The following information was obtained from the October 18 issue of the Texas Register.
Public Hearings and Notice
HHSC will hold a public hearing on Wednesday, November 20, 2013, at 1:30 p.m., to receive comment on proposed Medicaid payment rates for Doctor of Dentistry Surgical Services, second quarter 2013 Healthcare Common Procedure Coding System updates, Indian Health Services, Influenza Vaccines 90660 and 90672, Medicaid Biennial Calendar Fee Review, and Mirena. The hearing will take place in the Public Hearing Room, Brown-Heatly Building, located at 4900 North Lamar, Austin. See the Texas Register for more information.
HHSC submitted to CMS a request to amend the YES waiver programs, which would expand the geographical limitation area to include Harris, Ft. Bend, Brazoria, and Galveston counties in addition to Bexar, Tarrant, and Travis counties. For more information, see the Texas Register.
Proposed Rules
HHSC proposed new Subchapter L, §§354.2501, 354.2503, 354.2505 and 354.2507, the Medicaid Quality Improvement Process for Clinical Initiatives, which requires HHSC to develop and implement a quality improvement process to receive clinical suggestions that improve the quality of care and cost-effectiveness under the Medicaid program, and other changes. See the Texas Register for details.
HHSC proposed to amend §355.314, Supplemental Payments to Non-State Government-Owned Nursing Facilities, to revise the way the state calculates Medicaid supplemental payment limits and to address facility changes of ownership.
HHSC proposed new §355.9070, Reimbursement Methodology for Department DSHS HSC Adult Mental Health (HCBS-AMH) program; and amended the title of 1 TAC Chapter 355, Subchapter M, which describes the reimbursement methodology for the DSHS HCBS-AMH program. For more information about both entries, see the Texas Register.
HHSC proposed to amend Chapter 366, Medicaid Eligibility for Women, Children, Youth, and Needy Families, primarily to align Medicaid eligibility rules with new federal requirements. See the Texas Register for more information.
HHSC proposed to amend Chapter 370, CHIP, to align eligibility rules with new federal requirements. See the Texas Register for details.
HHSC proposed to amend Chapter 375, Refugee Cash Assistance and Medical Assistance Programs, which would align eligibility rules with new federal requirements. For more information, see the Texas Register.
The Texas Medical Board proposed to amend §195.2, Certification of Pain Management Clinics, which would revise the heading of subsection (a)(5) to read “Disciplinary Action,” and other changes. See the Texas Register for details.
- On DADS’ Behalf
HHSC proposed to amend §19.216, License Fees, and §19.2206, General Requirements for a Certified Facility, in Chapter 19, Nursing Facility Requirements for Licensure and Medicaid Certification, which would increase the maximum nursing facility license fee from $250 to $375 and the maximum per bed fee from $10 to $15. For more information, see the Texas Register.
HHSC proposed to repeal Chapter 50, §§50.1, 50.2, 50.4, 50.6, 50.8, 50.10, 50.12, 50.14, 50.16, 50.18, 50.20, 50.22, 50.24, 50.26, 50.28, 50.30, 50.32, 50.34, 50.36, 50.38, 50.40, 50.42, 50.44, and 50.46, §1915(c) Consolidated Waiver Program, which would delete CWP rules. See the Texas Register for details.
HHSC proposed to repeal Chapter 53, §§53.101, 53.103, 53.105, 53.107, 53.109, 53.111, 53.113, 53.201, 53.203, 53.205, 53.209, 53.211, 53.213, 53.301, 53.401, 53.403, 53.405, 53.407, 53.409, 53.411, 53.413, 53.415, 53.417, 53.501, 53.601, 53.603, 53.605, 53.607, 53.609, 53.611, 53.613, 53.615, 53.617, 53.619, 53.701, 53.703, 53.705, 53.707, 53.709, 53.711, 53.713, 53.715, 53.717, 53.731, 53.733, 53.735, 53.737, 53.739, 53.741, 53.743, 53.745, 53.747, 53.749, 53.751, 53.753, 53.755, 53.761, 53.763, 53.771, 53.781, 53.783, 53.791, 53.793, 53.795, 53.797, 53.799, 53.801, 53.811, 53.821, 53.831, 53.841, 53.843, 53.845, 53.847, 53.849, 53.851, 53.861, 53.863, 53.865, 53.867, 53.869, 53.871, 53.873, 53.875, 53.877, 53.879, 53.881, 53.883, 53.891, 53.893, 53.901, 53.903, 53.905, 53.907, 53.909, 53.911, 53.921, 53.923, 53.925, 53.927, 53.929, 53.931, 53.941, 53.1001, 53.1003, 53.1005, 53.1007, 53.1009, 53.1011, 53.1101, 53.1103, 53.1105, 53.1107, 53.1109, 53.1111, 53.1113, 53.1115, 53.1117, 53.1119, 53.1201, 53.1203, 53.1205, 53.1207, 53.1209, and 53.1211, ICM §1915(c) Waiver Services.
The repeal removes ICM §1915(c) waiver program rules, as ICM, determined to be an ineffective model, was terminated on January 31, 2011. See the Texas Register.
Withdrawn Rules
The Texas Health and Human Services Commission withdrew the proposed new §355.8204 which appeared in the June 28, 2013, issue of the Texas Register (38 TexReg 4122).
The Texas Medical Board withdrew the proposed amendment to §195.2 which appeared in the September 27, 2013, issue of the Texas Register (38 TexReg 6495).
Adopted Rules
HHSC adopted §354.1149, Exclusions and Limitations, and §354.1175, Organ Transplants, to be consistent with claims-processing system processes implemented as part of the new methodologies.
HHSC adopted amendments to §355.8600, Reimbursement Methodology for Ambulance Services, which adds a provision to allow approved governmental ambulance providers to receive supplemental payments for their un-reimbursed costs of providing ambulance services to uninsured patients as defined by CMS. See the Texas Register for both entries.
- On DADS’ Behalf
HHSC adopted an amendment to §19.2322, Medicaid Bed Allocation Requirements, and the repeal of §19.2324, Selection and Contracting Procedures for adding Medicaid beds in high-occupancy areas, in Chapter 19, Nursing Facility Requirements for Licensure and Medicaid Certification. The changes revise and clarify rules. For more information, see the Texas Register.