The following information was obtained from the July 29 issue of the Texas Register.
Public Hearings
HHSC will hold a public hearing on July 18, 2012, at 1 p.m. to receive comment on proposed payment rates DAHS in the CBA and MDCP waiver programs. At 2 p.m., HHSC will hear public comment on proposed rates under foster care redesign for Single Source Continuum Contractors that provide services in the 24-Hour Residential Child Care program.
The hearings will be held in the Lone Star Conference Room, Braker Center, Building H, located at 11209 Metric Blvd, in Austin. See the Texas Register for more information.
Proposed Rules
HHSC proposed new §354.1133, parental accompaniment requirement for the Medical Transportation Program (MTP) and Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services, which would clarify and confirm HHSC’s policy requiring a parent, a guardian, or another authorized adult to accompany a child who receives an EPSDT (“Texas Health Steps”) or who receives a service or benefit provided by MTP.
HHSC also proposed to amend §380.207, program limitations in the MTP operated under Chapter 380. See the previous entry for more information. For details about each proposed rule, see the Texas Register.
- On DADS’ behalf
HHSC proposed new rules §48.2916, DAHS activity under §1915(i) or Title XX of the Social Act, and §48.6033, DAHS; and amendments to §48.2915, DAHS; §48.6002, CBA definitions; §48.6011, Provider Claims Payment; §48.6040, RN delegation of nursing tasks; §48.6050, service array for HCSS; §48.6082, mutually exclusive services; §48.6084, service limits and claim limits; §48.6088, required documentation for service delivery; and §48.6090, fiscal monitoring and recoupment, in Chapter 48, Community Care for Aged and Disabled. Among other things, the new rules add DAHS as a waiver service to the CBA program. See the Texas Register for details.
HHSC proposed to amend §51.231, service limitations; §51.411, general service delivery requirements; §51.413, response to service authorization; §51.509, claims and service delivery records; §51.511, billable time and activities; and new §51.481, DAHS in Chapter 51, Medically Dependent Children Program. Among other things, the new rules add DAHS as a waiver service in MDCP. For more information, see the Texas Register.
Finally, HHSC proposed to amend §98.2, definitions; §98.201, eligibility requirements for participation; §98.206, program requirements; §98.207, suspension of DAHSSAHS; §98.211, billing and payment; and new §98.203, referral, authorization, and initiation of services under §1902, §1915(i), or Title XX of the Social Security Act; §98.204, authorization and initiation of services for individuals applying for or receiving DAHS through CBA or MDCP; §98.205, DAHS facility-initiated referrals; and the repeal of §98.203, written referrals for services; §98.204, DAHS facility initiated referrals; and §98.205, initiation of services, in Chapter 98, Adult Day Care and Day Activity and Health Services Requirements. An excerpt:
The proposal includes several key changes regarding DAHS. For all individuals, a DADS case manager will conduct an initial face-to-face evaluation and assessment of an individual to determine eligibility for DAHS; currently the DADS regional nurse determines eligibility based on information provided by the DAHS facility. For individuals receiving DAHS under §1915(i) or Title XX, a DADS case manager will conduct an annual reassessment to determine ongoing eligibility; current rules do not require an annual reassessment. For individuals receiving DAHS under §1915(i) or Title XX, the DAHS facility is required to obtain annual physician orders; current rules do not require such orders. The proposal also requires a DAHS facility to maintain seatbelts in all vehicles manufactured with seatbelts, include safety restraints for wheelchairs in all vehicles, and properly operate and maintain wheelchair lifts.
Adopted Rules
HHSC adopted amendments to §353.2, definitions, and §353.403, enrollment and disenrollment; and adopted new Subchapter K, consisting of §353.1001 and §353.1003, children’s Medicaid dental services. The new rules describe the default assignment process for dental homes and revise it for primary care providers to include criteria similar to those applied to dental home assignments. See the Texas Register for details.
HHSC adopted amendments to §354.1072, Authorized Inpatient Hospital Services, which implement the Medicare billing prohibition as a Medicaid cost containment measure. For more information, see the Texas Register.
Finally, HHSC adopted amendments to §370.4, definitions, §370.301, CHIP enrollment packet, and §370.303, completion of enrollment. The changes describe the default assignment process for dental homes; specifically, there is no limit to the number of times a CHIP member can request a change in dental home or primary care provider. See the Texas Register for more information.
The Texas Medical Board adopted changes to several sections of the code: