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December 2016 Texas Medicaid Provider Procedures Manual

Behavioral Health, Rehabilitation, and Case Management Services Handbook : 1 General Information

1 General Information
The information in this handbook is intended for the Case Management for the Blind Children’s Vocational Discovery and Development Program (BCVDDP), Case Management for Children and Pregnant Women, and services provided by a licensed clinical social worker (LCSW), licensed marriage and family therapist (LMFT), licensed professional counselor (LPC), Local Mental Health Authority (LMHA), or psychologist.
All providers are required to report suspected child abuse or neglect as outlined in subsection, “Reporting Child Abuse or Neglect” and subsection, “Training” in Section 1, “Provider Enrollment and Responsibilities” (Vol. 1, General Information).
All providers are required to read and comply with Section 1: Provider Enrollment and Responsibilities. In addition to required compliance with all requirements specific to Texas Medicaid, it is a violation of Texas Medicaid rules when a provider fails to provide health-care services or items to Medicaid clients in accordance with accepted medical community standards and standards that govern occupations, as explained in Title 1 Texas Administrative Code (TAC) §371.1659. Accordingly, in addition to being subject to sanctions for failure to comply with the requirements that are specific to Texas Medicaid, providers can also be subject to Texas Medicaid sanctions for failure to deliver, at all times, health-care items and services to Medicaid clients in full accordance with all applicable licensure and certification requirements including, without limitation, those related to documentation and record maintenance.
Refer to:
Appendix B: Vendor Drug Program (Vol. 1, General Information) for information about outpatient prescription drugs and the Medicaid Vendor Drug Program.

Texas Medicaid & Healthcare Partnership
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