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Note:  This document has been delivered to the Office of the Federal Register but has not yet been scheduled for publication.  The official version of this document is the document that is published in the Federal Register.

for parents, the Department’s position is that States must

have flexibility in determining the system of payments, including any fee structure.

However, the State’s fee structure is subject to the

requirements in §303.521(a), which requires that families

not be charged more than the actual cost of the Part C

service and that a parent’s inability to pay will not

result in a delay or denial of services under this part. We also expect to provide additional technical assistance and guidance to States on State system of payments.

Changes: None.

Comment: Two commenters recommended that we revise

§303.521(a) to require that States provide families with an

explanation of each item that is billed to them or to their insurance to ensure that the parents can confirm that the charges match the level or amount of service provided to children and their families.

Discussion: Part C of the Act does not address the methods that States must use to bill parents for Part C services. However, many lead agencies have developed policies and procedures regarding billing parents for Part C services. With regard to insurance billing, lead agencies may, but are not required under Part C of the Act to, develop methods or a process to inform a parent of each item billed