's parent or guardian/individual of record to pay an administrative fee.
•Comply with the state's requirements for ordering vaccines and other requirements as described by DSHS.
•Allow DSHS (or its contractors) to conduct onsite visits as required by TVFC regulations.
The provider or the state may terminate the agreement at any time for failure to comply with the requirements listed above.
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