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December 2016 Texas Medicaid Provider Procedures Manual

Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook : 1 General Information

1 General Information
The information in this handbook is intended for Texas Medicaid durable medical equipment (DME) supplier and medical supply company providers. This handbook provides information about the Texas Medicaid benefits, policies, and procedures that are applicable to these providers.
This handbook contains information about Texas Medicaid fee-for-service benefits. For information about managed care benefits, refer to the Texas Medicaid Managed Care Handbook.
Managed care carve-out services are administered as fee-for-service benefits. A list of all carve-out services is available in Section 9, “* Carve-Out Services” in the Medicaid Managed Care Handbook (Vol. 2, Provider Handbooks).
All providers are required to report suspected child abuse or neglect as outlined in subsection, “Reporting Child Abuse or Neglect” 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 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, at all times, to deliver 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:
Section 1: Provider Enrollment and Responsibilities (Vol. I, General Information) for more information about enrollment procedures.

Texas Medicaid & Healthcare Partnership
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