Texas Register – August 6, 2021 Vol: 46 Number: 32

Texas Register Table of Contents

Department of State Health Services

Emergency Rules Re:

Amending 25 TAC §448.603 to allow a licensed chemical dependency treatment facility to provide abuse, neglect, and exploitation training through live, interactive electronic mediums.

CHAPTER 448. STANDARD OF CARE
SUBCHAPTER F. PERSONNEL PRACTICES AND DEVELOPMENT
25 TAC §448.603

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 25, Texas Administrative Code, Chapter 448, Standard of Care, an amendment to §448.603, concerning Training, to expand a licensed chemical dependency treatment facility’s (CDTF) ability to provide staff training on abuse, neglect, and exploitation and nonviolent crisis intervention through live, interactive, instructor-led, electronic means in response to COVID-19.

HHSC is adopting an emergency rule amendment to §448.603(d)(1) to temporarily permit a licensed CDTF to provide abuse, neglect, and exploitation training to staff through live, interactive, instructor-led, electronic means to reduce the risk of COVID-19 transmission. HHSC is also adopting an emergency rule amendment to §448.603(d)(4) to temporarily permit a licensed CDTF to provide nonviolent crisis intervention training to staff through live, interactive, instructor-led, electronic means to reduce the risk of COVID-19 transmission. There are no other changes to §448.603.

BACKGROUND AND JUSTIFICATION

As authorized by Texas Government Code §2001.034, HHSC may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.

The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this amendment to §448.603, concerning Training.


Adopted Rules Re:

Amending 25 TAC §417.47 to allow State Mental Health Facilities to modify and expedite certain training training programs while requiring infection control training specific to COVID-19.

CHAPTER 417. AGENCY AND FACILITY RESPONSIBILITIES
SUBCHAPTER A. STANDARD OPERATING PROCEDURES
25 TAC §417.47

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts an amendment to §417.47, concerning Training Requirements for State Mental Health Facilities. Section 417.47 is adopted without changes to the proposed text as published in the June 4, 2021, issue of the Texas Register (46 TexReg 3496). This rule will not be republished.

HHSC is adopting the amendment to efficiently and effectively deploy staff to meet basic needs during this unprecedented time without posing risk to the individuals served. This amendment protects individuals served by the state hospitals and the public health, safety, and welfare of the state during a disaster, including the current COVID-19 pandemic.

BACKGROUND AND JUSTIFICATION

The amendment is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In the proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. Due to the imminent peril to the public health, safety, and welfare of the state, HHSC accordingly adopted an emergency amendment to a training rule. This amendment to the permanent rule replaces the emergency amendment when it expires.

This amendment allows for the efficient and effective deployment of staff to meet basic needs during this unprecedented time without posing risk to the individuals served. This amendment protects individuals served by the state hospitals and the public health, safety, and welfare of the state during a disaster, including the current COVID-19 pandemic.

SECTION-BY-SECTION SUMMARY

The amendment to §417.47 provides that training may be modified, to include the most essential content, and expedited, due to the COVID-19 pandemic declared disaster, and requires infection control training specific to COVID-19.

This amendment is identical to the existing emergency rule amendment to §417.17, Training Requirements for State Mental Health Facilities, created in response to the COVID-19 pandemic.


Health and Human Services

Emergency Rules Re:

Renewing 26 TAC §500.20 to allow certain end stage renal disease (ESRD) facilities to treat and train dialysis patients without obtaining a new license.

CHAPTER 500. COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSING
SUBCHAPTER B. END STAGE RENAL DISEASE FACILITIES
26 TAC §500.20

OVERVIEW

The Health and Human Services Commission is renewing the effectiveness of emergency new §500.20 for a 60-day period. The text of the emergency rule was originally published in the April 9, 2021, issue of the Texas Register (46 TexReg 2279).

The Executive Commissioner of the Health and Human Services Commission (HHSC) renews on an emergency basis new §500.20, ESRD Off-Site Facilities During the COVID-19 Pandemic, in Texas Administrative Code (TAC) Title 26, Chapter 500, Subchapter B. This emergency rule will allow end stage renal disease (ESRD) facilities to treat and train dialysis patients more effectively during the COVID-19 pandemic.

