The following was obtained from the August 26 issue of the Texas Register:
Public Notice
HHSC issued an amended public notice of intent to seek a waiver from CMS to expand the STAR+PLUS program. An excerpt:
The waiver request, in its final form, is now available to the public, as described below. HHSC is publishing this amended notice to alert interested parties that the comment period will remain open to take comments on the waiver request until 5:00 p.m., August 31, 2011.
The waivers relate to the transition of all current STAR and STAR+PLUS areas, the inclusion of 28 additional counties effective September 1, 2011, and the phase-in of more counties effective March 1, 2012. The counties are listed in the table below.
The waiver request would allow expansion of Medicaid managed care throughout Texas by maintaining historic local contributions to Medicaid for hospitals currently receiving upper payment limit payments. If approved, acute care benefits will be administered statewide through managed care. Other Medicaid services and long-term services and supports will be available in specific counties.
Proposed Rules
HHSC proposes new Division 27 in Chapter 354, Subchapter A, §§354.1361 – 354.1364, Women’s Health Program (WHP). Among other things, the changes would restrict applicability of the proposed new division to the WHP and define the terms “affiliate,” “corporate entity,” “elective abortion,” “health clinic,” “HHSC,” “promotes,” and “Women’s Health Program.” See the Texas Register for details.
- On DADS’s Behalf
HHSC proposes to repeal Subchapter C, §§8.51 – 8.63, Life-Sustaining Treatment, in Chapter 8, Client Care–Mental Retardation Services, to remove rules regarding life-sustaining treatment in state supported living centers.
HHSC proposes new §9.229, concerning critical incident reporting, and amendments to §9.238, concerning level of care I criteria, and §9.239, concerning ICF/MR level of care VIII criteria, in Chapter 9, Mental Retardation Services–Medicaid State Operating Agency Responsibilities, Subchapter E, ICF/MR Programs–Contracting. The changes would require ICF/MR providers to report data related to critical incidents, which would help DADS report certain information to HHSC annually.
HHSC proposes to amend §49.1, concerning definitions, in Subchapter A, Definitions; an amendment to §49.12, concerning general requirements for participation, and the repeal of §49.19, concerning advertising and solicitation of clients, in Subchapter B, Contractor Requirements; and an amendment to §49.61, concerning sanctions, in Subchapter F, Sanctions and Terminations, in Chapter 49, Contracting for Community Care Services, which would remove references to solicitation from Chapter 49 and update references to Texas Department of Human Services to reflect agency name changes to DADS.
For more information about each rule proposed on DADS’ behalf, see the Texas Register.
Withdrawn Rules
HHSC has withdrawn proposed amendments to §§48.6002, 48.6040, 48.6050, and 48.6078 which appeared in the July 1, 2011, issue of the Texas Register (36 TexReg 4098).
Adopted Rules
HHSC adopted amendments to §355.723, Reimbursement Methodology for HSC and TxHmL programs, which establishes the reimbursement methodology.
HHSC adopted amendments to §355.7103, Rate-Setting Methodology for 24-Hour Residential Child-Care Reimbursements, to delete the rate end date currently in the rule.
HHSC adopted the repeal of §355.8052, Medicaid Inpatient Hospital Reimbursement; and adopted new §355.8052, Medicaid Inpatient Hospital Reimbursement, which describes the new prospective payment system applicable to Medicaid inpatient hospital payments.
HHSC adopted new §355.8055, Reimbursement Methodology for Rural and Certain Other Hospitals, which describes the Medicaid methodology for reimbursing rural hospitals, rural referral centers, sole community hospitals, and critical access hospitals.
HHSC adopted an amendments to §355.8061, Payment for Hospital Services, to reorganize and clarify subsection (a)(2) and to change Medicaid payment methodology in two areas: (1) non-emergency services provided in an emergency department (ED); and (2) imaging services.
HHSC adopted amendments to §355.8551, concerning the dispensing fee for Medicaid pharmacy services reimbursement, to remove the reimbursement rate component fee amounts for the pharmacy dispensing fee, clarify terms in the dispensing fee formula, and add definitions for the components of the formula.
HHSC adopted the repeal of §370.47, State Kids Insurance Program (SKIP) to abolish it and allow children of qualifying state employees to enroll in the Children’s Health Insurance Program.
Finally, HHSC adopted amendments to §372.956, concerning the expedited Supplemental Nutrition Assistance Program (SNAP) application process; and the repeals of §§372.1201 – 372.1204, concerning finger-imaging requirements. The changes remove references to the finger-imaging requirement for Temporary Assistance to Needy Families and SNAP households from HHSC’s rule base in compliance with recent legislative direction.
For more information on each adopted rule, see the Texas Register.
- On DADS’s Behalf
HHSC adopted an amendment to §48.6026, in Chapter 48, Community Care for Aged and Disabled, to require an HCSSA contracting with DADS to provide CBA services to maintain licensure in the licensed home health services category and permit the provider to maintain licensure in the personal assistance services category to provide CBA personal care tasks that do not require nurse delegation or supervision, including the assignment of health maintenance activities. See the Texas Register for details
