DADS adopted new reimbursement rates for the following:
- Nursing Facility Payment Rates for State Veterans Homes
- Non-State Operated ICF/MR
- Nursing Facilities
HHSC announced a contract award to the Public Consulting Group, total value $50,000 plus contingency fee. For more information, see the Texas Register.
HHSC will hold a public hearing on August 17, 2010, at 1:30 p.m., to receive comment on proposed Medicaid payment rate for the following (all take place in Lone Star Conference Room):
- Indian Health Services
- Family Planning Providers
- Notice 1st and 2nd Quarter Healthcare Common Procedure Coding System
- Nutritional (Enteral) Products, Supplies, And Equipment – Comprehensive Care Program
- Total Parenteral Nutrition
- Birthing Center Services
Public hearing on August 18, 2010, at 1 p.m.:
HHSC intends to submit Amendment 944, Transmittal Number TX 10-051, to the Texas State Plan for Medical Assistance, under Title XIX of the Social Security Act, which would cover certain pharmacy supplies as part of the home health benefit that may be provided by a licensed pharmacy provider. HHSC will also submit to CMS a waiver amendment for the State of Texas Access Reform PLUS (STAR+PLUS) program. See the Texas Register for details.
Adopted Rules
HHSC adopted new rules to the Medicaid Health Services and Reimbursement Rates sections.
HHSC adopted new §354.1063, Preventable Adverse Events, relating to denied or reduced reimbursement for services associated with preventable adverse events. SB 203 requires the adoption of rules regarding the denial or reduction of Medicaid reimbursement for preventable adverse events, sometimes referred to as “never events” that occur in a hospital setting.
HHSC adopted new §354.1070, Definitions, and amended §354.1071, Additional Claim Information Requirements, and §354.1072, Authorized Inpatient Hospital Services, relating to present-on-admission requirements, preventable adverse events, and potentially preventable readmissions, as required by SB 203.
HHSC adopted amendments to §355.8021, concerning Reimbursement Methodology for Home Health Services and Durable Medical Equipment, Prosthetics, Orthotics and Supplies, which, among other things, describes the reimbursement methodology utilized to calculate Medicaid payment rates for therapy, nursing, and aide services for home health agencies. It also updates the list of sources that may be used to determine payment rates for these providers.
