The following was obtained from the August 19 issue of the Texas Register:
Public Notices
HHSC intends to submit amendments to the Texas State Plan for Medical Assistance, which would modify the reimbursement methodologies and reduce Medicaid fees as detailed below:
- Birthing Centers: 5 percent
- Case Management for Children and Pregnant Women: 5 percent
- Durable Medical Equipment Prosthetics, Orthotics, and Supplies (DMEPOS): various percentages averaging 10.5 percent
- Early and Periodic Screening, Diagnosis and Treatment: select services 5 percent
- Family Planning: 5 percent
- Hearing and Audiometric Evaluations: various percentages averaging 10.5 percent
- Home Health Services (DMEPOS) various percentages averaging 10.5 percent
- Tuberculosis Clinics: 5 percent
- Vendor Drug Dispensing Fee, fixed component of the fee: Reduced to $6.50
HHSC intends to submit a similar amendment to modify the reimbursement methodologies and reduce Medicaid fees as detailed below:
- Clinical Laboratory Services (non-state entities) – Implements a 10.5% rate reduction
- Freestanding Psychiatric Facilities (non-state entities) – Implements an 8% rate reduction
- Ambulatory Surgical Centers/Hospital Based Ambulatory Surgical Centers (ASC/HASC) – Implements an 5% rate reduction
- Hospital Outpatient Medicaid Services – Implements an 8% rate reduction, reduces payments for non-emergency services provided in an emergency room, and institutes a fee schedule for imaging services
- Renal Dialysis Facilities – Implements a 5% rate reduction
- Inpatient Hospital Services – Implements an 8% rate reduction, modifies the calculation of the standard dollar amount (SDA), and reduces the percent used in the computation of outlier payments as well as the change that hospitals in counties with 50,000 or fewer persons and certain other hospitals interim reimbursement will be based on cost-reimbursement methodology described in the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA).
See the Texas Register for more information.
Emergency Rules
The Texas Medical Board is renewing the effectiveness of the emergency adoption of the amendment to §187.83, for a 60-day period. See the Texas Register for details.
Proposed Rules
HHSC proposes to amend §355.8241, Medicaid reimbursement methodology for chemical dependency treatment facilities, to delete references to the Texas Commission on Alcohol and Drug Abuse (TCADA). On September 1, 2004, TCADA became a part of the Texas Department of State Health Services. The amendment also replaces an obsolete reimbursement methodology with a revised reimbursement methodology that reflects current rate determination practices.
HHSC also proposes to amend §355.8600, Medicaid Reimbursement for Ambulance Services, to allow for cost reconciliation and cost settlement based on total allowable Medicaid costs.
For details on these proposed rules, see the Texas Register.
The Texas Board of Nursing proposes to amend §223.1, Fees, to increase renewal fees for professional nurses to $73.
