Part 1.
TEXAS DEPARTMENT OF HUMAN SERVICES
Chapter 30.
MEDICAID HOSPICE PROGRAM
The Texas Department of Human Services (DHS) adopts amendments to §§30.14,
30.16, 30.20, 30.30, 30.54, and 30.82 in its Medicaid Hospice Program chapter
without changes to the proposed text published in the February 15, 2002, issue
of the
Texas Register
(27 TexReg 1126).
Justification for the amendments to physician certification and continuous
home care sections is to clarify the current requirement that providers who
serve dually eligible individuals must have a Medicaid hospice contract. Dually
eligible recipients must elect the Medicare and Medicaid hospice programs
at the same time.
Justification for amending §30.14 is to reflect Medicare guidelines.
Providers requested the language in subsection (b) to ensure that physicians
review information or talk to the referring physician before signing the forms.
Many recipients die before a physician makes a visit. Subsections (d) and
(f) were also relocated.
Justification for language added to §30.16 and §30.20 is to define
dual eligibility. DHS rules only addressed dual eligibility in §30.18,
whereas the Center for Medicare & Medicaid Services (CMS) Medicaid Guidelines, §4303,
Election, Revocation and Change of Hospice, addresses dual eligibility in
three sections. DHS rules were amended to add a reference to dual eligibility
to the two additional sections.
Justification for the addition of subsection (d) in §30.30 is to require
providers to have a Medicaid contract to receive Medicaid payment, which is
a federal requirement. The mailing address was corrected and an overnight
mailing address was included at the providers' request in subsection (h).
Justification for amendments to §30.54(a)(4) is to ensure appropriate
use of continuous home care at all times. DHS added the definitions in paragraph
(a)(6) because there was confusion about what these terms meant. As stipulated
in paragraph (a)(8), DHS will not accept faxed requests for extensions of
continuous care, because of the large amount of information faxed to the department.
The high probability that such information may not actually be faxed or received
via fax, combined with the amount of time and resources required to account
for such information, directed development of this policy. Subparagraph (a)(8)(A)
clarifies the mailing address. Clause (a)(8)(B)(i) was added, because additional
documentation is needed when reviewing continuous home care cases. This additional
information will document the circumstances that led up to the crisis and
show if those symptoms were observed the preceding week. Paragraph (a)(9)
was added because current time frames are difficult for DHS staff to meet
given current job duties. To avoid confusion, DHS will review one set of documentation
per extension as outlined under (a)(10).
Justification for the change to §30.82(d) is to correct the address
and include the overnight mailing address, which providers requested.
DHS received no comments regarding adoption of the amendments.
Subchapter B. ELIGIBILITY REQUIREMENTS
40 TAC §§30.14, 30.16, 30.20
The amendments are adopted under the Human Resources Code,
Title 2, Chapters 22 and 32, which authorizes the department to administer
public and medical assistance programs, and under Texas Government Code, §531.021,
which provides the Health and Human Services Commission with the authority
to administer federal medical assistance funds.
The amendments implement the Human Resources Code, §§22.001-22.030
and §§32.001-32.042.
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.
Filed with the Office of
the Secretary of State on April 11, 2002.
TRD-200202231
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Effective date: May 1, 2002
Proposal publication date: February 15, 2002
For further information, please call: (512) 438-3734
40 TAC §30.30
The amendment is adopted under the Human Resources Code, Title
2, Chapters 22 and 32, which authorizes the department to administer public
and medical assistance programs, and under Texas Government Code, §531.021,
which provides the Health and Human Services Commission with the authority
to administer federal medical assistance funds.
The amendment implements the Human Resources Code, §§22.001-22.030
and §§32.001-32.042.
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.
Filed
with the Office of the Secretary of State on April 11, 2002.
TRD-200202232
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Effective date: May 1, 2002
Proposal publication date: February 15, 2002
For further information, please call: (512) 438-3734
Subchapter C. PROVIDER REQUIREMENTS FOR ENTRANCE INTO THE TEXAS MEDICAID HOSPICE PROGRAM; DISCLOSURE REQUIREMENTS
Subchapter E. COVERED SERVICES