Texas Register - October 29, 2021 Volume: 46 Number: 44

Texas Register Table of Contents

1 Governor
- - 1.0.1 Executive Order GA-40
    - 1.0.1.1 The Governor issued Executive Order GA-40, relating to prohibiting vaccine mandates, subject to legislative action.
2 Health and Human Services Commission
- - 2.0.1 Proposed Rules Re:
  - 2.0.2 In addition Re:

Governor

Executive Order GA-40

The Governor issued Executive Order GA-40, relating to prohibiting vaccine mandates, subject to legislative action.

NOW, THEREFORE, Greg Abbott, Governor of Texas, by virtue of the power and authority vested by the Constitution and laws of the State of Texas, does hereby order the following on a statewide basis effective immediately:

No entity in Texas can compel receipt of a COVID-19 vaccine by any individual, including an employee or a consumer, who objects to such vaccination for any reason of personal conscience, based on a religious belief, or for medical reasons, including prior recovery from COVID-19. I hereby suspend all relevant statutes to the extent necessary to enforce this prohibition.
The maximum fine allowed under Section 418.173 of the Texas Government Code and the State’s emergency management plan shall apply to any “failure to comply with” this executive order. Confinement in jail is not an available penalty for violating this executive order.
This executive order shall supersede any conflicting order issued by local officials in response to the COVID-19 disaster. Pursuant to Section 418.016(a) of the Texas Government Code, I hereby suspend Sections 418.1015(b) and 418.108 of the Texas Government Code, Chapter 81, Subchapter E of the Texas Health and Safety Code, and any other relevant statutes, to the extent necessary to ensure that local officials do not impose restrictions in response to the COVID-19 disaster that are inconsistent with this executive order.

This executive order does not supersede Executive Orders GA-13, GA-37, GA-38, or GA-39. This executive order shall remain in effect and in full force unless it is modified, amended, rescinded, or superseded by the governor. This executive order may also be amended by proclamation of the governor.

Health and Human Services Commission

Proposed Rules Re:

Amending 26 TAC §745.8913 to clarify how Licensing will determine whether another state’s license requirements are substantially equivalent to the requirements for an administrator’s license.

CHAPTER 745. LICENSING
SUBCHAPTER N. ADMINISTRATOR’S LICENSING
DIVISION 1. OVERVIEW OF ADMINISTRATOR’S LICENSING
26 TAC §745.8913

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §745.8913, concerning Can my licensure in another state qualify me for an administrator’s license, §745.8933, concerning What must a complete application to become a licensed administrator include, §745.9025, concerning What terms must I know to understand this division, §745.9026, concerning What special considerations can Licensing give to a military member, military spouse, or military veteran that applies for an administrator’s license, §745.9027, concerning What must a military member, military spouse, or military veteran submit to Licensing in order to receive special consideration during the application process, and §745.9030, concerning When may a military spouse who has a substantially equivalent license in another state act as an administrator without obtaining a license under this subchapter, in Title 26, Texas Administrative Code, Chapter 745, Licensing, Subchapter N, Administrator’s Licensing.

The proposed amendment to §745.8913 adds a citation to clarify how Licensing will determine whether another state’s license requirements are substantially equivalent to the requirements for an administrator’s license under this subchapter.

BACKGROUND AND JUSTIFICATION

The proposal is to implement House Bill 139, 87th Legislature, Regular Session, 2021, which amended §§55.001, 55.004, and 55.0041 of Texas Occupations Code. The proposed changes will update the current requirements for a military member, spouse, or veteran that applies for an administrator’s license for a general residential operation, child-placing agency, or both, including a military spouse with an equivalent license in another state seeking to act as an administrator without obtaining an administrator’s license. Specifically the changes (1) expand military members of armed forces to include members of the space force; (2) clarify that a military member, spouse, or veteran must receive credit for any training, education, or experience that meets a requirement for an administrator’s license; and (3) require a military spouse with a license in another state seeking to act as an administrator without obtaining an administrator’s license to submit a copy of the permanent change of station order for the military member to whom the spouse is married to establish residency. In addition, HHSC is proposing changes to the rules, including the addition of citations, to improve the readability and understanding of the rules.