HHSC is renewing an emergency rule to allow a currently licensed ESRD facility to apply to operate an off-site outpatient facility without obtaining a new license at: (1) an ESRD facility that is no longer licensed that closed within the past 36 months; (2) a mobile, transportable, or relocatable medical unit; (3) a physician’s office; or (4) an ambulatory surgical center or freestanding emergency medical care facility that is no longer licensed that closed within the past 36 months.

BACKGROUND AND JUSTIFICATION

As authorized by Texas Government Code §2001.034, HHSC may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.

The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020 proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state exists and requires immediate adoption of this emergency rule for ESRD Off-Site Facilities During the COVID-19 Pandemic.


Renewing 26 TAC §550.213 to update screening requirements for certain persons authorized to enter a prescribed pediatric extended care center.

CHAPTER 550. LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS
SUBCHAPTER C. GENERAL PROVISIONS
DIVISION 1. OPERATIONS AND SAFETY PROVISIONS
26 TAC §550.213

OVERVIEW

The Health and Human Services Commission is renewing the effectiveness of emergency new §550.213 for a 60-day period. The text of the emergency rule was originally published in the April 9, 2021, issue of the Texas Register (46 TexReg 2280).

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) renews on an emergency basis in Title 26 Texas Administrative Code, Chapter 550, Licensing Standards for Prescribed Pediatric Extended Care Centers, Subchapter C, General Provisions, Division 1, Operations and Safety Provisions, new §550.213, concerning an emergency rule in response to COVID-19 in order to reduce the risk of transmission of COVID-19.

HHSC is renewing an emergency rule to update screening requirements for certain persons authorized to enter a prescribed pediatric extended care center. The updates are consistent with current guidance provided by the Centers for Disease Control and Prevention (CDC).

The emergency rule adds additional signs and symptoms, as outlined by the CDC, to the list of items a prescribed pediatric extended care center must screen for before allowing entry of persons providing critical assistance.

BACKGROUND AND JUSTIFICATION

As authorized by Texas Government Code §2001.034, the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.

The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this Emergency Rule for Prescribed Pediatric Extended Care Center Response to COVID-19–Screening.

To protect minors being served in a prescribed pediatric extended care center and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting an emergency rule to update screening requirements for certain persons authorized to enter a prescribed pediatric extended care center. The updates are consistent with current guidance provided by the Centers for Disease Control and Prevention (CDC).

The emergency rule adds additional signs and symptoms, as outlined by the CDC, to the list of items a prescribed pediatric extended care center must screen for before allowing entry of persons providing critical assistance.


Renewing 26 TAC §558.960 to require COVID-19 screening of staff, clients, and household and offer alternative methods to provide non-essential services.

CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES
SUBCHAPTER I. RESPONSE TO COVID-19 AND PANDEMIC-LEVEL COMMUNICABLE DISEASE
26 TAC §558.960

OVERVIEW

The Health and Human Services Commission is renewing the effectiveness of emergency new §558.960 for a 60-day period. The text of the emergency rule was originally published in the April 9, 2021, issue of the Texas Register (46 TexReg 2293).

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) renews on an emergency basis in Title 26 Texas Administrative Code, Chapter 558, Licensing Standards for Home and Community Support Services Agencies, new §558.960, concerning an emergency rule in response to COVID-19 in order to reduce the risk of transmission of COVID-19.

HHSC is renewing an emergency rule to require screening of staff, clients, and household members for COVID-19 and offer alternative methods to provide non-essential services.

BACKGROUND AND JUSTIFICATION

As authorized by Texas Government Code §2001.034, the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.

The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing critical essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this Emergency Rule for HCSSA Response to COVID-19.


Renewing 26 TAC §559.65 to update COVID-19 screening and training requirements for volunteers and other persons authorized to enter a day activity and health services facility.

CHAPTER 559. DAY ACTIVITY AND HEALTH SERVICES REQUIREMENTS
SUBCHAPTER D. LICENSURE AND PROGRAM REQUIREMENTS
26 TAC §559.65

OVERVIEW

The Health and Human Services Commission is renewing the effectiveness of emergency new §559.65 for a 60-day period. The text of the emergency rule was originally published in the April 9, 2021, issue of the Texas Register (46 TexReg 2295).

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC or Commission) renews on an emergency basis in Title 26, Texas Administrative Code, Chapter 559, Day Activity and Health Services Requirements, new §559.65, concerning an emergency rule in response to COVID-19 in order to reduce the risk of transmission of COVID-19.

