Texas Register Table of Contents
- 1 Texas Health and Human Services Commission
- 2 Texas Health and Human Services Commission
- 3 Texas Health and Human Services Commission
- 4 Texas Board of Nursing
- 5 Texas Medical Board
- 6 Texas State Board of Pharmacy
- 7 Texas State Board of Pharmacy
- 8 Texas Medical Board
- 9 Texas Health and Human Services Commission
- 10 Texas Health and Human Services Commission
- 11 Texas Health and Human Services Commission
- 12 Texas Health and Human Services Commission
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Texas Health and Human Services Commission
Proposed Rules
Proposed amendment to reimbursement methodology
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §355.112, concerning Attendant Compensation Rate Enhancement; §355.723, concerning Reimbursement Methodology for Home and Community-Based Services and Texas Home Living Programs; and §355.6907, Reimbursement Methodology for Day Activity and Health Services.
Texas Health and Human Services Commission
Proposed Rules
Proposed amendment to the cost-determination process
1 TAC §355.112STATUTORY AUTHORITYThe amendments are proposed under Texas Government Code §531.033, which provides the Executive Commissioner of HHSC with broad rulemaking authority; Texas Human Resources Code §32.021 and Texas Government Code §531.021(a), which provide HHSC with the authority to administer the federal medical assistance (Medicaid) program in Texas; and Texas Government Code §531.021(b), which establishes HHSC as the agency responsible for adopting reasonable rules governing the determination of fees, charges, and rates for Medicaid payments under Texas Human Resources Code, Chapter 32.The proposed amendments affect Texas Government Code, Chapter 531 and Texas Human Resources Code, Chapter 32.
Texas Health and Human Services Commission
Proposed Rules
Proposed amendment to reimbursement methodology for programs serving persons with mental illness or intellectual or developmental disability
The recommended modeled rates are determined for each HCS and TxHmL service listed in subsection (b)(1) – (2) of this section by type and, for services listed in subsection (b)(1) of this section, by level of need to include the following cost components: direct care worker staffing costs (wages, benefits, modeled staffing ratios for direct care workers, direct care trainers and job coaches), other direct service staffing costs (wages for direct care supervisors, benefits, modeled staffing ratios); facility costs (for respite care only); room and board costs for overnight, out-of-home respite care; administration and operation costs; and professional consultation and program support costs. The determination of all components except for the direct care worker staffing costs component is based on cost reports submitted by HCS and TxHmL providers in accordance with §355.722 of this subchapter (relating to Reporting Costs by Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Providers). The determination of the direct care worker staffing costs component is calculated as specified in §355.112 of this chapter (relating to Attendant Compensation Rate Enhancement).
Texas Board of Nursing
Proposed Rules
an amendment to §355.8052, concerning Inpatient Hospital Reimbursement.
SUBCHAPTER J. PURCHASED HEALTH SERVICESDIVISION 4. MEDICAID HOSPITAL SERVICES1 TAC §355.8052The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §355.8052, concerning Inpatient Hospital Reimbursement.BACKGROUND AND PURPOSEThe amendment to this rule is proposed to comply with the 2020-21 General Appropriations Act (Article II, H.B. 1, 86th Legislature, Regular Session, 2019, Rider 11 and Rider 28), which allocates certain funds appropriated to HHSC to provide increased inpatient reimbursement for rural hospitals. In addition, the amendments to the rule are proposed to comply with Senate Bill 500 (S.B. 500), which appropriates $50 million in general revenue funds for rate increases to Children’s Hospitals.The current Standard Dollar Amounts (SDAs) for rural hospitals have been in effect since September 1, 2013. Subsection (d) in Rider 11 directs HHSC to increase inpatient rates for rural hospitals by trending forward to 2020 using an inflationary factor. This rule amendment proposes to inflate the current SDAs using the Centers for Medicare and Medicaid Services Prospective Payment System Hospital Market Basket inflation factors. Applying these inflation factors will result in a 17.68 percent increase in the inpatient rate of each rural hospital.
Texas Medical Board
Proposed Rules
Proposed amendments to Chapter 193, relating to Standing Delegation Orders, §193.17.
