The following was obtained from the February 24 issue of the Texas Register:
Adopted Rules
HHSC adopted new §351.507, adverse licensing, listing, or registration decisions by HHS agencies, which authorizes each HHS agency to consider adverse decisions made by other HHS agencies when considering an application or renewal filed with that agency by another agency’s licensee. See the Texas Register for details.
HHSC adopted amendments to §§353.1 – 353.5, Medicaid managed care general provisions, §§353.101, 353.102, 353.104, and 353.105, provider and member education programs, §§353.201 – 353.203, member bill of rights and responsibilities, §§353.403, 353.405, 353.407, 353.409, 353.411, 353.413, 353.415, 353.417, 353.419, and 353.421, standards for Medicaid managed care, and §§353.601, 353.603, 353.605, and 353.607, the STAR+PLUS program; adopts the repeal of §§353.701 – 353.703, the Integrated Care Management program; adopts new §353.701 and §353.702, the STAR Health program; and adopts new §353.801 and §353.802, the STAR program, in Chapter 353, Medicaid Managed Care. An excerpt:
The amendments, new rules, and repeals are adopted to comply with certain provisions of Senate Bill 7 (S.B. 7), 82nd Legislature, First Called Session, 2011, and to comply with the cost-saving initiatives in the 2012-13 General Appropriations Act (Article II, Health and Human Services Commission, House Bill 1, 82nd Legislature, Regular Session, 2011).
Section 1.02 of S.B. 7, in part, required HHSC to determine the most cost-effective alignment of Medicaid managed care service delivery areas in Texas and removed the prohibition against health maintenance organization (HMO) service delivery in the South Texas counties of Cameron, Hidalgo, and Maverick. To comply with the Legislature’s direction regarding the statewide expansion of the Medicaid managed care program, HHSC sought a waiver under Section 1115 of the federal Social Security Act (42 U.S.C. §1315) (1115 waiver), which was approved by the Centers for Medicare and Medicaid Services (CMS) on December 12, 2011.
HHSC adopted amendments to §354.1189, the acute care Medicaid billing coordination system; §354.1416, eligibility criteria for the Texas Medicaid Wellness Program; and §354.1417, definitions for the Texas Medicaid Wellness Program, in Chapter 354, Medicaid Health Services, to conform to changes to adopted amendments and new rules in Chapter 353 of this title, published elsewhere in this issue of the Texas Register. See the Texas Register for details.
HHSC adopted an amendment to §357.1, definitions for its uniform fair hearing rules, to conform to other changes in Chapter 353 of this title. For more information, see the Texas Register.
HHSC adopted amendments to §§370.1, 370.4, and 370.10, CHIP administration; §370.21 and §370.49, application screening, referral, processing, renewal, and disenrollment; §§370.301, 370.303, 370.305, 370.307, 370.321, and 370.325, enrollment, renewal, disenrollment, and cost sharing in CHIP; §370.452 and §370.454, CHIP provider requirements; and §§370.501, 370.502, 370.504, and 370.505, special investigative units; adopts the repeal of §370.451, definitions; and adopts new §370.311, disenrollment; new §370.455, provider complaints and appeals processes; new Subchapter G, standards for CHIP managed care, consisting of §370.601 and §370.602; and new Subchapter H, outpatient pharmacy services, consisting of §370.701.
The changes conform to rules adopted in Chapter 353 of this title. For more information, see the Texas Register.