HHSC is renewing an emergency rule to update screening requirements in accordance with Centers for Disease Control and Prevention guidance for those persons authorized to enter a day activity and health services facility. In addition, the emergency rule allows for the entry of volunteers who pass screening and receive appropriate training in infection control and prevention to enter the facility to assist with facility-coordinated activities.

BACKGROUND AND JUSTIFICATION

As authorized by Texas Government Code §2001.034, the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.

The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this Emergency Rule for Day Activity and Health Services Response to COVID-19 – Screening and Activities.


Proposed Rules Re:

Amending 1 TAC §355.307 and §355.316 to update and clarify reimbursement methodology for nursing facilities.

CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER C. REIMBURSEMENT METHODOLOGY FOR NURSING FACILITIES
1 TAC §355.307, §355.316

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §355.307, concerning Reimbursement Setting Methodology; and new §355.316, concerning Reimbursement Methodology for Pediatric Care Facilities.

BACKGROUND AND JUSTIFICATION

The proposal is necessary to comply with the 2022-23 General Appropriations Act, Senate Bill (S.B.) 1, 87th Legislature, Regular Session, 2021 (Article II, HHSC, Rider 40), which requires HHSC to revise the reimbursement methodology for pediatric long-term care facilities to mirror that of Medicare reimbursement.

The proposal removes language related to the pediatric nursing facility rate methodology currently in §355.307(c)(1) – (c)(4) and moves it to new §355.316. The creation of new §355.316 improves clarity as it separates the pediatric care facility reimbursement methodology from the reimbursement methodology used for nursing facilities in general. The language in new §355.316 is updated to meet the requirements of the new reimbursement methodology.

SECTION-BY-SECTION SUMMARY

  • The proposed amendment to §355.307 removes all language in subsection (c)(1) – (c)(4); this language is moved to new §355.316. The proposed amendment to §355.307 adds a sentence to subsection (c) in order to reference new §355.316.
  • Proposed new §355.316 contains the language removed from §355.307, which describes the reimbursement methodology for the pediatric care facility special reimbursement class of nursing facilities.
    • Proposed new §355.316(a) provides the purpose of the section.
    • New subsection (b) provides the definitions used in this section.
    • New subsection (c) describes the payment rate determination process.
    • New §355.316(c)(2) describes the payment rate methodology that is revised to comply with Rider 40 and is based upon the unadjusted federal per diem rate for rural Medicare skilled nursing facilities for the most recent federal fiscal year.
    • Language removed from §355.307 that does not correspond with the revised payment rate methodology per Rider 40 is not included in proposed new §355.316.
    • Language removed from §355.307 that reflects payment rate determination on an annual schedule is also not included in proposed new §355.316.
    • Language removed from §355.307 and moved to proposed new §355.316 that contains the phrase “HHSC Rate Analysis” is replaced with “HHSC Provider Finance Department” to reflect the new name of the department.
    • New subsection (d) describes the process of disqualification from the pediatric care facility special reimbursement class. The proposal incorporates general clarifying edits into proposed new §355.316.

Adopted Rules Re:

Amending 1 TAC §353.2 to add definitions of “Adoption Assistance Program,” “Permanency Care Assistance Program,” and “DFPS.”

CHAPTER 353. MEDICAID MANAGED CARE
SUBCHAPTER A. GENERAL PROVISIONS
1 TAC §353.2

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §353.2, concerning Definitions; §353.702, concerning Member Participation; and §353.1203, concerning Member Participation.

Section 353.2 is adopted without changes to the proposed text as published in the April 2, 2021, issue of the Texas Register (46 Tex Reg 2132). This rule will not be republished.

The amendment to §353.2 adds definitions of “Adoption Assistance Program” and “Permanency Care Assistance Program” because these terms are used in the proposed amendments to §353.702 and §353.1203. The amendment also adds a definition of “DFPS.” The agency is referenced in the new definitions of “Adoption Assistance Program” and “Permanency Care Assistance Program;” in the current definitions of “Former Foster Care Children Program,” “Medicaid for transitioning foster care youth program,” and “STAR Health;” and in §353.702(a)(1) and §353.1203(d)(5). The acronym improves the readability of those provisions.

