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New Parental Accompaniment Rules

HHSC has adopted new rules requiring a parent, guardian or another adult selected by the parent to accompany a child age 14 or younger while the child is getting a Medicaid service, including transportation services.  The state will begin enforcing this new rule on April 1, 2013.

The rule allows parents or guardians to select another adult to accompany their child to a Medicaid appointment or on a ride provided by the Medical Transportation Program. The rules prohibit the authorized adult from being paid by or affiliated with the Medicaid provider billing for the service.

To view the new rules:

What does this mean for Medicaid and transportation providers?

  • If you or your employees serve as the authorized adult for a child for whom you are providing services, you will not be reimbursed for those services starting April 1, 2013. 

  • Please review the definition of affiliate in section 354.1133 to ensure compliance with the rules. If you allow a person affiliated with you or your organization to serve as the authorized adult for a child for whom you are providing services, you will not be reimbursed for those services starting April 1, 2013.

  • Medicaid providers are encouraged to review their responsibilities under section 33.6 of Title 25, Part 1 of the Texas Administrative Code which includes the providers’ responsibility to assure that a parent, guardian or authorized adult who accompanies a client age 14 or younger to a visit continue to wait while the check-up or treatment takes place.

  • Parents or guardians who need to designate an adult to accompany their child to services can do so by completing the Parent Authorization Form.