4510 Home-Delivered Meals Description

Revision 19-13; Effective November 5, 2019

The home-delivered meals (HDMs) benefit provides hot, nutritious meals that are served in 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.

4520 Provider Responsibilities

Revision 19-13; Effective November 5, 2019

Home-delivered meals (HDMs) are delivered to the member’s home as authorized by the managed care organization (MCO). The individual delivering the meal reports any member illnesses, potential threats to his or her safety, or observable changes in the member’s condition to the provider. The provider must notify the MCO service coordinator about the report within 24 hours.

The provider also informs the MCO service coordinator whenever:

  • the HDM is found uneaten or untouched and the member cannot be found; or
  • the meals are repeatedly found to be uneaten or untouched.

This report must also reach the MCO within 24 hours of the event.

The MCO must notify the provider on the day that meals services are suspended. The MCO must suspend services in any of the following situations:

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

Unless the interruption is the result of one of the above situations, the provider must 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.

4520.1 Frozen or Shelf-Stable Meals

Revision 19-13; Effective November 5, 2019

A provider that contracts with the managed care organization (MCO) to provide home-delivered meals (HDMs) 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 HDMs 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.