40 TAC §159.6
The Texas Commission for the Blind proposes an amendment
to §159.6, concerning payment rates for medical services provided to
consumers. The proposed amendment adds a specific and separate payment rate
to the agency's rate schedule for high index aspheric lenses if a prescription
equals or is greater than +/- 8D. There is no Medicaid or Medicare code that
specifically defines these high-index lenses. Presently, these lenses are
purchased under a miscellaneous code. A separate code will eliminate unneeded
administrative steps.
Alvin Miller, Chief Financial Officer, has determined that there will be
no implications relating to cost or revenues of the state or local governments
as a result of enforcing or administering the amended rule for the first five
year period.
Mr. Miller has also determined that for each year of the first five years
the rules are in effect the anticipated public benefits will be the more efficient
delivery of these restoration services. There will be no economic cost to
small businesses or individuals as a result of the rule.
Comments on the proposal may be submitted to Policy and Rules Coordinator,
Texas Commission for the Blind, 4800 North Lamar, Austin, Texas 78756, or
by e-mail to pio@tcb.state.tx.us, or by fax (512) 377-0682. Comments must
be received by the Commission no later than 30 days from the date this proposal
is published in the
Texas Register
.
The rule is proposed under the authority of Human Resources Code,
Title 5, Chapter 91, §91.029, which authorizes the Commission to adopt
rules and standards governing the determination of rates the Commission will
pay for medical services.
The proposal affects no other statutes.
§159.6.Rates for Medical Services.
(a)
(No change.)
(b)
Rate schedule. Based on the standards set forth in subsection
(a) of this section, the Commission shall pay for medical services according
to the following:
(1)-(5)
(No change.)
(6)
For services and items for which there is neither a rate
nor an industry standard that takes into consideration the unique needs of
persons with vision loss, the Commission shall pay according to the following:
(A)-(K)
(No change)
(L)
High index aspheric lenses
allowable if RX is equal or greater than +/- 8D. Pay at $45 per lens.
(c)-(d)
(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 February 14, 2003.
TRD-200301167
Terrell I. Murphy
Executive Director
Texas Commission for the Blind
Earliest possible date of adoption: March 30, 2003
For further information, please call: (512) 377-0611