The following information was obtained from the December 24 issue of the Texas Register:
Public Hearings and Notices
HHSC proposes the following per diem reimbursement rates for the DADS-operated, non-state-operated ICF/MR program, effective February 1, 2011. HHSC also proposes the following per diem reimbursement rates for the DADS-operated NF program, effective February 1, 2011. See the Texas Register for details about each proposed rule.
HHSC will hold a public hearing, “Medicaid Managed Care Stakeholder Forum of the Expansion of STAR+PLUS,” in the Tarrant Service Area on January 13, 2011, from 9-11 a.m., at the Texas Health Resources Corporate Office, Executive Conference Hall, 7th Floor, 612 E. Lamar Blvd, in Arlington.
HHSC will hold a public hearing, “Medicaid Managed Care Stakeholder Forum of the Expansion of STAR+PLUS,” in the Dallas Service Area on January 13, 2011, from 1-3 p.m. at the Texas Health Resources Corporate Office, Executive Conference Hall, 7th Floor, 612 E. Lamar Blvd, in Arlington.
See the Texas Register for contact information.
HHSC will conduct the following Medicaid payment reduction hearings next month:
January 7 @ 8 a.m.: Clinical Laboratory Services (non-state entities), Freestanding Psychiatric Facilities (non-state entities), Renal Dialysis Facilities, Ambulatory Surgical Centers/Hospital Based Ambulatory Surgical Centers, Hospital Outpatient Medicaid Services and Inpatient Hospital Services.
January 7 @ 10 a.m.: NF program and the Out-of-Home Respite in a NF and CDS Out-of-Home Respite in a NF services in the CBA and ICM HCSSA and AL/RC waiver programs, the Out-of-Home Respite in a NF and CDS Out-of-Home Respite in a NF services in the CWP, and the Out-of-Home Respite service in the MDCP program.
January 7 @ 11 a.m.: Non-state operated ICF/MR program and the HCS and TxHmL waiver programs and the Out-of-Home Respite in an ICF/MR, CDS Out-of-Home Respite in an ICF/MR and 24-Hour Residential Habilitation services in the CWP and the Supported Employment and Employment Assistance services in the DBMD waiver program.
January 7 @ 1 p.m.: Ambulance Services; Case Management for Pregnant Women; Early and Periodic Screening, Diagnosis and Treatment Services, including Medical Checkups, Private Duty Nursing, and Therapies in a Comprehensive Outpatient Rehabilitation Facility/Outpatient Rehabilitation Facility (but not including Personal Care Services); Family Planning Services; Home Health Services, including Professional Services and Durable Medical Equipment and Expendable Supplies, etc. See the full list here.
All hearings will be held in the Brown-Heatly Building Public Hearing Room, 4900 North Lamar Boulevard, Austin, Texas. For details and contract information, see the Texas Register.
Earlier this month, state agencies were asked to identify savings of their original general revenue and general-dedicated-appropriations for fiscal year 2011. Medicaid provider reimbursements are proposed to be reduced by one percent.
HHSC intends to submit amendments to reduce Medicaid reimbursement rates for Clinical Laboratory Services, Freestanding Psychiatric Facilities and Ambulatory Surgical Centers. Hospital Outpatient Medicaid Services, Renal Dialysis Facilities, Ambulance Services, Case Management for Pregnant Women, Early and Periodic Screening, Diagnosis and Treatment Services, and other programs. For the full list, see the Texas Register.
HHSC will submit an amendment that would reduce the add-on percentage to the Medicare Economic Index from 1.5 percent to 0.5 percent, and add language instructing providers to reselect their reimbursement methodology once a change to the methodology has been made.
Finally, HHSC will submit amendments that would modify the reimbursement methodologies in the State Plan NFs and non-state ICFs/MR. See the Texas Register for more information.
Proposed Rules
The Texas Medical Board proposes to amend §185.4, concerning Procedural Rules for Licensure Applicants, and §185.6, concerning Annual Renewal of License. Changes would correct the name for the Accreditation Review Commission on Education for the Physician Assistant, Inc., and a rule citation. Changes to §185.6 would provide that CME may be approved by the board for course credit.
The Texas Medical Board proposes amendments to §§187.8, 187.14, 187.27, 187.55, and 187.59, concerning Procedural Rules. Among other things, changes would establish that the party requesting the Board to issue a subpoena in relation to a case filed at the State Office of Administrative Hearings is responsible for accomplishing service of the subpoena.
See the Texas Register for details about each proposed change.
Adopted Rules
HHSC adopted an amendment to §355.508, concerning Reimbursement Methodology for Transition Assistance Services, which adds Transitional Services from the YES waiver to the list of services included in the reimbursement methodology for Transition Assistance Services.
HHSC adopted an amendment to §358.107, concerning coverage groups, in Chapter 358, Medicaid Eligibility for the Elderly and People with Disabilities, which adds the Medicaid Buy-In for Children program to the list of Medicaid-funded programs for the elderly and people with disabilities covered under the Texas State Plan for Medical Assistance.
Finally, HHSC adopted new §361.101, concerning overview and purpose; §361.103, concerning definitions; §361.105, concerning applying and providing information; §361.107, concerning nonfinancial requirements; §361.109, concerning third-party resources; §361.111, concerning income; §361.113, concerning employer-sponsored health insurance; §361.115, concerning cost sharing; §361.117, concerning notice of eligibility determination and right to appeal; and §361.119, concerning medical effective date, in Chapter 361, Medicaid Buy-In for Children Program (MBIC).
Among other things, the changes place in rule the eligibility requirements for MBIC. See the Texas Register for more information.
The Texas Board of Nursing adopted amendments to §214.2 (relating to Definitions), §214.3 (relating to Program Development, Expansion, and Closure), §214.4 (relating to Approval), §214.5 (relating to Philosophy/Mission and Objectives/Outcomes), §214.6 (relating to Administration and Organization), §214.7 (relating to Faculty), §214.8 (relating to Students), and §214.9 (relating to Program of Study). Among other things, the changes are necessary to clarify several of the existing definitions within the section and to add a new definition of “simulation.”
The board adopted amendments to §215.2 (relating to Definitions); §215.3 (relating to Program Development, Expansion, and Closure), §215.4 (relating to Approval), §215.5 (relating to Philosophy/Mission and Objectives/Outcomes), §215.8 (relating to Students), and §215.9 (relating to Program of Study), which are necessary to :clarify definitions within the chapter; (ii) emphasize the importance of faculty supervised, hands-on patient care in clinical practice; (iii) clarify the Board’s ability to change a nursing education program’s level of approval status; (iv) correct typographical errors; and (v) eliminate redundant and contradictory language within the chapter.”
For more information about Board of Nursing rule changes, see the Texas Register.
HHSC adopted amendments to §41.103 in Subchapter A, Introduction; §41.239 and §41.241 in Subchapter B, Responsibilities of Employers and Designated Representatives; and §41.335 in Subchapter C, Enrollment and Responsibilities of CDSA, in Chapter 41, CDS Option, which revise documentation requirements to allow an employer and a consumer directed services agency to document services in accordance with the Electronic Visit Verification (EVV) system.
HHSC also adopted new Chapter 68, §§68.101 – 68.103, concerning EVV, which requires a DADS contractor providing certain services and a CDS option participant receiving certain services to use an EVV system approved by DADS.
For more information about changes to EVV rules, see the Texas Register.
