1 TAC §355.457
The Health and Human Services Commission (HHSC) adopts the
amendment to §355.457, concerning the reimbursement methodology for Intermediate
Care Facilities for persons with mental retardation (ICF/MR), in its Medicaid
Reimbursement Rates chapter, without changes to the proposed text as published
in the February 4, 2005, issue of the
Texas Register
(30 TexReg 453) and will not be republished.
The amended §355.457(c)(2)(B), Fiscal Accountability, changes reference
from Texas Department of Mental Health and Mental Retardation (TDMHMR) to
the Department of Aging and Disability Services (DADS). The proposal also
reinstates language inadvertently deleted that relates to the fiscal accountability
requirements for providers and the requirements for repayment of funds to
DADS when the fiscal accountability requirements are not met.
The amended §355.457(c)(2)(B) and (C) changes references from TDMHMR
to DADS.
The amended §355.457(c)(2)(D) sets forth the repayment requirements
for providers whose spending is between 85 and 90 percent of direct service
revenues.
The amended §355.457(c)(3) establishes that the total direct service
revenue of the modeled rates is the direct service portion of the rate multiplied
by the number of allowable units paid for services provided during the reporting
period.
The amended §355.457(c)(3)(A) establishes that Providers whose direct
service costs are 90% or more of the direct service revenues will not be subject
to repayment under this section.
The amended §355.457(c)(3)(B) sets forth the repayment requirements
for providers whose direct service costs are less than 85% of the direct service
revenues.
The amended §355.457(c)(3)(C) sets forth the repayment requirements
for providers whose direct service costs are between 85% and 90% of the direct
service revenues.
HHSC did not receive any comments regarding the proposed amendment during
the comment period, which included a public hearing on February 15, 2005.
The amendment is adopted under the Texas Government Code, §531.033,
which provides the commissioner of HHSC with broad rulemaking authority; the
Human Resources Code, §32.021; the Texas Government Code, §531.021(a),
which provide HHSC with the authority to administer the federal medical assistance
(Medicaid) program in Texas; and the Texas Government Code, §531.021(b),
which provides HHSC with the authority to propose and adopt rules governing
the determination of Medicaid reimbursements.
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 May 9, 2005.
TRD-200501880
Steve Aragón
Chief Counsel
Texas Health and Human Services Commission
Effective date: May 29, 2005
Proposal publication date: February 4, 2005
For further information, please call: (512) 424-6900