BACKGROUND AND JUSTIFICATION

The amendments are in response to Texas Government Code §533.00531, concerning Medicaid benefits for certain children formerly in foster care, which was added by House Bill (H.B.) 72, 86th Legislature, Regular Session, 2019. Section 533.00531 requires HHSC to allow the adoptive parent or permanent managing conservator of a child who participates in the Adoption Assistance (AA) Program or Permanency Care Assistance (PCA) Program operated by the Texas Department of Family and Protective Services, and is receiving Supplemental Security Income (SSI) or was receiving SSI before enrolling in the AA Program or PCA Program, to choose for the child to receive Medicaid benefits through the STAR Health program or the STAR Kids program, instead of being required to receive benefits through STAR Kids.

The adopted rules make changes to the eligibility criteria for the STAR Health and STAR Kids programs to implement the requirements of §533.00531. In addition, the adopted rules allow children and young adults who participate in the AA Program or PCA Program and are enrolled in a Medicaid §1915(c) waiver or Medicare, to choose to receive benefits through the STAR Health program or the STAR Kids program, unless they are in a category that is specifically excluded from the STAR Kids program.


Amending 1 TAC §353.702 to update eligibility for the STAR Health program.

CHAPTER 353. MEDICAID MANAGED CARE
SUBCHAPTER H. STAR HEALTH
1 TAC §353.702

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §353.2, concerning Definitions; §353.702, concerning Member Participation; and §353.1203, concerning Member Participation.

Sections 353.702 and 353.1203 are adopted with changes to the proposed text as published in the April 2, 2021, issue of the Texas Register (46 Tex Reg 2132). These rules will be republished at 46 Tex Reg 4843, 4844.

BACKGROUND AND JUSTIFICATION

The amendments are in response to Texas Government Code §533.00531, concerning Medicaid benefits for certain children formerly in foster care, which was added by House Bill (H.B.) 72, 86th Legislature, Regular Session, 2019. Section 533.00531 requires HHSC to allow the adoptive parent or permanent managing conservator of a child who participates in the Adoption Assistance (AA) Program or Permanency Care Assistance (PCA) Program operated by the Texas Department of Family and Protective Services, and is receiving Supplemental Security Income (SSI) or was receiving SSI before enrolling in the AA Program or PCA Program, to choose for the child to receive Medicaid benefits through the STAR Health program or the STAR Kids program, instead of being required to receive benefits through STAR Kids.

The adopted rules make changes to the eligibility criteria for the STAR Health and STAR Kids programs to implement the requirements of §533.00531. In addition, the adopted rules allow children and young adults who participate in the AA Program or PCA Program and are enrolled in a Medicaid §1915(c) waiver or Medicare, to choose to receive benefits through the STAR Health program or the STAR Kids program, unless they are in a category that is specifically excluded from the STAR Kids program.


Amending 1 TAC §353.1203 to update and clarify eligibility requirements for STAR Kids.

CHAPTER 353. MEDICAID MANAGED CARE
SUBCHAPTER N. STAR KIDS
1 TAC §353.1203

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §353.2, concerning Definitions; §353.702, concerning Member Participation; and §353.1203, concerning Member Participation.

Sections 353.702 and 353.1203 are adopted with changes to the proposed text as published in the April 2, 2021, issue of the Texas Register (46 Tex Reg 2132). These rules will be republished at 46 Tex Reg 4843, 4844.

BACKGROUND AND JUSTIFICATION

The amendments are in response to Texas Government Code §533.00531, concerning Medicaid benefits for certain children formerly in foster care, which was added by House Bill (H.B.) 72, 86th Legislature, Regular Session, 2019. Section 533.00531 requires HHSC to allow the adoptive parent or permanent managing conservator of a child who participates in the Adoption Assistance (AA) Program or Permanency Care Assistance (PCA) Program operated by the Texas Department of Family and Protective Services, and is receiving Supplemental Security Income (SSI) or was receiving SSI before enrolling in the AA Program or PCA Program, to choose for the child to receive Medicaid benefits through the STAR Health program or the STAR Kids program, instead of being required to receive benefits through STAR Kids.

The adopted rules make changes to the eligibility criteria for the STAR Health and STAR Kids programs to implement the requirements of §533.00531. In addition, the adopted rules allow children and young adults who participate in the AA Program or PCA Program and are enrolled in a Medicaid §1915(c) waiver or Medicare, to choose to receive benefits through the STAR Health program or the STAR Kids program, unless they are in a category that is specifically excluded from the STAR Kids program.


