TITLE health-services

Part II. Texas Department of Mental Health and Mental Retardation

Chapter 409. Medicaid Programs

Subchapter J. Reimbursement for Services in Institutions for Mental Diseases (IMD)

25 TAC §409.374

The Texas Department of Mental Health and Mental Retardation (TDMHMR) adopts an amendment to §409.374, concerning institutions for mental diseases (IMD) without changes to the proposed text as published in the August 23, 1996, edition of the Texas Register (21 TexReg 7938-7939).

The adopted amendments would provide clarification of the time line for which initial and continued stay authorizations for eligible recipients of IMD services must be submitted by enrolled providers to the office of Medicaid Administration. The requirement for submission of the request for initial authorization would be within seven calendar days of the first day for which Medicaid reimbursement will be requested. Additionally, the maximum number of days for which continued stay will be valid would be extended from 30 to 31 days.

Operating agency responsibility for reimbursement of inpatient hospital services in IMDs was vested in TDMHMR by the single state Medicaid agency, the Health and Human Services Commission, following the approval of a similar rule proposal at the July 1996 meeting of the Medical Care Advisory Committee. The proposed amendments were additionally approved by the TDMHMR Medicaid Guidance Team and the state Medicaid director.

A public hearing was held on September 9, 1996, during which no oral or written testimony concerning the proposed amendments was given. There was no written comment received by the department concerning the proposed amendments during the required thirty day public comment period.

The section is adopted under the Texas Health and Safety Code, Title 7, §532.015, which provides the Texas Board of Mental Health and Mental Retardation with rulemaking powers; and under the provisions of Texas Government Code, Chapter 531, §531.021, which provides the Health and Human Services Commission with the authority to administer federal medical assistance funds.

The amendment affects the Texas Human Resources Code §22.002 and §32.001- .040 and Texas Government Code, Chapter 531, §531.021.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Issued in Austin, Texas, on January 22, 1997.

TRD-9700981

Ann Utley

Chairman, Texas MHMR Board

Texas Department of Mental Health and Mental Retardation

Effective date: February 12, 1997

Proposal publication date: August 23, 1996

For further information, please call: (512) 206-4516