The following information was obtained from the October 29 issue of the Texas Register:
Public Notices
HHSC intends to submit amendments to the Texas State Plan for Medical Assistance, which would amend the payment methodology for inpatient hospital services to rebase the payment division standard dollar amounts and diagnosis related group factors with more recent cost data.
HHSC will hold a public hearing on November 4, 2010 from 10-11 a.m. to receive comments on the proposed amendment to §353.601 to Title 1, Part 15, Chapter 353, Subchapter G, STAR+PLUS, General Provisions, Member Participation, Participating Providers, and STAR+PLUS Handbook. The hearing will be held in the Lone Star Conference Room.
See the Texas Register for details.
Proposed Rules
HHSC proposes to amend several sections of the code:
Medicaid Managed Care (“to reflect the current program description and member participation guidelines and to update the geographic locations where the program is available”)
Medicaid Health Services (“clarifies the process HHSC follows to demonstrate that a provider is out of business and the debt is uncollectible”)
Reimbursement Rates (“adds language allowing appropriate actuarial adjustments to the PACE upper payment limit (UPL) methodology to account for statistical outliers, small populations, programmatic changes, catastrophic events, or other economic changes”)
Medicaid Buy-In Program – (implements new federal law related to cost sharing exemptions for certain MBI recipients and aligns the MBI program cost sharing policy with the MBIC program cost sharing policy”)
Adopted Rules
HHSC adopted an amendment to Title 1, Part 15, Subchapter J, Division 4, §355.8052, concerning Inpatient Hospital Reimbursement, which updates the Medicaid inpatient hospital reimbursement methodology for state fiscal year 2011. For more information, see the Texas Register.