Texas Register – December 17, 2021 Volume: 46 Number: 51

Health and Human Services Commission

Emergency Rules Re:

Renewing 26 TAC §500.4 to allow for the temporary expansion of hospital capacity through participation in the CMS Acute Hospital Care at Home Program. 

CHAPTER 500. COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSING
SUBCHAPTER A. HOSPITALS
26 TAC §500.4

OVERVIEW

The Health and Human Services Commission is renewing the effectiveness of emergency new §500.4 for a 60-day period. The text of the emergency rule was originally published in the August 20, 2021, issue of the Texas Register (46 Tex Reg 5119).

HHSC is renewing an emergency rule to temporarily permit a currently licensed hospital to participate in the CMS hospitals at home program to expand hospital capacity in response to the COVID-19 pandemic.

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 Participating in the Centers for Medicare and Medicaid Services Acute Hospital Care at Home Program During the COVID-19 Pandemic.


New 26 TAC §551.46, outlining the requirements for ICF/IID Provider Response to COVID-19.

CHAPTER 551. INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS
SUBCHAPTER C. STANDARDS FOR LICENSURE
26 TAC §551.46

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26, Part 1, Texas Administrative Code, Chapter 551, Subchapter C, new §551.46, concerning an emergency rule to mitigate and contain COVID-19 in an intermediate care facility for individuals with an intellectual disability (ICF/IID) or related condition.

HHSC is adopting an emergency rule to mitigate and contain COVID-19. The purpose of the new rule is to describe requirements for ICF/IID Provider Response to COVID-19.

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 this 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 ICF/IID Provider Response to COVID-19 – Mitigation.


Renewing 26 TAC §551.48 to require intermediate care facilities for individuals with an intellectual disability to report COVID-19 vaccination status of staff and other individuals in the facility.

CHAPTER 551. INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS
SUBCHAPTER C. STANDARDS FOR LICENSURE
26 TAC §551.48

The Health and Human Services Commission is renewing the effectiveness of emergency new §551.48 for a 60-day period. The text of the emergency rule was originally published in the August 27, 2021, issue of the Texas Register (46 Tex Reg 5333).

HHSC is renewing an emergency rule to require ICF/IID to report COVID-19 vaccinations of staff and individuals in ICF/IID and to require enrollment for the emergency communication system. The emergency rule describes the requirements related to such reporting and enrollment.

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 emergency rule for ICF/IID Provider COVID-19 Vaccination Data Reporting Requirement.


New 26 TAC §553.2001, requiring assisted living facility actions to mitigate and contain COVID-19.

CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER K. COVID-19 RESPONSE
26 TAC §553.2001

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC or Commission) adopts on an emergency basis in Title 26 Texas Administrative Code, Chapter 553, Licensing Standards for Assisted Living Facilities, new §553.2001, concerning an emergency rule in response to COVID-19 and requiring assisted living facility actions to mitigate and contain COVID-19.

HHSC is adopting an emergency rule to require assisted living facility actions to mitigate and contain COVID-19. The purpose of the new rule is to describe these requirements.

BACKGROUND AND JUSTIFICATION

As authorized by Texas Government Code §2001.034, the Commission 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 Assisted Living Facility COVID-19 Response.


In Addition Re:

Public Notice – Texas State Plan for Home Health Care and Related Services Amendment Effective October 1, 2021

OVERVIEW

The Texas Health and Human Services Commission (HHSC) announces its intent to submit an amendment to the Texas State Plan for Home Health Care and Related Services under Title XIX of the Social Security Act. The proposed amendment is effective October 1, 2021.

BACKGROUND AND JUSTIFICATION

The purpose of the amendment is to update Home Health Care and Related Services pages to allow a physician assistant (PA), certified nurse practitioner (CNP), or clinical nurse specialist (CNS), to the extent allowed by Texas state licensure, to certify eligibility for home health services, as well as establish and periodically review the home health plan of care. This proposal aligns with CMS-5531-IFC codified at 42 C.F.R. §440.70. The relevant sections of CMS-5531-IFC adopted permanent federal regulation that is not subject to the Public Health Emergency and went into effect on May 8, 2020, with a retroactive application date of March 1, 2020.

Interested parties may obtain additional information and/or a free copy of the proposed amendments by contacting Shae James, State Plan Coordinator, by mail at the Health and Human Services Commission, P.O. Box 13247, Mail Code H-600, Austin, Texas 78711; or by email at Medicaid_ Chip_ SPA_ Inquiries@hhsc.state.tx.us. Copies of proposed amendment will be available for review at the local county offices of HHSC, (which were formerly the local offices of Texas Department of Aging and Disability Services).


Public Notice – Texas State Plan for Medical Assistance Amendments Effective January 2, 2022

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 are effective January 1, 2022.

BACKGROUND AND JUSTIFICATION

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:

2022 Annual Healthcare Common Procedure Coding System (HCPCS) Updates:

  • Ambulance Services;
  • Ambulatory Surgical Center;
  • Birthing Center Facility Services;
  • Case Management Services;
  • Certified Pediatric Nurse Practitioners and Certified Family Nurse Practitioners;
  • Certified Registered Nurse Anesthetists and Anesthesiologist Assistants;
  • Clinical Diagnostic Laboratory Services;
  • Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS);
  • Early and Periodic Screening, Diagnosis, and Treatment Services (EPSDT);
  • Family Planning Services;
  • Hearing Aids and Audiometric Evaluations;
  • Home Health Services;
  • Indian Health Services;
  • Licensed Clinical Social Worker Services;
  • Licensed Professional Counselor Services;
  • Licensed Marriage and Family Therapist Services;
  • Physicians and Other Practitioners;
  • Physician Assistants;
  • Rehabilitative Chemical Dependency Treatment Facility Services; and
  • Vision Care Services.

The proposed amendments are estimated to result in an annual aggregate expenditure of $1,188,367 for federal fiscal year (FFY) 2022, consisting of $722,527 in federal funds and $465,840 in state general revenue. For FFY 2023, the estimated result is an annual aggregate expenditure of $1,557,237, consisting of $951,316 in federal funds and $605,921 in state general revenue. For FFY 2024, the estimated result is an annual aggregate expenditure of $1,530,452, consisting of $934,953 in federal funds and $595,499 in state general revenue.

Further detail on specific reimbursement rates and percentage changes will be made available on the HHSC Provider Finance website under the proposed effective date at: http://pfd.hhs.texas.gov/rate-packets.

A rate hearing will be held both online and in person to address the 2022 Annual Healthcare Common Procedures Coding System (HCPCS) Updates. Once available, information about the proposed rate changes and the hearing will be published in a subsequent issue of the Texas Register at http://www.sos.state.tx.us/texreg/index.shtml.

Interested parties may obtain additional information and/or a free copy of the proposed amendments by contacting Holly Freed, 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@hhs.texas.gov. Copies of the proposed amendments 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).