Epilepsy Program Policy Manual

EPPM Revisions

25-1, Updates Miscellaneous Sections and Form 3094

Revision 25-1; Effective Feb. 24, 2025

The following changes(s) were made:

Revised	Title	Change
1100	Contact Information	Updates link to SharePoint Contractor Portal.
2100	Program Authorization and Services	Clarifies content for Funding Sources.
3100	Administrative Policies	Updates: subsection 3110 Maintaining Clinic Information on 2-1-1, and subsection 3130 Important Information for Former Military Service Members.
3200	Abuse and Neglect Reporting	Replaces link to Texas Family Code PDF with link to website.
3300	Confidentiality	Updates: link to U.S. Health Insurance Portability and Accountability Act of 1996 (HIPPA), and subsection 3310 with link to HHSC Requirements for Contractors.
3600	Facilities and Equipment	Updates subsection 3640 Radiology Equipment and Standards to add link to DSHS Radiation Control.
4200	Client Eligibility Screening Process	Clarifies Texas Administrative Code
6100	Reimbursement, Data Collection and Reports	Clarifies content.
Appendix I	Epilepsy Program Definition of Income	Clarifies content.

Forms

The following forms were revised in the Epilepsy Program Policy Manual:

Form No.	Title	Change
Form 3094	Application for Program Benefits	Updates Application for Program Benefits.

24-3, Updates Section 4300

Revision 24-3; Effective May 1, 2024

The following changes(s) were made:

Revised	Title	Change
4300	Procedures and Terminology When Determining Epilepsy Eligibility	Updates Documentation of Residency and Calculation of Applicant’s Federal Poverty Level (FPL) Percentage tables with Fiscal Year 2024 changes.

24-2, Appendix II Revised

Revision 24-2; Effective March 1 2024

The following changes(s) were made:

Revised	Title	Change
Appendix II	Optional Copay Table Based on Monthly Federal Poverty Level (FPL)	Updates appendix with fiscal year 2024 Federal Poverty Level for program eligibility.

24-1, Miscellaneous Changes

Revision 24-1; Effective Jan. 8, 2024

The following change(s) were made:

Revised	Title	Change
4100	Eligibility and Assessment of Copay and Fees	Updates form numbers.
4200	Eligibility and Fees	Updates form numbers.
4300	Procedures and Terminology When Determining Epilepsy Eligibility	Updates form numbers.