Amending 1 TAC §354.1311 and §354.1312 update benefits and provider requirements for Substance Abuse Dependency and Treatment Services.

CHAPTER 354. MEDICAID HEALTH SERVICES
SUBCHAPTER A. PURCHASED HEALTH SERVICES
DIVISION 22. SUBSTANCE ABUSE AND DEPENDENCY TREATMENT SERVICES
1 TAC §354.1311, §354.1312

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to §354.1311, concerning Benefits and Limitations, and §354.1312, concerning Conditions for Participation.

The amendment to §354.1312 is adopted with changes to the proposed text as published in the February 12, 2021, issue of the Texas Register (46 Tex Reg 1002). This rule will be republished. The amendment to §354.1311 is adopted without changes to the proposed text as published in the February 12, 2021, issue of the Texas Register (46 Tex Reg 1002). This rule will not be republished.

BACKGROUND AND JUSTIFICATION

The amendments update rules for Substance Abuse Dependency and Treatment Services and are necessary to comply with the Mental Health Parity and Addiction Equity Act of 2008 and the Centers for Medicare & Medicaid Services (CMS) Medicaid and CHIP Mental Health Parity Final Rule issued in March 2016, related to mental health parity requirements for Medicaid and CHIP managed care organizations. The final CMS Medicaid/CHIP parity rule requires that quantitative treatment limits (limits on scope or duration) for mental health (MH) and substance use disorder (SUD) benefits cannot be more restrictive than substantially all medical or surgical benefits in a classification (e.g., outpatient services).

SECTION-BY-SECTION SUMMARY

The amendment to §354.1311 modernizes the title from Substance Abuse and Dependency Treatment Services to Substance Use Disorder (SUD) Treatment Services and allows limits on outpatient counseling (both individual and group) and residential treatment for adults to be exceeded with documentation of the supporting medical necessity for continued services. Previously, only children under the age of 21 could exceed benefit limits for these services.

The amendment to §354.1312 clarifies and expands the types of providers who may deliver medication assisted treatment (MAT), consistent with the Comprehensive Addiction and Recovery Act of 2016; the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act of 2018; Senate Bill 1564, 86th Legislature, Regular Session, 2019; and Medicaid SUD medical policy updates to the Texas Medicaid Provider Procedures Manual.


In Addition Re:

Public Notice: Texas State Plan for Medical Assistance Amendment Effective October 1, 2021

OVERVIEW

The Texas Health and Human Services Commission (HHSC) announces its intent to submit two amendments to the Texas State Plan for Medical Assistance under Title XIX of the Social Security Act. The amendments are proposed to be effective on October 1, 2021.

The proposed amendments will create a Hospital Augmented Reimbursement Program (HARP) for eligible hospitals. HHSC is creating this program to continue the financial transition for providers who have historically participated in the Delivery System Reform Incentive Payment program. HARP will provide additional funding to hospitals to help offset the cost hospitals incur while providing Medicaid services. The payment calculation will be based on a participating hospital’s Medicare payment gap and/or Average Commercial Reimbursement (ACR) gap. The non-federal share of the payments will come from intergovernmental transfers and not general revenue.

BACKGROUND AND JUSTIFICATION

Information about the proposed rule can be found in the July 16, 2021, issue of the Texas Register (46 Tex Reg 4248) at http://www.sos.state.tx.us/texreg/index.shtml. The proposed rule is also posted on the HHSC website at https://pfd.hhs.texas.gov/sites/rad/files/documents/pfc/harp-tac-draft-proposed-rule.pdf.

Interested parties may obtain additional information and/or a free copy of the proposed amendments by contacting Holly Freed, State Plan Team Lead, by mail at the Health and Human Services Commission, P.O. Box 13247, Mail Code H-600, Austin, Texas 78711; by telephone at (512) 428-1932; by facsimile at (512) 730-7472; or by e-mail at Medicaid_Chip_SPA_Inquiries@hhsc.state.tx.us. Copies of the proposed amendment will be available for review at the local county offices of HHSC, (which were formerly the local offices of the Texas Department of Aging and Disability Services).

