Texas Register Table of Contents
- 1 Texas Health and Human Services Commission
- 2 Texas Department on Aging and Disability Services
- 3 Texas Department of State Health Services
- 4 Texas Department of State Health Services
- 5 Texas Health and Human Services Commission
- 6 Texas Health and Human Services Commission
- 7 Texas Health and Human Services Commission
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Texas Health and Human Services Commission
Emergency Rule
Renewing the effectiveness of 26 TAC §500.1 to allow licensed hospitals to operate an off-site inpatient facility without obtaining a new license during the COVID-19 crisis
CHAPTER 500. COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSINGSUBCHAPTER A. HOSPITALS26 TAC §500.1OVERVIEWThe Health and Human Services Commission is renewing the effectiveness of emergency new §500.1 for a 60-day period in order to allow licensed hospitals to operate an off-site inpatient facility without obtaining a new license in response to the COVID-19 crisis. EMERGENCY RULE DETAILSThe text of the emergency rule was originally published in the April 3, 2020, issue of the Texas Register (45 TexReg 2279).Emergency rule 26 TAC §500.1 allows a currently licensed hospital to operate an off-site inpatient facility without obtaining a new license at: (1) another type of facility currently licensed or licensed within the past 36 months or a facility pending licensure that has passed its final architectural review inspection, such as an ambulatory surgical center, an assisted living facility, a freestanding emergency medical care facility, an inpatient hospice unit, a mental hospital, or a nursing facility; (2) an outpatient facility operated by the hospital; (3) a formerly licensed hospital that closed within the past 36 months or a hospital pending licensure that has passed its final architectural review inspection; (4) a hospital exempt from licensure; and (5) a mobile, transportable, or relocatable unit.
Texas Department on Aging and Disability Services
Emergency Rule
Amending 40 TAC §30.14 to allow physicians to virtually conduct face-to-face assessments for Medicaid hospice re-certification
CHAPTER 30. MEDICAID HOSPICE PROGRAMSUBCHAPTER B. ELIGIBILITY REQUIREMENTS40 TAC §30.14OVERVIEWThe Executive Commissioner of the Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 40 Texas Administrative Code, Chapter 30, Medicaid Hospice Program, an amendment to §30.14(e), concerning an emergency rule in response to COVID-19 in order to allow face-to-face reassessments for recertification to be conducted as a telemedicine medical service. The emergency amendment to §30.14(e) allows a hospice physician or hospice advanced practice registered nurse to conduct a face-to-face assessment of an individual as a telemedicine medical service, as defined in Texas Government Code §531.001(8), if the sole purpose of the assessment is for hospice recertification. This amendment will reduce the risk of transmitting COVID-19.BACKGROUND AND JUSTIFICATIONAs 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. The Commission accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this emergency amendment to §30.14, concerning Certification of Terminal Illness and Record Maintenance.
Texas Department of State Health Services
Proposed Rules
Repealing 25 TAC §73.11 and §73.52 to shift responsibility for the certification of milk and shellfish laboratories to the Consumer Protection Division
CHAPTER 73. LABORATORIES25 TAC §73.11, §73.52OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), proposes the repeal of §73.11, concerning Certification of Milk and Shellfish Laboratories; and the repeal of §73.52, concerning Fees for the Certification of Milk and Shellfish Laboratories.BACKGROUND AND JUSTIFICATION The purpose of the proposal is to remove the DSHS State Laboratory rules in Chapter 73, concerning Laboratories, and create new rules in Texas Administrative Code Title 25, Chapter 218, concerning Evaluation of Milk and Shellfish Laboratories.Currently, the responsibility for the evaluation of milk and shellfish laboratories resides with the DSHS Consumer Protection Division through its Milk and Dairy program. However, the rules are located in Chapter 73, as the DSHS State Laboratory Services Section was previously responsible for the program.New §§218.1 – 218.7, concerning Evaluation of Milk Laboratories, and new §§218.21 – 218.26, concerning Evaluation of Shellfish Laboratories are published elsewhere in this issue of the Texas Register. The new rules in Chapter 218 reflect updated language and laboratory practices concerning the Milk and Dairy program and the Seafood and Aquatic Life program.
