Revision 20-2; Effective October 1, 2020

7510 Description

Revision 20-2; Effective October 1, 2020

The home-delivered meals benefit provides hot, nutritious meals that are delivered to the member's home. Meals provided by contracted agencies are approved by a dietitian consultant who is either a registered dietitian licensed by the Texas State Board of Examiners of Dietitians or has a baccalaureate degree with major studies in food and nutrition, dietetics or food service management.

7520 Provider Responsibilities

Revision 20-2; Effective October 1, 2020

Providers contracted to provide home-delivered meals must comply with the requirements of Texas Administrative Code (TAC), Title 40, Part 1, Chapter 55, Contracting to Provide Home-Delivered Meals.

Home-delivered meals are delivered to the member’s home as authorized by the managed care organization (MCO). The meal must be delivered directly to the member or responsible party. The MCO must require providers to ensure that the provider’s employee or volunteer delivering the meal report any member illnesses, potential threats to the member’s safety or observable changes in the member’s condition to the provider. The MCO must require the provider to notify the MCO orally within one business day and in writing within five business days from the report.

If the member or responsible party is not home to accept the delivery of a meal, the provider must comply with 40 TAC § 55.27(e).

The MCO must notify the provider prior to, or no later than, the day that meal services are suspended. The MCO must suspend services in any of the following situations:

  • The member enters an institution.
  • The member requests that services be suspended or terminated.
  • The member dies.
  • The MCO service coordinator directs the provider to suspend services.

Unless the interruption is the result of one of the above situations, the MCO must require the provider to obtain the MCO service coordinator's approval for service interruptions of more than two consecutive days. When the member requests that services be suspended and specifies a date for services to resume, the provider is not required to notify the MCO service coordinator.

7520.1 Frozen or Shelf-Stable Meals

Revision 20-2; Effective October 1, 2020

A provider that contracts with the managed care organization (MCO) to provide home-delivered meals must agree to provide services:

  • for a specific number of service days, with a minimum of five meals per week; and
  • to all eligible members in the service area unless services are suspended or the provider is unable to provide a certain therapeutic medical diet.

Providers of home-delivered meals must submit a waiver request to the MCO if the provider determines that delivery of frozen or shelf-stable meals is required for certain individuals within the provider’s contracted service area. Any waiver granted is effective for a period not to exceed one fiscal year. The provider must not implement the waiver for delivery of a hot meal five days a week before MCO approval of the waiver request.