22 TAC §193.17The Texas Medical Board (Board) proposes amendments to Chapter 193, relating to Standing Delegation Orders, §193.17.The amendment to §193.17, relating to Nonsurgical Medical Cosmetic Procedures, requires providing notice to patients of the identity and license number of the physician supervisor at a facility providing nonsurgical cosmetic procedures. It also requires posting notice of how and where to file a complaint against a physician or physician assistant involved at one of these facilities.
Texas State Board of Pharmacy
Adopted Rules
Proposed amendments to §295.5, concerning Pharmacist License or Renewal Fees
CHAPTER 295. TEXAS STATE BOARD OF PHARMACY22 TAC §295.5The Texas State Board of Pharmacy proposes amendments to §295.5, concerning Pharmacist License or Renewal Fees. The amendments, if adopted, will increase pharmacist license fees based on expected expenses.
Texas State Board of Pharmacy
Adopted Rules
Proposed amendments to §295.5, concerning Pharmacist License or Renewal Fees
CHAPTER 295. TEXAS STATE BOARD OF PHARMACY22 TAC §295.5The Texas State Board of Pharmacy proposes amendments to §295.5, concerning Pharmacist License or Renewal Fees. The amendments, if adopted, will increase pharmacist license fees based on expected expenses.
Texas Medical Board
Adopted Rules
Adopts amendments to §183.20, concerning Continuing Acupuncture Education
CHAPTER 183. ACUPUNCTURE22 TAC §183.20The Texas Medical Board (Board) adopts amendments to §183.20, concerning Continuing Acupuncture Education (CAE). The amendments to §183.20 are being adopted without changes to the proposed text as published in the February 15, 2019, issue of the Texas Register (44 TexReg 661). The adopted amendments will not be republished.The amendments to §183.20 change the CAE requirements so that hours from courses that relate to business practices and office administration will be optional rather than required. Further amendments are proposed so that the number of required core hours in the topics of ethics and safety will be reduced from four to two.
Texas Health and Human Services Commission
In Addition
The Texas Health and Human Services Commission (HHSC) will conduct a public hearing on July 9, 2019, at 9:30 a.m.
Notice of Public Hearing on Payment RatesHearing. The Texas Health and Human Services Commission (HHSC) will conduct a public hearing on July 9, 2019, at 9:30 a.m., to receive comment on proposed rate increases for: the Residential Care (RC), Primary Home Care (PHC), Community Attendant Services (CAS), Family Care (FC), and Day Activity and Health Services (DAHS) programs; Community Living Assistance and Support Services (CLASS) Respite; STAR+PLUS Home and Community-Based Services (HCBS) Waiver Personal Assistance Services (PAS), Respite Care, and Habilitation (HAB) Proxy Rates; and STAR Kids Waiver Attendant, Attendant with Registered Nurse (RN) Delegation, and Community First Choice Habilitation (CFC HAB) Proxy Rates.The public hearing will be held in HHSC’s Public Hearing Room at the Brown-Heatly Building, located at 4900 North Lamar Boulevard, Austin, Texas. Entry is through Security at the main entrance of the building, which faces Lamar Boulevard. HHSC will broadcast the public hearing. Persons watching remotely can submit written comments. The broadcast can be accessed at https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings, and it will be archived for access on demand at the same website. The public hearing will be held in compliance with Texas Human Resources Code §32.0282, which requires public notice of and hearings on proposed Medicaid reimbursements.Proposal. HHSC proposes to increase the attendant base wage to $8.11 for the attendant cost component for: RC, PHC, CAS, FC, DAHS, and CLASS Respite; STAR+PLUS HCBS Waiver PAS, Respite Care, and HAB Proxy Rates; STAR Kids Waiver Attendant; Attendant with RN Delegation, and CFC HAB Proxy Rates, in accordance with the 2020-21 General Appropriations Act (Article II, 86th Legislature, Regular Session, 2019, Rider 45). These payment rates are proposed to be effective September 1, 2019.
Texas Health and Human Services Commission
In Addition
The Texas Health and Human Services Commission (HHSC) will conduct a public hearing on July 9, 2019, at 9:00 a.m.