Texas Department of State Health Services
Proposed Rules
New 25 TAC §§218.1 – 218.7, establishing rules for milk laboratories under the Consumer Protection Division’s Milk and Dairy Program
CHAPTER 218. EVALUATION OF MILK AND SHELLFISH LABORATORIESSUBCHAPTER A. EVALUATION OF MILK LABORATORIES25 TAC §§218.1 – 218.7OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), proposes new §§218.1 – 218.7, concerning Evaluation of Milk Laboratories.BACKGROUND AND JUSTIFICATION The purpose of the proposal is to remove the rules from the DSHS State Laboratory Services Section in Chapter 73, concerning Laboratories, and create new Texas Administrative Code Title 25, Chapter 218, concerning Evaluation of Milk and Shellfish Laboratories.Currently, the responsibility for the evaluation of milk and shellfish laboratories resides with the DSHS Consumer Protection Division through its Milk and Dairy program. However, the rules are located in Chapter 73, as the DSHS State Laboratory Services Section was previously responsible for the program. The repeal of §73.11, concerning Certification of Milk and Shellfish Laboratories, and the repeal of §73.52, concerning Fees for the Certification of Milk and Shellfish Laboratories, are published elsewhere in this issue of the Texas Register.The new rules in Chapter 218 reflect updated language and laboratory practices concerning the Milk and Dairy program.SECTION-BY-SECTION SUMMARYProposed new §218.1, Purpose, provides the purpose of the subchapter that establishes the procedures for milk laboratories to become accredited or approved laboratories.Proposed new §218.2, Definitions, adds definitions to reflect updated milk laboratory practices.Proposed new §218.3, Evaluation of Milk Laboratories, includes the adoption of Evaluation of Milk Laboratories, published by the U.S. Department of Health and Human Services, Public Health Service, Food and Drug Administration, and the National Conference on Interstate Milk Shipments as a reference for the procedures for the evaluation of milk laboratories.Proposed new §218.4, Accreditation or Approval Application, describes the application process and includes the current categories of milk laboratories.Proposed new §218.5, Standards, contains the minimum standards for laboratories applying for or renewing accreditation or approval and includes Milk and Dairy Unit contact information.Proposed new §218.6, Inspections, adds the language for laboratory inspections for compliance with minimum standards.Proposed new §218.7, Withdrawal of Accreditation or Approval, adds language for the withdrawal of accreditation or approval.
Texas Health and Human Services Commission
Adopted Rules
Amending 1 TAC §353.1305 to extend eligibility for the Medicaid Managed Care uniform hospital rate increase program to non-state-owned institutions for mental disease
CHAPTER 353. MEDICAID MANAGED CARESUBCHAPTER O. DELIVERY SYSTEM AND PROVIDER PAYMENT INITIATIVES1 TAC §353.1305OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts an amendment to §353.1305, concerning Uniform Hospital Rate Increase Program. The amendment is adopted with changes to the proposed text as published in the April 24, 2020, issue of the Texas Register (45 TexReg 2620). The rule will be republished.The purpose of the rule amendment is to include non-state-owned institutions for mental diseases (IMDs) as a class of hospital eligible for rate increases under the uniform hospital rate increase program (UHRIP).BACKGORUND AND JUSTIFICATIONUHRIP is a Medicaid managed care directed payment program authorized by 42 CFR §438.6(c). HHSC launched UHRIP as a pilot project in December 2017 in the El Paso and Bexar managed care service delivery areas (SDAs). In September 2018, UHRIP expanded to the entire state. Through UHRIP, managed care organizations (MCOs) are contractually required to increase the reimbursement rate paid to hospitals for inpatient and outpatient services. The rate increase is a uniform percentage that varies by hospital class. UHRIP is a voluntary program and requires participation from all MCOs and network hospitals in an SDA.Federal regulation has largely prohibited states from receiving federal Medicaid funds for services provided to beneficiaries in IMDs. This restriction is commonly referred to as the “Medicaid IMD Exclusion.” However, two exemptions exist under §1905(a) of the Social Security Act: (1) inpatient hospital services and nursing facility services for individuals 65 years of age or older, and (2) inpatient psychiatric hospital services for individuals under age 21.The rule amendment includes non-state-owned IMDs among the classes of hospitals eligible for rate increases under UHRIP. Rate increases will apply only to payments made for inpatient psychiatric hospital services provided by non-state-owned IMDs to individuals under the age of 21 or inpatient hospital services provided by non-state-owned IMDs to individuals 65 years of age or older. Expanding UHRIP to these providers will increase the availability of services for eligible Medicaid beneficiaries with behavioral health needs.The rule amendment provides that UHRIP rate increases apply only to the in-network managed care claims billed under the primary National Provider Identifier (NPI) number associated with the hospital. The amendment clarifies that a non-hospital sub-provider owned or operated by a hospital is not eligible to receive the increase.
