1. (a) Service coordination may be funded by:

   1. (1) personal funds or third-party insurance other than Medicaid;
   2. (2) Medicaid targeted case management; or
   3. (3) general revenue.

2. (b) Service coordination funded by Medicaid targeted case management:

   1. (1) may be provided only to an individual who is a Medicaid recipient and only if:

      1. (A) the individual meets at least one of the criteria described in §331.7(a)(1)(A) - (D) of this chapter (relating to Eligibility); or
      2. (B) the individual meets the criteria described in §331.7(a)(1)(E) or (a)(2) of this chapter and the service coordination is provided during the last 180 days before the individual transitions to community-based services from an ICF/IID or a nursing facility; and

   2. (2) may not be provided to an individual:

      1. (A) who resides in an institution for mental diseases; or
      2. (B) who is enrolled in a Medicaid waiver program other than the HCS or TxHmL Program.

Source Note:The provisions of this §331.9 adopted to be effective June 1, 2010, 35 TexReg 4439; amended to be effective March 20, 2016, 41 TexReg 1864; transferred effective July 1, 2022, as published in the Texas Register June 3, 2022, 47 TexReg 3275; amended to be effective October 19, 2025, 50 TexReg 6669.