This is the reason for the new letter:
Some ICF/IID program providers have reported having difficulty obtaining a
physician signature on an intellectual disability/related condition (ID/RC)
assessment form due to the COVID-19 pandemic. In response, the Texas
Health and Human Services Commission (HHSC) is advising providers to
renew an individual’s level of care that expired in March, April, or May as
explained in this letter if the program provider did not get a physician’s
signature on the ID/RC assessment form before the level of care expired.