Texas Health and Human Services Commission
In Addition
HHSC will request an amendment to the THTQIP waiver to provide Medicaid Home and Community-Based Services to certain individuals deemed medically fragile
OVERVIEWThe Health and Human Services Commission (HHSC) plans to submit a request to the Centers for Medicare & Medicaid Services (CMS) for an amendment to the Texas Healthcare Transformation Quality Improvement Program (THTQIP) waiver under section 1115 of the Social Security Act. CMS has approved this waiver through September 30, 2022.If determined cost effective and approved by CMS, the waiver amendment proposed by HHSC will provide Medicaid Home and Community-Based Services (HCBS) to a limited number of medically fragile adults whose health care costs exceed current cost limits with an effective date of September 1, 2021.BACKGROUND AND JUSTIFICATION This amendment is in response to House Bill (H.B.) 4533, SECTION 32, 86th Legislature, Regular Session, 2019 which requires HHSC to pursue a benefit for medically fragile individuals.The medically fragile group will consist of individuals who have high medical needs based on an assessment and whose needs exceed existing program cost limits. When it is determined an individual’s service plan is at or near the STAR+PLUS Home and Community-Based Services (HCBS) program cost limit (usually prior to aging out of children’s Medicaid or when leaving a nursing facility), the individual may be considered for the proposed program. If determined eligible for the program, these members will be able to access additional home and community-based services through Texas’ 1115 waiver, without an individual cost limit. There will be a limit on the number of slots in this category, to be determined based on cost effectiveness.ADDITIONAL INFORMATIONAn individual may obtain a free copy of the proposed waiver amendment, ask questions, obtain additional information, or submit comments regarding this amendment by contacting Luis Solorio by U.S. mail, telephone, or email. The respective addressed are listed in this week’s edition of the Texas Register (45 Tex Reg 5431).
Texas Health and Human Services Commission
In Addition
HHSC will request amendments to the Title XIX Texas State Plan for Medical Assistance to update fee schedules for early and periodic screening, diagnosis, and treatment services
OVERVIEWThe 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 part of a Special Review of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) as a result of the 21st Century Cures Act (P.L. 114-255), signed into law on December 13, 2016. The amendments are proposed to be effective August 1, 2020.The purpose of the amendments is to update the fee schedules in the current state plan by adjusting fees, rates, or charges for DMEPOS and Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services.HEARINGHHSC will conduct a public rate hearing online for the proposed rate changes. For information on the date, time, and how to access the hearing, please continue to monitor the HHSC website at https://hhs.texas.gov/about-hhs/communications-events/meetings-events. 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.ADDITIONAL INFORMATIONInterested parties may obtain additional information and/or a free copy of the proposed amendments by contacting Cynthia Henderson, State Plan Policy Advisor, at addresses provided in this week’s edition of the Texas Register (45 Tex Reg 5431).