Pursuant to Tex. Code Crim. Proc. Art. 56.385, the OAG may review all bills and requests for reimbursements for health care services before making a compensation payment to determine if the services were medically necessary subject to the following provisions:

1. (1) Medically necessary services are those that cure or relieve the effects naturally resulting from the injury; that promote recovery; and that enhance the victim's or claimant's ability to return to pre-crime health status.
2. (2) Health care services provided as maintenance for wellness and prevention of disease or to maintain or prevent deterioration of a chronic condition will be considered maintenance health care services that are not eligible for reimbursement. Clinical improvement must be documented and care must be corrective, not supportive as reflected by the treatment plan.
3. (3) The OAG must be able to properly verify information as submitted to determine if the health care services were medically necessary. Unless the OAG has made a determination that extenuating circumstances exist, the OAG will not process bills and requests for reimbursements for health care services that are received five years after the date of service. For child victim treatment reimbursement up to the patient's 21st birthday, medical records will need to be secured and submitted by the requestor for consideration of payment.

Source Note:The provisions of this §61.508 adopted to be effective May 8, 2005, 30 TexReg 2491.