(a) An individual or the individual's LAR may make a written or oral request to the LIDDA serving the area in which the individual resides for a review of an existing DID report or a diagnostic assessment that reflects current functioning to determine eligibility. An authorized provider may:
  (1) endorse the DID report;
  (2) endorse the diagnostic assessment report;
  (3) conduct additional testing to determine eligibility; or
  (4) conduct a new DID.
(b) Except as provided in subsection (d) of this section, if an individual has been determined to have an ID, ASD, or a related condition on the current HHSC-approved list of related conditions, by an authorized provider who is not employed by or contracting with the LIDDA at which the individual or the individual's LAR is seeking services, the LIDDA must ensure that:
  (1) the diagnostic assessment report is reviewed by an authorized provider employed by or contracting with the LIDDA; and
  (2) the authorized provider conducting the review interviews and observes the individual in-person or in real time using audio-visual technology.
(c) Except as provided in subsection (d) of this section, if an individual has been determined to have an ID, ASD, or a related condition on the current HHSC-approved list of related conditions, by an authorized provider who is not employed by or contracting with the SSLC at which the individual is receiving services, the SSLC must ensure that:
  (1) the diagnostic assessment report is reviewed by an authorized provider employed by or contracting with the SSLC; and
  (2) the authorized provider conducting the review interviews and observes the individual in-person or in real time using audio-visual technology.
(d) An authorized provider employed by or contracting with a LIDDA or SSLC:
  (1) may, but is not required to, endorse a DID conducted by another authorized provider employed by or contracting with a LIDDA or SSLC; and
  (2) must not endorse a DID that they conducted without adhering to endorsement requirements in subsections (b) - (c) of this section.
(e) If a diagnostic assessment report reviewed in accordance with subsection (b) or (c) of this section is endorsed by the authorized provider employed by or contracting with the LIDDA or SSLC as a valid reflection of the individual's current level of functioning, within 30 days after the review is completed:
  (1) the authorized provider must:
    (A) document the outcome of the review; and
    (B) inform the individual or the individual's LAR orally and in writing of the outcome of the review; and
  (2) the LIDDA or SSLC must inform the individual or the individual's LAR orally and in writing of the right to an administrative hearing to contest the determination of ID, as described in 40 TAC Chapter 4, Subchapter D (relating to Administrative Hearings under Texas Health and Safety Code, Title 7, Subtitle D).
(f) If a DID or other diagnostic assessment report reviewed in accordance with subsection (b) or (c) of this section is not endorsed by the authorized provider as a valid reflection of the individual's current level of functioning, the authorized provider must, within 30 days after the review is completed:
  (1) inform the individual or the individual's LAR orally and in writing of:
    (A) the outcome of the review; and
    (B) the opportunity to have an authorized provider employed by or contracting with the LIDDA or SSLC conduct a diagnostic assessment at no expense to the individual or the individual's LAR; and
  (2) the LIDDA or SSLC must inform the individual or the individual's LAR orally and in writing of the right to an administrative hearing to contest the determination of ID, as described in 40 TAC Chapter 4, Subchapter D.

Source Note: The provisions of this §304.403 adopted to be effective November 30, 2021, 46 TexReg 8062