Subchapter A. STANDARD OPERATING PROCEDURES

The Health and Human Services Commission (HHSC), on behalf of the Department of Aging and Disability Services (DADS), adopts amendments to §§30.32, 30.62, 30.82, and 30.100; adopts new §§30.2, 30.30, 30.34, and 30.36; and adopts the repeal of §§30.2, 30.30, 30.34, and 30.36 in Chapter 30, governing the Medicaid Hospice Program. New §30.30 is adopted with changes to the proposed text published in the March 3, 2006, issue of the Texas Register (31 TexReg 1426). The amendments to §§30.32, 30.62, 30.82, and 30.100; new §§30.2, 30.34, and 30.36; and the repeal of §§30.2, 30.30, 30.34, and 30.36 are adopted without changes to the proposed text.

The amendments, new sections, and repeal are adopted to require hospice providers to follow additional requirements in the Contracting for Community Care Services chapter, clarify current hospice rules, and add a new rule covering voluntary termination of a Medicaid contract. The adopted rules clarify that a hospice must have a Medicaid contract with DADS before billing for Medicaid services and identify the requirements for general contracting, disclosure, contract termination, processing claims, and sanctions.

New §30.2 is adopted to establish the purpose of the Medicaid Hospice Program chapter, which contains both the contracting requirements for a Medicaid hospice provider and the eligibility requirements for an individual electing into the Medicaid Hospice Program.

The repeal of §§30.2, 30.30, 30.34, and 30.36 is adopted to delete requirements and contracting procedures that have been moved to the Contracting for Community Care Services chapter or reorganized within the Medicaid Hospice Program chapter.

New §30.30 is adopted to require a hospice to meet federal and state regulations in order to be approved for participation in the Medicaid Hospice Program. The new section clarifies that DADS does not pay for hospice services provided before the date the hospice has a Medicaid hospice contract with DADS, the individual makes a valid election into the Medicaid Hospice Program, and the hospice has a contract with the nursing facility or intermediate care facility for persons with mental retardation or related conditions in which the individual resides, if applicable. The new section also clarifies that the valid Medicaid hospice election must be dated on or after the date the hospice has contracted with DADS and the facility, if a contract with a facility is required. The amendment to §30.32 moved material on sanctions and requesting a hearing to §30.82. New §30.34 is adopted to require a hospice to notify DADS in writing at least 10 days before the hospice terminates its contract. The new section also states the steps a hospice must follow to ensure the needs of individuals served by the hospice are met if the hospice terminates its contract. New §30.36 is adopted to define acceptable methods for submitting written information to DADS.

The amendment to §30.62 is adopted to require a Medicaid hospice provider to have a contract with DADS and to submit a complete and accurate claim. The amendment also adds that DADS will deny claims for hospice services and for room and board provided to an individual before the effective date of the Medicaid hospice contract.

The amendment to §30.82 is adopted to remove the details of sanctions DADS may take against a hospice and instead, adds a cross-reference to the rule governing sanctions in the Contracting for Community Care Services chapter. The amendment also updates the procedures for requesting a hearing. The amendment to §30.100 is adopted to require a hospice to document hospice services provided to an individual within the clinical or client record and to remove a cross-reference to the solicitation rule in the Contracting for Community Services chapter because a hospice must comply with the solicitation requirements in this chapter instead.

A minor editorial change was made to the text of §30.30 to clarify and improve the accuracy of the section.

DADS received one written comment from the Texas Association for Home Care in support of the amendments, new sections, and repeal.

Subchapter A. INTRODUCTION

Subchapter E. FLEET MANAGEMENT