Amending 26 TAC §745.8933 to clarify requirements for military spouses with a license in another state seeking to act as an administrator without obtaining a new administrator’s license under this subchapter.

CHAPTER 745. LICENSING
SUBCHAPTER N. ADMINISTRATOR’S LICENSING
DIVISION 2. SUBMITTING YOUR APPLICATION MATERIALS
26 TAC §745.8933

OVERVIEW

The proposed amendment to §745.8933 clarifies that a military spouse with a license in another state seeking to act as an administrator without obtaining an administrator’s license under this subchapter must complete the application as specified in §745.9030. There is also a change to improve readability and understanding.

BACKGROUND AND JUSTIFICATION

Amending 26 TAC §§745.9025 – 745.9027, 745.9030 to improve transparency regarding administrator’s licensing requirements for military members, military spouses, and military veterans.

CHAPTER 745. LICENSING
SUBCHAPTER N. ADMINISTRATOR’S LICENSING
DIVISION 5. MILITARY MEMBERS, MILITARY SPOUSES, AND MILITARY VETERANS
26 TAC §§745.9025 – 745.9027, 745.9030

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed amendment to §745.9025 clarifies that the armed forces include the space force.
The proposed amendment to §745.9026 clarifies (1) the title of the Associate Commissioner; (2) that a military member, spouse, or veteran must receive credit for any military service, training, education, or experience that meets a requirement for an administrator’s license; (3) that Licensing will waive the application and examination fees for a military member, spouse, or veteran whose military service, training, education, or experience substantially meets the requirements for an administrator’s license; and (4) how Licensing will determine whether another state’s license requirements are substantially equivalent to the requirements for a license under this subchapter by adding a citation. There are also changes to improve readability and understanding.
The proposed amendment to §745.9027 clarifies that a military spouse with a license in another state seeking to act as an administrator without a license under this subchapter must comply with the requirements of §745.9030 to receive special consideration during the application process. There is also a change to improve readability and understanding.
The proposed amendment to §745.9030 (1) makes several changes to improve the readability and understanding and (2) requires a military spouse to submit a copy of the permanent change of station order for the military member to whom the spouse is married to establish residency.

In addition Re:

Notice of Proposed Implementation of Revenue Code Benefit Ending for End-Stage Renal Disease (ESRD) Facility Reimbursement

HEARING DETAILS

The Health and Human Services Commission (HHSC) will conduct a public hearing to receive comments regarding the Medical Policy Review of End Stage Renal Dialysis (ESRD) Facilities. HHSC proposes that, effective March 1, 2022, revenue codes for the following services will no longer be a benefit of the Texas Medicaid Program: 634, 635, 636, 845, and 855. HHSC will hold the hearing on the proposal on November 19, 2021, at 1:00 p.m. HHSC will consider all concerns expressed at the hearing prior to final approval. This public hearing will be held in compliance with Texas Human Resources Code §32.0282, which requires a public hearing on proposed payment adjustments. Due to the declared state of disaster stemming from COVID-19, this hearing will be conducted both in-person and as an online event. To join the hearing from your computer, tablet, or smartphone, register for the hearing in advance using the following link:

https://attendee.gotowebinar.com/register/8422603633781796878

SUMMARY

HHSC has realigned revenue codes to conform with medical policy for ESRD Facilities, effective March 1, 2022.

METHODOLOGY

The affected revenue codes were either end dated or designated “Not A Benefit” to comply with the associated ESRD medical policy, which requires provider notification.

Notice of Public Hearing on Proposed Medicaid Payment Rates for the Medicaid Biennial Calendar Fee Review

HEARING DETAILS

The Texas Health and Human Services Commission (HHSC) will conduct a public hearing on November 19, 2021, at 1:00 p.m., to receive public comments on proposed Medicaid payment rates for the Medicaid Biennial Calendar Fee Review.

