Texas Register Table of Contents
- 1 Governor
- 2 Texas Health and Human Services Commission
- 2.0.1 In Addition Re:
- 2.0.1.1 Public Notice – Texas State Plan for Medical Assistance Amendment to update the fee schedule for Ambulatory Surgical Center services.
- 2.0.1.2 Public Notice – Texas State Plan for Medical Assistance Amendment, which would update the reimbursement methodology for the outpatient hospital services to an outpatient prospective payment system (OPPS).
- 2.0.1.3 Public Notice – Texas State Plan for Medical Assistance Amendment, regarding updating the reimbursement methodology for the Disproportionate Share Hospital (DSH) Program.
- 2.0.1 In Addition Re:
- 3 Texas Department of State Health Services
Governor
Appointment Re:
The Governor appointed one person to the Cancer Prevention and Research Institute of Texas Oversight Committee on April 13, 2023.
Appointed to the Cancer Prevention and Research Institute of Texas Oversight Committee for a term to expire January 31, 2029, David A. Cummings, M.D. of San Angelo, Texas.
Proclamations Re:
Proclamation 41-3966, renewing the disaster proclamation in response to the ongoing COVID-19 disaster.
Greg Abbott, Governor of Texas, issued a disaster proclamation on March 13, 2020, certifying under Section 418.014 of the Texas Government Code that COVID-19 poses an imminent threat of disaster for all counties in the State of Texas.
In accordance with the authority vested by Section 418.014 of the Texas Government Code, the Governor does hereby renew the disaster proclamation for all counties in Texas.
Texas Health and Human Services Commission
In Addition Re:
Public Notice – Texas State Plan for Medical Assistance Amendment to update the fee schedule for Ambulatory Surgical Center services.
OVERVIEW
The Texas Health and Human Services Commission (HHSC) announces its intent to submit amendments to the Texas State Plan for Medical Assistance, under Title XIX of the Social Security Act. The proposed amendments will be effective June 1, 2023.
The purpose of the amendments is to update the fee schedules in the current state plan by adjusting fees, rates, or charges for the following services:
- Ambulatory Surgical Centers
The proposed amendment is estimated to result in an annual aggregate expenditure of $744,953 for federal fiscal year (FFY) 2023, consisting of $469,320 in federal funds and $275,633 in state general revenue. For FFY 2024, the estimated annual aggregate expenditure is $1,964,891 consisting of $1,189,349 in federal funds and $775,542 in state general revenue. For FFY 2025, the estimated annual aggregate expenditure is $1,944,061 consisting of $1,169,353 in federal funds and $774,708 in state general revenue.
Public Notice – Texas State Plan for Medical Assistance Amendment, which would update the reimbursement methodology for the outpatient hospital services to an outpatient prospective payment system (OPPS).
OVERVIEW
The Texas Health and Human Services Commission (HHSC) announces its intent to submit an amendment to the Texas State Plan for Medical Assistance, under Title XIX of the Social Security Act. The proposed amendment is effective September 1, 2023.
The purpose of the amendment is to update the reimbursement methodology for the outpatient hospital services to an outpatient prospective payment system (OPPS) in the current state plan by updating a number of items. The OPPS that HHSC is proposing to implement is the EAPG grouper methodology. EAPGs are a visit-based classification system intended to reflect the utilization and type of resources of outpatient encounters for patients with similar clinical characteristics. EAPGs are used in OPPS for a variety of outpatient settings, including but not limited to: hospital emergency rooms, outpatient clinics, renal dialysis facilities, and same day surgery. EAPGs are proprietary to 3MTM Health Information Systems and 3MTM initially developed Ambulatory Patient Groups (APGs) prior to 2000. In 2007, 3MTM made significant changes to its earlier variant of the grouper to reflect current clinical practice including coding and billing practices and to describe a broader, non-Medicare population which resulted in what we now call EAPGs. EAPGs group procedures and medical visits that share similar clinical characteristics, resource utilization patterns and cost so that payment is based on the relative intensity of the entire visit. The EAPG grouping system is designed to recognize clinical and resource variations in severity, which results in higher payments for higher intensity services and lower payments for less intensive services. While each claim may receive multiple EAPGS, each procedure is assigned to only one EAPG.
OVERVIEW
The Texas Health and Human Services Commission (HHSC) announces its intent to submit an amendment to the Texas State Plan for Medical Assistance, under Title XIX of the Social Security Act. The proposed amendment is effective June 1, 2023.
The purpose of the amendment is to update the reimbursement methodology for the Disproportionate Share Hospital (DSH) Program. This proposal amends the definition of the rural provider classes, establishes a new rural DSH pool, describes a methodology for redistribution of certain recouped funds, modifies the calculation of the Low-Income Utilization Rate to reflect federal law, updates the calculation of the State Payment Cap and payment allocation methodology, establishes changes to qualifications of the program and makes other clarifying amendments. For the DSH program, the annual aggregate expenditures are expected to remain fiscally neutral with this update.
Texas Department of State Health Services
In Addition Re:
Licensing Actions for Radioactive Materials
For more information, please visit this week’s edition of the Texas Register at 48 Tex Reg 2208.
Order Adding Ganaxolone in Schedule V, Adding Amineptine, Methiopropamine, Mesocarb and Zipeprol in Schedule I, and Removing Fenfluramine from Control.
For more information, please visit this week’s edition of the Texas Register at 48 Tex Reg 2213.