Texas Register Table of Contents
- 1 The Governor
- 1.0.1 Appointments Re:
- 1.0.1.1 Appointed to the Chronic Kidney Disease Task Force for a term to expire at the pleasure of the Governor, Jose L. Almeda, M.D.
- 1.0.1.2 Appointed to the Chronic Kidney Disease Task Force for a term to expire at the pleasure of the Governor, Lauren R. Ramsey.
- 1.0.1.3 Appointed to the Chronic Kidney Disease Task Force for a term to expire at the pleasure of the Governor, Leila Williams, D.O.
- 1.0.1.4 Designated as presiding officer of the Chronic Kidney Disease Task Force for a term to expire at the pleasure of the Governor, Tiffany N. Jones-Smith.
- 1.0.1 Appointments Re:
- 2 Texas Optometry Board
- 3 Texas Health and Human Services Commission
- 3.0.1 Adopted Rules Re:
- 3.0.1.1 Adopting 1 TAC §§353.1502, 353.1504, 353.1506, to replace certain terms and definitions and make formatting changes.
- 3.0.1.2 Adopting 1 TAC §355.456, to update the reimbursement procedures for Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID) high medical needs add-on rates based on the Patient-Driven Payment Model Long-Term Care (PDPM LTC) for nursing facilities.
- 3.0.1.3 Adopting 1 TAC §355.503, §355.507, to clarify the reimbursement methodologies for the long-term services and supports (LTSS) state plan and waiver services delivered through managed care.
- 3.0.2 Transferred Rules Re:
- 3.0.3 Proposed Rule Reviews Re:
- 3.0.1 Adopted Rules Re:
The Governor
Appointments Re:
Appointed to the Chronic Kidney Disease Task Force for a term to expire at the pleasure of the Governor, Jose L. Almeda, M.D.
Appointed to the Chronic Kidney Disease Task Force for a term to expire at the pleasure of the Governor, Lauren R. Ramsey.
Appointed to the Chronic Kidney Disease Task Force for a term to expire at the pleasure of the Governor, Leila Williams, D.O.
Designated as presiding officer of the Chronic Kidney Disease Task Force for a term to expire at the pleasure of the Governor, Tiffany N. Jones-Smith.
Texas Optometry Board
Proposed Rules Re:
Amending 22 TAC §275.2, to proposes new changes to replace the expired statute requiring a prescriber of opioids to take an annual hour of continuing education relating to opioid prescribing best practices.
CHAPTER 275. CONTINUING EDUCATION
22 TAC §275.2
OVERVIEW
The Texas Optometry Board proposes amendments to 22 TAC §275.2 – Required Education Section 481.0764, Texas Health and Safety Code, expired on August 31, 2023. This statute required a prescriber of opioids to take an annual hour of continuing education relating to opioid prescribing best practices. This section of statute expired in 2023 and the Board has determined that changes to §275.2 – Required Education are necessary.
BACKGROUND AND JUSTIFICATION
As the section requiring continuing education related to opioid prescribing best practices has expired, the Board is repealing the requirement from its rules. The Board recognizes these courses are useful for its licensees that prescribe opioids. However, the vast majority of its licensees have expressed they do not prescribe opioids. Additionally, for those licensees who do prescribe, the U.S. Drug Enforcement Agency requires the licensees to take continuing education on the topic. Any opioid continuing education taken by licensees could still be used to meet the hours required prior to renewal of the license.
Texas Health and Human Services Commission
Adopted Rules Re:
Adopting 1 TAC §§353.1502, 353.1504, 353.1506, to replace certain terms and definitions and make formatting changes.
CHAPTER 353. MEDICAID MANAGED CARE
SUBCHAPTER R. TELECOMMUNICATIONS IN MANAGED CARE SERVICE COORDINATION AND ASSESSMENTS
1 TAC §§353.1502, 353.1504, 353.1506
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §353.1502, concerning Definitions; §353.1504, concerning Use of Telecommunications in Service Coordination and Service Management; and §353.1506, concerning Additional Requirements for Assessments and Service Management in STAR Health.
Section 353.1502 is adopted with changes to the proposed text as published in the December 20, 2024, issue of the Texas Register (49 TexReg 10167). This rule will be republished.
Section 353.1504 and §353.1506 are adopted without changes to the proposed text as published in the December 20, 2024, issue of the Texas Register (49 TexReg 10167). These rules will not be republished.
BACKGROUND AND JUSTIFICATION
The amendments are necessary to comply with House Bill 4, 87th Legislature, Regular Session, 2021, which requires telecommunications allowances to the new service coordination levels for STAR Health. The amendments reflect the STAR Health programmatic changes by incorporating service coordination levels and replacing the term “service management” with “service coordination.” These changes allow the STAR Health managed care organization to conduct assessments and provide service coordination services using telecommunications or information technology when it is clinically effective and cost-effective to do so.