Due to the declared state of disaster stemming from COVID-19, this hearing will be conducted both in-person and as an online event. To join the hearing from your computer, tablet, or smartphone, register for the hearing in advance using the following link:

https://attendee.gotowebinar.com/register/8422603633781796878

PROPOSAL OVERVIEW

The payment rates for the Medicaid Biennial Calendar Fee Review are proposed to be effective March 1, 2022, for the following services:

Allergy Tests
Auditory System Surgery
Autism Services
Cardiovascular Services plus Cardiography & Echocardiography
Cardiovascular Services (Hospitals)
Diagnostic Radiology (Hospitals)
Renal Dialysis
Ear, Nose, and Throat
Female Genital System Surgery
Gastroenterology (non-Hospital)
Gastroenterology (Hospitals)
IV Treatment Including Chemotherapy
Male Genital System Surgery
Medicine (Other)
Medicine (Other) Anesthesia
Noninvasive Vascular Diagnostic Studies (Acute Care)
Noninvasive Vascular Diagnostic Studies (Hospitals)
Outpatient Behavioral Health Services (includes Peer Support Specialists)
Pulmonary Services
Radiation Oncology
Radiopharmaceuticals
R Codes
Blood Products
Musculoskeletal System Surgery
Nuclear Medicine
Nuclear Medicine (Hospitals)
Physician Administered Drugs – Non-Oncology
Physician Administered Drugs – Oncology
Physician Administered Drugs – NDCX
Substance Abuse Disorder Services
Q Codes TOS 1, 4, I, T
Q Codes TOS 9, J
Q Codes Drugs
Q Codes Hospitals
Dialysis

BACKGROUND AND JUSTIFICATION

The proposed payment rates were calculated in accordance with Title 1 of the Texas Administrative Code:

§355.8021, which addresses the reimbursement methodology for home health services;
§355.8023, which addresses the reimbursement methodology for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS);
§355.8052, which addresses the reimbursement methodology for inpatient hospital services;
§355.8061, which addresses outpatient hospital reimbursement;
§355.8085, which addresses the reimbursement methodology for physicians and other practitioners;
§355.8091, which addresses reimbursement methodology for licensed professional counselors, licensed clinical social workers, and licensed marriage and family therapists;
§355.8097, which addresses the reimbursement methodology for physical, occupational, and speech therapy services;
§355.8161, which addresses the reimbursement methodology for midwife services;
§355.8181, which addresses the reimbursement methodology for birthing center reimbursement;
§355.8221, which addresses the reimbursement methodology for a certified registered nurse anesthetist (CRNA) or an anesthesiologist assistant;
§355.8441, which addresses the reimbursement methodologies for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services (known in Texas as Texas Health Steps) and the THSteps Comprehensive Care Program (CCP);
§355.8610, which addresses the reimbursement methodology for clinical laboratory services; and
§355.8660, which addresses the reimbursement methodology for renal dialysis.

COMMENT DETAILS

Written comments regarding the proposed payment rates may be submitted in lieu of, or in addition to, oral testimony until 5:00 p.m. the day of the hearing. Written comments may be sent by U.S. mail to the Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, P.O. Box 149030, Austin, Texas 78714-9030; by fax to Provider Finance at (512) 730-7475; or by e-mail to PFDAcuteCare@hhs.texas.gov. In addition, written comments may be sent by overnight mail to Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, North Austin Complex, 4601 Guadalupe St, Austin, Texas 78751.

Notice of Public Hearing on Proposed Medicaid Payment Rates for the Medical Policy Review of IV Therapy Equipment and Supplies

HEARING DETAILS

https://attendee.gotowebinar.com/register/8422603633781796878

PROPOSAL OVERVIEW

The payment rates for the Medicaid Medical Policy Review of IV Therapy Equipment and Supplies are proposed to be effective March 1, 2022.

