1. (a) To be approved by HHSC as a provider, an applicant must:

   1. (1) not be listed on the HHSC Office of Inspector General's Excluded Individual/Entities nor on the U.S. HHS Office of Inspector General List of Excluded Individuals/Entities (LEIE);

   2. (2) complete:

      1. (A) a pre-planning process with HHSC that includes a review of case manager qualifications listed in §257.19 of this subchapter (relating to Case Manager Qualifications) and an overview of case management activities as listed in §257.21 (Case Manager Responsibilities); and
      2. (B) the HHSC standardized case management training provided by HHSC; and

   3. (3) agree to:

      1. (A) employ or contract with one or more case managers who each meet at least one of the qualifications listed in §257.19 of this subchapter (relating to Case Manager Qualifications); and

      2. (B) comply with:

         1. (i) the rules, policies, and procedures of HHSC relating to Case Management for Children and Pregnant Women; and
         2. (ii) applicable state and federal laws governing participation of providers in the Medicaid program and enrollment as a state Medicaid provider.
2. (b) HHSC notifies an applicant that complies with subsection (a) of this section whether HHSC approves the applicant's enrollment to be a Medicaid provider of Case Management for Children and Pregnant Women services.

Source Note:The provisions of this §257.15 adopted to be effective May 29, 2025, 50 TexReg 3129.