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K.5 Parental Accompaniment
HRC §§32.024(s)-(s-1) requires DSHS to require, as a condition for provider reimbursement, that a child younger than 15 years of age be accompanied by the child's parent, guardian, or other authorized adult during medical and dental check ups or screenings and dental treatment. DSHS has implemented this requirement through rules found in 25 TAC §33.134 (THSteps medical) and 25 TAC §33.318 (THSteps dental) and the definitions found in 25 TAC §33.15 for medical and 25 TAC §33.301 for dental.
The DSHS rules require that the parent, guardian, or authorized adult come with the child to the check up or screening, and that the parent, guardian, or authorized adult must continue to wait for the child while the check up, treatment, or service takes place.
Providers will not be required to submit documentation to TMHP to verify compliance with this policy in order for TMHP to process claims. By submitting the claim for reimbursement, the provider acknowledges compliance with all Medicaid requirements. Additional assurances are not necessary.
Exception: School health clinics, Head Start programs, and childcare facilities are exempt from this policy if the clinic, program, or facility encourages parental involvement in the health care of the child and obtains written consent for the services. The consent from the child's parent or guardian must have been received within the one-year period before the date on which the services are provided and must not have been revoked. Refer to: HRC §§32.024(s)-(s-1)25 TAC §33.15, §33.134, §33.301, and §33.318.
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