TITLE 1.ADMINISTRATION

Part 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION

Chapter 355. MEDICAID REIMBURSEMENT RATES

Subchapter J. PURCHASED HEALTH SERVICES

2. MEDICAID HOME HEALTH PROGRAM

1 TAC §355.8021

The Health and Human Services Commission (HHSC) proposes an amendment to §355.8021 concerning reimbursement methodology for home health services. Section 355.8021 is being amended to continue the current reimbursement methodology for skilled nursing visits, home health aide visits, physical therapy, and occupational therapy services provided by enrolled home health agencies. Enrolled home health agencies will be reimbursed the reasonable cost of supplying the service, applying the same standards, cost reporting period, and cost reimbursement principles used in computing reimbursement for comparable services under Title XVIII Medicare prior to October 1, 2000. Effective October 1, 2000, the Medicare program is scheduled to begin reimbursing home health services utilizing a prospective payment system (PPS).

Don Green, Chief Financial Officer, has determined that for each year of the first five years the section is in effect there will be no fiscal implications for state or local government as a result of enforcing or administering the section. This amendment does not have any foreseeable implications relating to cost or revenues of local governments.

Mr. Stephen Lorenzen, Director of Medicaid rate setting, has determined that for each year of the first five years the section is in effect, the public benefit anticipated as a result of enforcing the section will be a clearer understanding of the reimbursement methodology used for covered services. There will be no effect on small business or micro-businesses to comply with this section as proposed. This was determined by interpretation of the rule that small businesses and micro-businesses will not be required to alter their business practices in order to comply with the rule as proposed. There are no anticipated economic costs to persons who are required to comply with the section as proposed. There will be no impact on local employment.

Comments on the proposal may be submitted to Jeff Phelps, Program Administrator, Medicaid Reimbursement Division, Texas Health and Human Services Commission, P.O. Box 13247, Austin, Texas 78711-3247 or at (512) 424-6657, within 30 days of publication of this proposal in the Texas Register . To comply with federal regulations, a copy of the proposal is being sent to each Texas Department of Human Services (DHS) office where it will be available for public review upon request.

A public hearing will be held at 1:30 p.m., Central Daylight Savings Time, on January 22, 2001, in the Public Hearing Room, Building 3, first floor of the Riata Crossing Facility, 12555 Riata Vista Circle, Austin, Texas 78727-6404, to accept comments on the proposal.

The amendment is proposed under the Human Resources Code, §32.021 and the Texas Government Code, §531.021, which provide the Health and Human Services Commission with the authority to adopt rules to administer the state's medical assistance program.

The proposed amendment affects Chapter 32 of the Human Resources Code and Chapter 531 of the Government Code.

§355.8021.Reimbursement Methodology for Home Health Services.

(a)

Reimbursement methodology for services provided by a home health agency.

(1)

Except for expendable medical supplies and DME, authorized home health services provided for eligible Medicaid recipients are reimbursed the reasonable cost of supplying the service, applying the same standards, cost reporting period, and cost reimbursement principles [ currently ] used in computing reimbursement for comparable services under Title XVIII Medicare prior to October 1, 2000 .

(2)

(No change).

(b)

Reimbursement methodology for expendable medical supplies provided by enrolled home health agencies and DME providers/suppliers. Participating providers are reimbursed the maximum allowable fee for expendable medical supplies established by the department. The maximum allowable fee is based upon the lesser of the following:

(1)

(No change).

(2)

the Medicare fee schedule in place prior to October 1, 2000, as defined in Title 25, §29.301 , [ of this title ] (relating to General); or

(3)

the expendable medical supply acquisition fee as defined in Title 25 §29.301 [ of this title ].

(c)

Reimbursement methodology for durable medical equipment provided by enrolled home health agencies and DME providers/suppliers. Participating providers are reimbursed the maximum allowable fee for durable medical equipment established by the department. The maximum allowable fee for durable medical equipment is based on the lesser of the following:

(1)-(2)

(No change).

(3)

the Medicare fee schedule as defined in Title 25 §29.301 [ of this title ]; or

(4)

(No change).

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 December 21, 2000.

TRD-200008892

Marina Henderson

Executive Deputy Commissioner

Texas Health and Human Services Commission

Earliest possible date of adoption: February 4, 2001

For further information, please call: (512) 458-7236