1 TAC §371.204, §371.208
The Health and Human Services Commission (HHSC) adopts amendments
to §371.204 and §371.208, relating the Hospital Screening Criteria
for Texas Medical Review Program (TMRP), Tax Equity and Fiscal Responsibility
Act (TEFRA), and LoneSTAR Select II Contract Reviews and Appeals Related to
Utilization Review Department Review Decisions. The amendments to §371.204
and §371.208 are adopted without changes to the proposed text as published
in the May 12, 2006, issue of the
Texas Register
(31 TexReg 3763) and will not be republished.
Section 371.204 establishes new criteria for utilization reviews of inpatient
hospital stays because the existing "physician-developed and physician-approved
inpatient hospital" criteria are no longer available for use.
Section 371.208 clarifies the HHSC section responsible for reviewing appeals
related to utilization review decisions.
A public hearing was held on May 24, 2006, at 2:00 p.m. in the Lone Star
Conference Room at 11209 Metric Boulevard, Building H, Austin, Texas. No comments
were received during the comment period.
The amendments are adopted under the Texas Government Code, §531.033,
which provides the Executive Commissioner of HHSC with broad rulemaking authority;
the Human Resources Code, §32.021, and the Texas Government Code, §531.021(a),
which provide HHSC with the authority to administer the Texas Medicaid program;
and Government Code §2001.006, which allows state agencies to adopt rules
in preparation for the implementation of legislation. HHSC has the authority
to obtain any information or technology necessary to enable the office to
meet its responsibilities under §531.102(a), relating to Office of Inspector
General.
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 June 29, 2006.
TRD-200603527
Steve Aragón
Chief Counsel
Texas Health and Human Services Commission
Effective date: August 1, 2006
Proposal publication date: May 12, 2006
For further information, please call: (512) 424-6900