BACKGROUND AND JUSTIFICATION

The proposed payment rates were calculated in accordance with Title 1 of the Texas Administrative Code:

§355.8085, which addresses the reimbursement methodology for physicians and other practitioners;
§355.8023, which addresses the reimbursement methodology for durable medical equipment, prosthetics, orthotics, and supplies; and
§355.8441, which addresses the reimbursement methodology for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services (known in Texas as Texas Health Steps) and the THSteps Comprehensive Care Program (CCP).

COMMENT DETAILS

Notice of Public Hearing on Proposed Medicaid Payment Rates for the Medical Policy Review of Mobility Aids

HEARING DETAILS

https://attendee.gotowebinar.com/register/8422603633781796878 Webinar ID: 519-279-099

PROPOSAL OVERVIEW

The payment rates for the Medicaid Medical Policy Review of Mobility Aids are proposed to be effective June 1, 2022.

BACKGROUND AND JUSTIFICATION

The proposed payment rates were calculated in accordance with Title 1 of the Texas Administrative Code:

§355.8023, which addresses the reimbursement methodology for durable medical equipment, prosthetics, orthotics, and supplies; and
§355.8441, which addresses the reimbursement methodologies for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services (known in Texas as Texas Health Steps).

COMMENT DETAILS

Notice of Public Hearing on Proposed Medicaid Payment Rates for the Medical Policy Review of Q Codes

HEARING DETAILS

https://attendee.gotowebinar.com/register/8422603633781796878

PROPOSAL OVERVIEW

The payment rates for the Medicaid Medical Policy Review of Q Codes are proposed to be effective March 1, 2022.

BACKGROUND AND JUSTIFICATION

The proposed payment rates were calculated in accordance with Title 1 of the Texas Administrative Code:

§355.8085, which addresses the reimbursement methodology for physicians and other practitioners; and
§355.8441, which addresses the reimbursement methodologies for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services (known in Texas as Texas Health Steps).

COMMENT DETAILS

Notice of Public Hearing on Proposed Medicaid Payment Rates for the Quarterly Healthcare Common Procedure Coding System (HCPCS) Updates

HEARING DETAILS

https://attendee.gotowebinar.com/register/8422603633781796878

PROPOSAL OVERVIEW

The payment rates for the Quarterly HCPCS Updates are proposed to be effective March 1, 2022, for the following services:

Q1 HCPCS Drugs TOS 1
Q2 HCPCS Drugs TOS 1
Q1 HCPCS TOS 9
Q1 HCPCS TOS 4 Non-Hospitals
Q1 HCPCS TOS 4 Hospitals
Q2 HCPCS TOS 1 Non-Drugs
Q2 HCPCS TOS 2

BACKGROUND AND JUSTIFICATION

The proposed payment rates were calculated in accordance with Title 1 of the Texas Administrative Code:

§355.8023, which addresses the reimbursement methodology for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS);
§355.8052, Which addresses the reimbursement methodology for inpatient hospital services;
§355.8061, which addresses outpatient hospital reimbursement;
§355.8085, which addresses the reimbursement methodology for physicians and other practitioners; and
§355.8441, which addresses the reimbursement methodologies for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services (known in Texas as Texas Health Steps) and the THSteps Comprehensive Care Program (CCP).

COMMENT DETAILS

Notice of Public Hearing on Proposed Medicaid Payment Rates for the Special Fee Review of Cardiac Magnetic Resonance Imaging

HEARING DETAILS

https://attendee.gotowebinar.com/register/8422603633781796878

PROPOSAL OVERVIEW

The payment rates for the Medicaid Special Fee Review of Cardiac Magnetic Resonance Imaging are proposed to be effective March 1, 2022.

BACKGROUND AND JUSTIFICATION

The proposed payment rates were calculated in accordance with Title 1 of the Texas Administrative Code:

§355.8085, which addresses the reimbursement methodology for physicians and other practitioners; and
§355.8441, which addresses the reimbursement methodologies for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services (known in Texas as Texas Health Steps) and the THSteps Comprehensive Care Program (CCP).