HEARING DETAILS

A proposed rule was published on July 16, 2021, in the Texas Register. The HHSC conducted a public hearing on July 29, 2021, at 11:00 a.m. to receive public comments on the proposed rule for the HARP.


Public Notice: Texas State Plan for Medical Assistance Amendment Effective September 1, 2021

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, 2021.

BACKGROUND AND JUSTIFICATION

The purpose of the amendment is to update the fee schedules in the current state plan by adjusting fees, rates, or charges for the following services:

  • Ambulatory Surgical Centers / Hospital Based Ambulatory Surgical Centers;
  • Clinical Diagnostic Laboratory Services;
  • Durable Medical Equipment, Prosthetics, Orthotics and Supplies;
  • Early and Periodic Screening, Diagnosis and Treatment Services;
  • Home Health Services; and
  • Physicians and Other Practitioners.

Interested parties may obtain additional information and/or a free copy of the proposed amendment by contacting Kevin Niemeyer, State Plan Policy Advisor, by mail at the Health and Human Services Commission, P.O. Box 13247, Mail Code H-600, Austin, Texas 78711; by telephone at (512) 487-3349; by facsimile at (512) 730-7472; or by e-mail at Medicaid_Chip_SPA_Inquiries@hhsc.state.tx.us. Copies of the proposed amendment will be available for review at the local county offices of HHSC (which were formerly the local offices of the Texas Department of Aging and Disability Services).

HEARING DETAILS

A rate hearing was conducted online on May 25, 2021, at 9:00 a.m. Information about the proposed rate changes and the hearing were published in the May 7, 2021 issue of the Texas Register (46 TexReg 3057). The notice of hearing can be found at http://www.sos.state.tx.us/texreg/index.shtml.

A rate hearing was also conducted online on July 12, 2021, at 9:00 a.m. Information about the proposed rate changes and the hearing were published in the July 2, 2021 issue of the Texas Register (46 Tex Reg 4045). The notice of hearing can be found at http://www.sos.state.tx.us/texreg/index.shtml.


Department of Aging and Disability Services

Emergency Rules Re:

Renewing 40 TAC §9.597 to outline requirements for Texas Home Living providers in response to COVID-19.

CHAPTER 9. INTELLECTUAL DISABILITY SERVICES–MEDICAID STATE OPERATING AGENCY RESPONSIBILITIES
SUBCHAPTER N. TEXAS HOME LIVING (TXHML) PROGRAM AND COMMUNITY FIRST CHOICE (CFC)
40 TAC §9.597

OVERVIEW

The Department of Aging and Disability Services is renewing the effectiveness of emergency new §9.597 for a 60-day period. The text of the emergency rule was originally published in the April 2, 2021, issue of the Texas Register (46 Tex Reg 2128).

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) renews on an emergency basis in Title 40, Texas Administrative Code, Chapter 9, Intellectual Disability Services – Medicaid State Operating Agency Responsibilities, new §9.597, concerning Program Provider Response to COVID-19 Emergency Rule.

HHSC is renewing an emergency rule to reduce the risk of spreading COVID-19 to individuals in the Texas Home Living program. This new rule describes the requirements that Texas Home Living providers must immediately put into place.

BACKGROUND AND JUSTIFICATION

As authorized by Texas Government Code §2001.034, HHSC may adopt an emergency rule without prior notice or hearing if it finds that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.

The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this emergency rule for provider response to COVID-19.


Texas Board of Physical Therapy Examiners

Adopted Rules Re:

Amending 22 TAC §329.1 to update application requirements for Physical Therapy licensure.

CHAPTER 329. LICENSING PROCEDURE
22 TAC §329.1

The Texas Board of Physical Therapy Examiners adopts amendments to 22 Texas Administrative Code (TAC) §329.1. General Licensure Requirements and Procedures. The amendments are adopted without changes to the proposed text as published in the March 12, 2021, issue of the Texas Register (46 Tex Reg 1584). The rule will not be republished.

The amendment is adopted to add reference to the definitions of an accredited PT and PTA program; to differentiate between the school transcript requirement for an applicant by exam and an applicant by endorsement; to allow for digital submission of a letter of completion for applicants by exam; and to eliminate the requirement for a letter of completion for an applicant by endorsement if the transcript indicates the date the degree was conferred. The amendment will remove potential barriers to licensure and will improve the efficiency of issuing licenses.