The following information was obtained from the Texas Register.
Public Notices
HHSC intends to submit an amendment to the Texas State Plan for Medical Assistance under Title XIX of the Social Security Act to update the fee schedules in the current state plan for:
Durable Medical Equipment, Prosthetics, Orthotics, and Supplies; Early and Periodic Screening, Diagnosis, and Treatment Services; and Physicians and Other Practitioners.
HHSC intends to submit an amendment to update the fee schedules for Clinical Diagnostic Laboratory Services.
Finally, HHSC will negotiate during the rulemaking process to develop an implementation plan in the form of a rule that would establish an informal dispute resolution process that provides for adjudication by an appropriate disinterested person of disputes relating to a statement of violations submitted by DADS. For details about each entry, see the Texas Register.
Adopted Rules
HHSC adopted amendments to §355.502, Reimbursement Methodology for Common Services in HCS Services Waivers; §355.505, Reimbursement Methodology for the CLASS Waiver Program; and §355.723, Reimbursement Methodology for HCS and TxHmL Programs. To add a rehabilitative services reimbursement methodology for cognitive rehabilitation therapy as a service in the CLASS and HCS programs.
HHSC adopted amendments to §355.8548, certain Medicaid fee-for-service pharmacy provider types that are enrolled in a federal drug pricing discount program, that will discontinue the methodology that requires a covered entity to submit its actual acquisition cost, replacing it with a reimbursement methodology that is based upon the drug ingredient costs for pharmacies enrolled in the Section 340B drug-pricing program using HHSC’s best estimate of the 340B Program price.