Notice of Public Hearing on Proposed Medicaid Payment Rates for the Deaf-Blind with Multiple Disabilities Waiver ProgramHearing. The Texas Health and Human Services Commission (HHSC) will conduct a public hearing on July 9, 2019, at 9:00 a.m., to receive comment on proposed Medicaid payment rates for the Deaf-Blind with Multiple Disabilities Waiver Program (DBMD).The public hearing will be held in HHSC’s Public Hearing Room at the Brown-Heatly Building, located at 4900 North Lamar Boulevard, Austin, Texas. Entry is through Security at the main entrance of the building, which faces Lamar Boulevard. HHSC will broadcast the public hearing. Persons watching remotely can submit written comments. The broadcast can be accessed at https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings, and it will be archived for access on demand at the same website. The public hearing will be held in compliance with Texas Human Resources Code §32.0282, which requires public notice of and hearings on proposed Medicaid reimbursements.Proposal. HHSC proposes to increase the payment rates for all DBMD services in accordance with the 2020-21 General Appropriations Act (Article II, 86th Legislature, Regular Session, 2019, Rider 44). These payment rates are proposed to be effective September 1, 2019.
Texas Health and Human Services Commission
In Addition
The Texas Health and Human Services Commission (HHSC) will conduct a public hearing on July 9, 2019, at 10:30 a.m.
Notice of Public Hearing on Reimbursement Rates for the Home Delivered MealsHearing. The Texas Health and Human Services Commission (HHSC) will conduct a public hearing on July 9, 2019, at 10:30 a.m., to receive comment on the Reimbursement Rates for the Home Delivered Meals (HDM). These payment rates are proposed to be effective September 1, 2019.The public hearing will be held in HHSC’s Public Hearing Room at the Brown-Heatly Building, located at 4900 North Lamar Boulevard, Austin, Texas. Entry is through Security at the main entrance of the building, which faces Lamar Boulevard. HHSC will broadcast the public hearing. Persons watching remotely can submit written comments. The broadcast can be accessed at https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings, and it will be archived for access on demand at the same website. The public hearing will be held in compliance with Texas Human Resources Code §32.0282, which requires public notice of and hearings on proposed Medicaid reimbursements.Proposal. HHSC proposes to increase the payment ceilings for the HDM Program in accordance with the 2020-21 General Appropriations Act (Article II, 86th Legislature, Regular Session, 2019, Rider 99), which appropriated $3 million general revenue in each State Fiscal Year of the 2020-2021 biennium to increase the maximum rate for HDM to $5.31 per meal effective September 1, 2019.
Texas Health and Human Services Commission
In Addition
Public Notice: Children’s Health Insurance Program (CHIP) State Plan Amendments: 45, 46, and 47
Public Notice: Children’s Health Insurance Program (CHIP) State Plan Amendments: 45, 46, and 47The Texas Health and Human Services Commission announces its intent to submit State Plan Amendments (SPAs) transmittal numbers 45, 46, and 47 to the Texas State Plan for the Children’s Health Insurance Program (CHIP), under Title XXI of the Social Security Act.The purpose of CHIP SPA transmittal number 45 is to demonstrate compliance with the Medicaid managed care final rule (81 FR 27497, http://www.federalregister.gov/d/2016-09581). The requested effective date for the proposed amendment is August 31, 2019. The submission of a SPA to CMS is done through a template form provided by CMS. This amendment transitions HHSC to using a new CMS template which includes new language.The purpose of CHIP SPA transmittal number 46 is to demonstrate compliance with the Affordable Care Act CHIP external review process. The requested effective date for the proposed amendment September 1, 2019. This amendment updates the state plan to be consistent with policy requiring CHIP managed care organizations to offer members the opportunity to access a third-party review of certain denials through an external review process after exhausting the MCO internal appeal process.The purpose of CHIP SPA transmittal number 47 is to demonstrate compliance with the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patient and Communities Act. The requested effective date for the proposed amendment is October 24, 2019. This amendment will expand the CHIP Perinatal service array, including adding mental health and substance use services.