Revision 19-1; Effective May 1, 2019
The following changes were made:
Chapter | Title | Change |
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1 | CRS Program Overview | Updates CRS contact information. |
1.2 | Referrals to CRS | Adds the referral form, process and contact information. |
3.2 | Language Services | Adds Language Services Standard for providers. |
3.4 | Facility Safety Protocol |
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4.5 | Staff Training | Adds Cardiopulmonary arrest (CPR), Basic Life Support (BLS) training and Fall Prevention. |
4.6 | Staff Qualifications | Adds qualification of Community Independence Supports (CIS). |
5.1 | Overview | Updates when and where to report incidents to CRS. |
5.3 | CRS Service Number | Adds ombudsman’s number and CRS email because CRS does not have a direct phone line. |
5.4 | Grievance Procedure | Updates ombudsman’s contact information. |
6.4 | Invoices |
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6.5 | Use of Comparable Benefits or Third Party Billing | Adds amount CRS pays if a participant is using their insurance's out of network provider. |
7.2 | Quality Reviews | Adds services that are billed and paid based on services and contracted rate. |
8 | Compliance and Quality Review for Traumatic Brain Injury | Changes Utilization Review to Compliance and Quality Review. |
8.2 | Review Types |
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8.4 | Prospective Reviews | Changes title to Clinical Reviews and adds detail of what a clinical review covers. |
8.5 | Concurrent and/or Retrospective Reviews | Changes title to Purchasing Reviews and adds detail of what a clinical review covers. |
9.1 | Overview |
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9.2 | Intake Process | Adds information that providers must have participants sign an intake acknowledgement form and must place the form in the participant’s file. |
10.2 | Assessment |
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10.3 | Development of Individualized Service Plan | Adds this section. |
10.4 | Interdisciplinary Team Meetings |
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10.5 | Behavior Management Plans |
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10.6 | Emergency Restrictive Procedures | Adds procedure for minors who receive chemical or physical restraints more than once within 30 days. |
11.2 | Required Documentation | Adds that PM&R physician overseeing the participant’s care while in ICMRS is a separate service requiring pre-authorization. |
11.3 | Assessment, Planning and Interdisciplinary Meetings | Adds Assessment, Planning and Interdisciplinary Meetings section. |
11.4 | Billing Guidelines | Updates billing guidelines and when invoices must be submitted. |
12.1 | Overview | Clarifies what outpatient therapy services refer to and where they are referenced. |
12.3 | Assessment, Planning and Interdisciplinary Meetings |
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12.4 | Billing Guidelines | Updates billing guidelines and when invoices must be submitted. |
13.1 | Overview | Adds link for updated rates. |
13.2 | Required Documentation | Adds information for providers about required documentation. |
13.3 | Assessment and Planning |
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13.6.1 | Licensure and Accreditation | Changes Department of Aging and Disability Services to Texas Health and Human Services. |
13.6.7 | Utilization Review | Removes this section. |
13.6.7 | Exceptions and Limitations | Updates therapeutic passes. |
13.7 | Non-Residential | Adds post-acute rehabilitation non-residential services to also include case management, community independence supports, medical team conferences. |
13.7.1 | Licensure and Accreditation | Changes Department of Aging and Disability Services to Texas Health and Human Services. |
13.7.3 | Billing Guidelines | Adds uploading into CRS Data Reporting System. |
14.1 | Overview | Adds information about meeting treatment goals. |
14.2 | Durable Medical Equipment | Adds this section. |
14.3 | Home Modification | Adds this section. |
14.4 | Required Documentation | Adds requirements for receiving durable medical equipment. |
14.5 | Billing Guidelines | Updates billing guideline requirements for providers for ancillary goods and services and DME. |
14.6 | Exceptions and Limitations | Updates this section with what is covered under the CRS program as well as when competitive bids are required. |
15.1 | Overview | Adds information about discharge planning. |
15.3 | Termination from Program | Adds information about providers documenting attempted interventions. |
Appendix A | Definitions | Adds the following terms:
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Appendix B | Post-Acute Rehabilitation Core Services Modality and Staff Qualifications |
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Appendix C | Base Services and Tier Structure | Changes title to PARS Residential Base Services and Tier Structure |
Appendix D | Service Record for CRS Data Reporting System | Adds clarification text. |