(a) A contractor must have and maintain a license, certification, accreditation, or other documentation required of an applicant in §49.205 of this chapter (relating to License, Certification, Accreditation, and Other Requirements), except:
  (1) a contractor that has had a contract for the DBMD Program continuously since September 1, 1999, and that does not provide home health or personal assistance services is not required to have a HCSSA license issued in accordance with Chapter 97 of this title (relating to Licensing Standards for Home and Community Support Services Agencies) for a contract in effect on September 1, 2014; and
  (2) a contractor that has had a contract for AFC services in a four-bed home continuously since January 15, 2009, and that has an assisted living facility Type C license issued in accordance with Chapter 92 of this title (relating to Licensing Standards for Assisted Living Facilities) is not required to have an assisted living facility Type A or Type B license issued in accordance with Chapter 92 of this title.
(b) A contractor must complete any training required by HHSC as stated on the HHSC website before HHSC places a contract of the contractor on a choice list.
(c) A contractor must ensure that an employee, subcontractor, or volunteer can effectively communicate with an individual or LAR concerning service planning and the provision of services, which may require the contractor to provide an interpreter for the individual.
(d) Except as provided in HHSC rules governing services provided under the contract, a contractor must not allow an individual to perform services under the contract or perform other work that benefits the contractor.
(e) A contractor must comply with the terms of its contract, which requires compliance with applicable federal and state laws, rules, and regulations, including this chapter, rules governing services provided under the contract, and applicable reimbursement rules in 1 TAC Chapter 355 (relating to Reimbursement Rates).
(f) A contractor:
  (1) must accept the reimbursement rate for a service in effect at the time the service is provided as payment in full for performance under the contract; and
  (2) must not make an additional charge to the individual, any member of the individual's family, or any other source for supplementation for performance under the contract, unless specifically allowed by federal or state law, rule, or regulation.
(g) A contractor must:
  (1) subscribe to receive HHSC e-mail updates, using the link provided at the HHSC website and, for its contract, select the following categories:
    (A) information letters; and
    (B) provider alerts; and
  (2) be informed of the content of the e-mail updates.
(h) A contractor must notify HHSC of a change of ownership or change in legal entity in accordance with §49.210(a)(1) of this chapter (relating to Contractor Change of Ownership or Legal Entity).
(i) If there is a change to a contractor's physical, mailing, or e-mail address, as stated on the contractor's contract application packet or on a prior written notice of change to the information, the contractor must notify HHSC of the change and provide the new physical, mailing, or e-mail address:
  (1) at least 30 days before the address changes; or
  (2) if a natural or unforeseen disaster prevents compliance with paragraph (1) of this subsection, within three days after the change.
(j) If there is a change to the name of the signature authority, the contractor must notify HHSC of the change within 30 days after the change by submitting a new, fully executed HHSC "Governing Authority Resolution" form.
(k) If there is a change to the information regarding the applicant or a controlling person of the applicant being confirmed by DFPS or HHSC as having committed abuse, neglect, or exploitation, as stated on the contractor's contract application packet or on a prior written notice of change to the information, the contractor must notify HHSC of the change within three business days after the contractor or controlling person becomes aware of the change.
(l) If a controlling person of a contractor is convicted of any crime listed in §49.206 of this chapter (relating to Ineligibility Due to Criminal History), the contractor must notify HHSC within three business days after the contractor or controlling person becomes aware of the conviction.
(m) If a contractor files for bankruptcy, the contractor must notify HHSC within 14 days after filing.
(n) If a contractor or controlling person of a contractor is excluded in accordance with §§1128, 1128A, 1136, 1156, or 1842(j)(2) of the Social Security Act, the contractor must notify HHSC of the exclusion change within three business days after the contractor or controlling person becomes aware of the exclusion.
(o) If a contractor or a controlling person of a contractor becomes aware the contractor or controlling person is listed on any of the following, the contractor must notify HHSC within three business days after the contractor becomes aware of the listing:
  (1) the HHSC employee misconduct registry as unemployable;
  (2) the HHSC nurse aide registry as revoked or suspended;
  (3) the United States System for Award Management maintained by the General Services Administration;
  (4) the LEIE maintained by the United States Department of Health and Human Services, Office of Inspector General;
  (5) the LEIE maintained by the HHSC Office of Inspector General; or
  (6) the Debarred Vendor List maintained by the Texas Comptroller of Public Accounts.
(p) If there is a change to any of the information on the contractor's contract application packet or on a prior written notice of change to the information, other than the information referenced in subsections (i) - (o) of this section, a contractor must notify HHSC of the change and provide the new information within 14 days after the information changes.
(q) For a notice that a contractor is required to send to HHSC in accordance with this chapter, the contractor must ensure that the notice is:
  (1) in writing;
  (2) signed by the signature authority; and
  (3) sent to the HHSC mailing address or email address identified on the form "Contract Approval Letter" issued to the contractor when the contract was awarded.
(r) A contractor must allow HHSC and any authorized federal or state agency access to:
  (1) individuals;
  (2) employees, subcontractors, or volunteers of the contractor; and
  (3) any premises controlled by the contractor.
(s) A contractor must not pay for any item or service furnished, ordered, or prescribed by an individual listed on either LEIE described in §49.304(f)(1) of this subchapter (relating to Background Checks).

Source Note: The provisions of this §52.103 adopted to be effective September 1, 2014, 39 TexReg 6637; amended to be effective September 1, 2018, 43 TexReg 5230; transferred effective April 29, 2024, as published in the March 29, 2024, issue of the Texas Register, 49 TexReg 2091