TITLE administration

Part XV. Health and Human Services

Chapter 361. Children's Health Insurance Program

1 TAC §361.001

The Health and Human Services Commission submits proposed new §361.001 in new chapter 361, Children's Health Insurance Program, concerning the definition of significant traditional providers in the Children's Health Insurance Program (CHIP). Section 62.155(b) of the Health and Safety Code, added by Senate Bill 445, 76th Legislature (1999), directs the Health and Human Services Commission to define significant traditional providers in the Children's Health Insurance Program by rule. New section 361.001 contains the new proposed definition.

Mr. Don Green, Chief Financial Officer, has determined that for the first five-year period that the section is in effect, there will be no net fiscal implications as a result of administering §361.001. There will be no fiscal implications for local governments.

Mr. Green has also determined that for the first five-year period the section is in effect, the public benefit anticipated as a result of enforcing the section will be the inclusion of providers who have traditionally served a majority of the recipients in the Medicaid program and enrollees in Texas Healthy Kids Corporation's program. There will be no costs to small businesses or persons complying with the section as proposed. There will be no impact on local employment.

Comments may be submitted in writing to Jason Cooke, Associate Commissioner for Children's Health, Texas Health and Human Services Commission, 4900 North Lamar Boulevard, 4th Floor, Austin, Texas 78751, (512) 424-6568, or e-mail at Jason.Cooke@hhsc.state.tx.us. Comments will be accepted for 30 days following publication of this proposal in the Texas Register .

The new rule is proposed under the Texas Government Code, §531.033, which provides the commissioner of HHSC with broad rulemaking authority and under Texas Health and Safety Code, chapter 62, §62.051(d), which authorizes the commissioner to adopt rules necessary to implement the child health plan for certain low-income children.

The new rule implements Health and Safety Code, §62.155(b).

§361.001. Definition of Significant Traditional Provider.

In the Children's Health Insurance Program, significant traditional provider (STP) means:

(1)

all hospitals receiving disproportionate share hospital funds in State Fiscal Year 1999; and

(2)

all other providers in a county that, when listed by provider type in descending order by the number of recipient or enrollee encounters, provided the top 80 percent of recipient or enrollee encounters for either the Texas Medicaid Program in State Fiscal Year 1997, as previously determined by the Texas Department of Health or the Texas Healthy Kids Corporation in State Fiscal Year 1999, as determined by the Texas Healthy Kids Corporation for each provider type.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State, on July 12, 1999.

TRD-9904182

Marina S. Henderson

Executive Deputy Commissioner

Health and Human Services Commission

Earliest possible date of adoption: August 22, 1999

For further information, please call: (512) 424-6576