The following information was obtained from the April 2 issue of the Texas Register:
HHSC proposes to repeal §355.746 and replace it with new §355.746, concerning Reimbursement Methodology for Mental Retardation (MR) Service Coordination. An excerpt:
“The providers in this program are currently paid a statewide interim rate which is then later cost-settled to each provider’s cost within certain parameters. Providers whose costs are less than 95 percent of the interim rate must repay the difference between their costs and 95 percent of the interim rate. Providers whose costs are more than the interim rate are paid an amount equal to their cost, up to 125 percent of the interim rate. The existing rate is based upon the provider’s cost using the State’s Time And Financial Information (TAFI) methodology and a time study. The Centers for Medicare and Medicaid Services (CMS) has indicated the TAFI may continue to be used in determining state plan rates for these programs; however, a time study is not required.
“The proposed new rule explains that HHSC will determine an initial rate based on the cost experience of the current MR Service Coordination program and the appropriations determined for the Home and Community-Based Services (HCS) case management services.”