1. (a) A recipient receives notices when placed on limited status. The recipient may designate a provider from a list of physicians or pharmacists provided by the Texas Department of Health (department). If the recipient's choice is not received by the department within 20 business days of the date on the letter, the department designates a provider for the recipient. Recipients have the right to request a change of a provider.
2. (b) In accordance with federal requirements, the department ensures reasonable access to Medicaid services. Recipients who are on limited status may receive emergency care services for an emergency medical condition. Providers other than the designated providers may provide the emergency care services. The emergency care provider must certify that the recipient required emergency care services for an emergency medical condition. The program also reimburses providers to whom the recipient has been referred by his or her designated primary physician provider.
3. (c) In accordance with federal and state regulations, the department gives timely and adequate notice of the action to limit the recipient to a designated provider and an opportunity for a fair hearing. If a hearing is requested, the procedures described in Chapter 1 of this title (relating to Texas Board of Health) apply.

Source Note:The provisions of this §354.2407 adopted to be effective April 2, 2000, 25 TexReg 2817; transferred effective September 1, 2001, as published in the Texas Register May 24, 2002, 27 TexReg 4563.