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December 2016 Texas Medicaid Provider Procedures Manual

Children’s Services Handbook : 2 Medicaid Children’s Services Comprehensive Care Program (CCP) : 2.12 Community First Choice (CFC) Services

CFC providers, including providers offering the Service Responsibility Option (SRO), must be licensed and enrolled in Texas Medicaid and comply with all applicable federal, state, and local laws and regulations. When CFC is provided through the Consumer Directed Services (CDS) option by a Financial Management Services Agency (FMSA), the FMSA must be certified and enrolled in Texas Medicaid as a FMSA and must comply with all applicable federal, state, and local laws and regulations.
CDS, FMSA, and SRO are defined in the Title 40 Texas Administrative Code (TAC), Part 1, Chapter 41. Licensure requirements for FMSA and SRO providers are defined in the Title 40 TAC, Part 1, Chapter 49.
Any organization that employs attendants who provide CFC, and any organization serving as an FMSA, must comply with all documentation requirements as specified in CFC program policy.
All CFC providers must maintain written policies and procedures for obtaining consent for medical treatment for clients in the absence of a responsible adult that meet the standards of the Texas Family Code, Chapter 32.
Providers must only accept clients when there is a reasonable expectation and evidence that the client’s CFC needs can be adequately met in the place of service.
The CFC provider is responsible for supervising the CFC attendant in accordance with the provider’s licensure requirements.
For CFC services delivered through a Department of Aging and Disability Services (DADS) 1915(c) waiver or through a managed care organization (MCO), providers must refer to DADS or the MCO for information about benefits, limitations, prior authorization, reimbursement, and specific claim processing procedures.

Texas Medicaid & Healthcare Partnership
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