Adopting 1 TAC §355.456, to update the reimbursement procedures for Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID) high medical needs add-on rates based on the Patient-Driven Payment Model Long-Term Care (PDPM LTC) for nursing facilities.
CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER D. REIMBURSEMENT METHODOLOGY FOR INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS (ICF/IID)
1 TAC §355.456
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts an amendment to §355.456, concerning Reimbursement Methodology.
Section 355.456 is adopted without changes to the proposed text as published in the November 15, 2024, issue of the Texas Register (49 TexReg 9134). This rule will not be republished.
BACKGROUND AND JUSTIFICATION
The adoption updates the reimbursement methodology for the Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID) high medical needs add-on rates based on the Patient Driven Payment Model Long-Term Care (PDPM LTC) for nursing facilities. The current reimbursement methodology for the ICF/IID high medical needs add-on is based on the Resource Utilization Group version 3 (RUG-III) classification system and associated costs. The 2024-25 General Appropriations Act, House Bill 1, 88th Legislature, Regular Session, 2023 (Article II, Health and Human Services Commission, Rider 25) directed HHSC to “develop and implement a Texas version of the Patient Driven Payment Model methodology for the reimbursement of long-term stay nursing facility services in the Medicaid program.” The PDPM LTC methodology implements a new nursing facility classification system for Medicaid residents. This amendment uses PDPM LTC classifications to establish the reimbursement methodology for the ICF/IID high medical needs add-ons.
Adopting 1 TAC §355.503, §355.507, to clarify the reimbursement methodologies for the long-term services and supports (LTSS) state plan and waiver services delivered through managed care.
CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER E. COMMUNITY CARE FOR AGED AND DISABLED
1 TAC §355.503, §355.507
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §355.503, concerning Reimbursement Methodology for Long-Term Services and Supports State Plan and Home and Community-Based Services Waiver Program Services Delivered through the STAR+PLUS Managed Care Program, and §355.507, concerning Reimbursement Methodology for Long-Term Services and Supports State Plan and Medically Dependent Children Waiver Program Services Delivered through the STAR Kids and STAR Health Managed Care Programs.
Section 355.503 and §355.507 are adopted without changes to the proposed text as published in the November 1, 2024, issue of the Texas Register (49 TexReg 8635). The rules will not be republished.
BACKGROUND AND JUSTIFICATION
The purpose of the proposal is to clarify the reimbursement methodologies for the Long-term Services and Supports (LTSS) state plan and waiver services delivered through managed care. HHSC maintains fee schedules for LTSS programs and services delivered in STAR+PLUS or STAR Kids programs that represent the rates HHSC would pay contracted providers for these services if the services were delivered under a fee-for-service delivery model. The adoption ensures that HHSC has an established rate methodology for all the services delivered in managed care based on the STAR+PLUS and STAR Kids LTSS billing matrices. The adoption relabels and adds language to the rules to reference the STAR+PLUS and STAR Kids managed care programs and removes references to the expired Community-Based Alternatives Waiver Program and Integrated Care Management-Home and Community Support Services Program. The adoption also consolidates rate methodologies for LTSS state plan services delivered through STAR+PLUS and STAR Kids into the applicable Texas Administrative Code rule. The adoption revises the rate methodology for out-of-home respite under the STAR Kids Medically Dependent Children Program (MDCP) to mirror waiver changes and the published billing matrix. Finally, the adoption adds language to the rules to distinguish in-home and out-of-home settings for home health care services. These services include nursing, occupational therapy, and physical therapy, ensuring compliance with the 21st Century Cures Act, which requires all states to implement the use of electronic visit verification (EVV).
Transferred Rules Re:
Transferring the HHSC rules in Texas Administrative Code, Title 26, Part 1, Chapter 567, to OPIC in Texas Administrative Code, Title 28, Part 7, Chapter 280, Certificate of Public Advantage.
OVERVIEW
Pursuant to Texas Health and Safety Code Section §314A.004, the Governor of Texas designates the state agency responsible for reviewing applications for certificates of public advantage and supervising the activities for which those certificates are issued. On August 14, 2024, the Governor replaced the Texas Health and Human Services Commission (HHSC) as the designated agency with the Office of Public Insurance Counsel (OPIC). Therefore, the HHSC rules in Texas Administrative Code, Title 26, Part 1, Chapter 567, Certificate of Public Advantage are being transferred to OPIC in Texas Administrative Code, Title 28, Part 7, Chapter 280, Certificate of Public Advantage.
Proposed Rule Reviews Re:
Reviewing Title 26, Part 1, to consider for readoption, revision, or repeal of the chapter concerning Medicaid Hospice Program.
OVERVIEW
The Texas Health and Human Services Commission (HHSC) proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 26, Part 1, of the Texas Administrative Code (TAC):
Chapter 266, Medicaid Hospice Program