The following information was obtained from the June 22 issue of the Texas Register.
Public Notice Correction
A notice in the June 8, 2012, issue incorrectly stated that an amendment changed the NorthSTAR behavioral health program enrollment period from 30 days to 15 days. The correct period is from 45 days to 15 days. See the Texas Register for details.
Withdrawn Rules
HHSC withdraws the emergency new §355.8201 and §355.8202, which appeared in the January 20, 2012, issue, effective July 1, 2012.
Adopted Rules
HHSC adopted an amendment to §354.1143, Coordination of Medicaid with Medicare Parts A, B, and C, which authorizes the agency to make higher cost-sharing payments for dual eligibles for certain services if it determines that it’s necessary to ensure adequate access to care or would be more cost-effective to the state.
HHSC also adopted new §355.8066, Hospital-Specific Limit Methodology. An excerpt:
Because of the dual role of the HSL in determining hospital reimbursement in both the DSH and Waiver programs, HHSC had proposed that language pertaining to the calculation of HSLs be removed from §355.8065(f) concurrently with the adoption of new §355.8066. In response to comments submitted pertaining to proposed changes to §355.8065, those changes are not being adopted at this time; instead, HHSC plans to delete language pertaining to the calculation of HSLs contained in §355.8065(f) at a future date. When that language is deleted, a single rule will govern the calculation of HSLs. Creation of this single rule will allow HHSC more flexibility in managing future changes to the HSL calculation as it applies to both the DSH program and the Waiver. In the interim, HHSC has added language to §355.8066(a) to state that if the language contained in §355.8066 conflicts with language contained in §355.8065(f), the language in §355.8066 will govern the calculation of the HSL. This change to proposed §355.8066 is being made as a result of comments made in regards to §355.8065.
See the Texas Register for more information.
- On DADS’ Behalf
Intellectual Disability Services–Medicaid State Operating Agency Responsibilities – Amendments to §9.203, Definitions, and §9.219, Provider Reimbursement, which states that DADS returns a claim identified as having a third-party possibly liable for payment and requires the provider to re-submit the claim with the information that results from billing the third party.
Nursing Facility Requirements for Licensure and Medicaid Certification – Amendment to §19.2609, in Chapter 19, Nursing Facility Requirements for Licensure and Medicaid Certification: see above.
Medicaid Hospice Program – Amendment to §30.60, in Chapter 30, Medicaid Hospice Program: see above.
Licensing Standards for Home and Community Support Services Agencies – Various amendments, new rules, and a repeal that require an HCSSA to report changes in certain information provided on an initial or renewal application after the license is issued and allow DADS to assess a fee for some of the reportable changes.