COMMENT DETAILS

Notice of Public Hearing on Proposed Payment Rates for FFY 2022 Medicaid Community Hospice, Personal Attendant Services, and the Biennial Fee Review

HEARING DETAILS

The Texas Health and Human Services Commission (HHSC) will conduct a public hearing on November 12, 2021, at 9:00 a.m. in the Public Hearing Room 125 of the John H. Winters Building, 701 W 51st St., Austin, Texas 78751, to receive public comments on the proposed payment rates for multiple long-term services and supports programs.

Increased payment rates are proposed for Medicaid Community Hospice; Personal Attendant Services in Community Living Assistance and Support Services (CLASS); and Community Attendant Services, Family Care, and Primary Home Care (CAS/FC/PHC). Increased payment rates are also proposed for the state fiscal year 2022-23 first quarter biennial fee review for Intervener Services in the Deaf-Blind with Multiple Disabilities Waiver (DBMD) program and Transportation Services in the Prescribed Pediatric Extended Care Centers (PPECC) program.

This hearing will also be available online. To join the hearing from your computer, tablet, or smartphone, register for the hearing in advance using the following link:

https://attendee.gotowebinar.com/register/1224682648494391053, webinar ID: 843-982-027.

PROPOSAL OVERVIEW

HHSC proposes to increase payment rates for Medicaid Community Hospice for federal fiscal year 2022 for routine home, continuous home, inpatient respite, and general inpatient care services, effective retroactive to October 1, 2021.

HHSC proposes a correction to payment rates for personal attendant services in CLASS and CAS/FC/PHC to align with the 2020-21 General Appropriations Act, House Bill 1, 86th Legislature, Regular Session, 2019 (Article II, HHSC, Rider 45), effective January 1, 2022.

HHSC also proposes to increase the DBMD Intervener rates and the PPECC Transportation rates, effective March 1, 2022.

BACKGROUND AND JUSTIFICATION

The increased payment rates for Medicaid Community Hospice for routine home, continuous home, inpatient respite, and general inpatient care services were determined in accordance with the hospice reimbursement methodology located at the Code of Federal Regulations, Title 42, Part 418, Subpart G.

The proposed rates for CLASS and CAS/FC/PHC were calculated to align with the legislative intent of Rider 45.

The proposed payment rates for DBMD were guided by Title 1 of the Texas Administrative Code (1 TAC) §355.513, related to the Reimbursement Methodology for the Deaf-Blind with Multiple Disabilities Waiver Program. The proposed payment rate for PPECC was guided by 1 TAC §355.9080, related to the Reimbursement Methodology for Prescribed Pediatric Extended Care Centers.

COMMENT DETAILS

Written comments regarding the proposed payment rates may be submitted in lieu of, or in addition to, oral testimony until 5:00 p.m. the day of the hearing. Written comments may be sent by U.S. mail to the Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, P.O. Box 149030, Austin, Texas 78714-9030; by fax to Provider Finance at (512) 730-7475; or by e-mail to PFD-LTSS@hhs.texas.gov. In addition, written comments may be sent by overnight mail or hand delivered to Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, North Austin Complex Building, 4601 W Guadalupe St., Austin, Texas 78751.

Public Notice – Texas State Plan for Medical Assistance Amendment Effective December 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 amendment is proposed to be effective December 1, 2021.

BACKGROUND AND JUSTIFICATION

The proposed amendment will ensure that the Texas Medicaid State Plan is in compliance with the Bipartisan Budget Act (BBA) of 2018 and the Medicaid Services Investment and Accountability Act (MSIAA) of 2019, affecting the BBA of 2013, that modified third party liability (TPL) requirements related to special treatment of certain types of care and payment.

Interested parties may obtain a copy of the proposed amendment and/or additional information about the amendment 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) 963-6205; by facsimile at (512) 730-7472; or by email 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 the Texas Health and Human Services Commission (which were formerly the local offices of the Department of Aging and Disability Services).