Part 12. COMMISSION ON STATE EMERGENCY COMMUNICATIONS
Chapter 251. REGIONAL PLANS--STANDARDS
The Commission on State Emergency Communications (Commission) adopts the repeal of §251.6, concerning guidelines for strategic plans, amendments and allocation of funds as posted in the June 22, 2007, issue of the Texas Register (32 TexReg 3773) without changes and will not be republished.
Section 251.6 established a framework for RPCs to use when developing regional strategic plans for provisioning 9-1-1 service. The rule also provided instructions on the allocation of revenue and parameters on funding for ancillary equipment such as voice recorders and pagers, and emergency power equipment, including generators.
At its June 7, 2007 commission meeting, the Commission moved the provisions pertaining to the developing and amending of regional plans from §251.6 into Commission Program Policy Statement 033. The remaining provisions of §251.6, concerning the allocation of revenue, consisted primarily of a citation of applicable provisions from Texas Health and Safety Code Chapter 771. Such provisions are applicable to the Commission irrespective of whether they are incorporated into a rule. Accordingly, §251.6 no longer serves a purpose and the repeal thereof eliminates an obsolete section.
The Commission did not receive any comments on the proposed repeal of §251.6.
The repeal is adopted pursuant to the Texas Health and Safety Code, Chapter 771, §§771.051, 771.071, 771.0711, 771.072, and 771.075; and Texas Administrative Code, Title 1, Part 12, Chapter 251, Regional Plan Standards, which authorize the Commission to plan, develop, fund, administer, approve, and enhance the provisioning and effectiveness of 9-1-1 service.
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 July 27, 2007.
TRD-200703260
Paul Mallett
Executive Director
Commission on State Emergency Communications
Effective date: August 16, 2007
Proposal publication date: June 22, 2007
For further information, please call: (512) 305-6930
The Commission on State Emergency Communications (Commission) adopts amendments to §251.14, concerning general provisions and definitions as posted in the June 22, 2007, issue of the Texas Register (32 TexReg 3773) without changes and will not be republished.
Section 251.14 establishes the general provisions for defining terms utilized within the context of Commission rules. This rule allows for compilation of frequently used 9-1-1 industry related terms used in the rulemaking process.
The amendments adopt by reference 9-1-1 related terms and definitions contained within applicable federal and state laws or regulations, Public Utility Commission of Texas rules, and the National Emergency Number Association Master Glossary of 9-1-1 Terminology. Alignment will provide consistency for all definitions and acronyms, and will reduce the work required to establish definitions for terms and acronyms consistently utilized by the 9-1-1 entities in Texas. Terms unique to the statewide 9-1-1 program are retained in the rule.
No comments were received regarding adoption of amendments to §251.14.
Amendments to §251.14 are adopted under Health and Safety Code, Chapter 771, §§771.051, 771.055, 771.056, 771.057, 771.071, 771.072, 771.075, 771.0751, 771.079; which authorize the Commission to plan, develop, fund, and provide provisions for the enhancement of effective and efficient 9-1-1 service. The amendments are proposed in accordance with the process for rulemaking as prescribed by Texas Government Code, Chapter 2001, Subchapter B. No other statutes, articles, or codes are affected by the proposed amendments.
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 July 27, 2007.
TRD-200703259
Paul Mallett
Executive Director
Commission on State Emergency Communications
Effective date: August 16, 2007
Proposal publication date: June 22, 2007
For further information, please call: (512) 305-6930
Chapter 353. MEDICAID MANAGED CARE
Subchapter E. STANDARDS FOR MEDICAID MANAGED CARE
The Texas Health and Human Services Commission (HHSC) adopts new §353.421, relating to Special Disease Management, without changes to the proposed text as published in the April 27, 2007, issue of the Texas Register (32 TexReg 2331) and will not be republished.
Senate Bill (S.B.) 1188, 79th Legislature, Regular Session, 2005, codified at §533.009(f), Government Code, relating to Special Disease Management , requires HHSC to promulgate rules prescribing the minimum requirements Medicaid managed care organizations (MCOs) must meet to be eligible to contract with HHSC to provide disease management services. The proposed rule requires that MCO disease management programs have performance measures that are comparable to those of the Medicaid fee-for-service disease management program, and that the MCOs demonstrate an ability to manage complex diseases among the Medicaid population. Pursuant to House Bill (H.B.) 1252, 79th Legislature, Regular Session, 2005, the new rule also includes requirements for MCOs that provide disease management services for chronic kidney disease and its complications.
HHSC received one comment regarding the proposed rule during the 30-day comment period, which included a public hearing on May 17, 2007. A summary of the comment and HHSC's response follows.
Comment
HHSC received a comment from Fresenius Medical Care North America in which the commenter expressed concern regarding §354.421, subsection (e). The concern was that the MCOs would be conducting screenings or other medical services rather than providers.
HHSC Response
HHSC acknowledges the comment and disagrees with the commenter. MCOs contract with providers to render screenings and other medical services to Medicaid members, so providers will be conducting these services. Therefore, HHSC did not modify the rule to address this comment.
The new rule is adopted under the Texas Government Code, §531.033, which provides the Executive Commissioner of HHSC with broad rulemaking authority; and the Human Resources Code, §32.021 and the Texas Government Code, §531.021(a), which provide HHSC with the authority to administer the federal medical assistance (Medicaid) program in Texas.
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 July 30, 2007.
TRD-200703307
Steve Aragón
Chief Counsel
Texas Health and Human Services Commission
Effective date: August 19, 2007
Proposal publication date: April 27, 2007
For further information, please call: (512) 424-6900
Subchapter A. PURCHASED HEALTH SERVICES
Division 5. PHYSICIAN AND PHYSICIAN ASSISTANT SERVICES
The Texas Health and Human Services Commission (HHSC) adopts new §354.1069, Sign Language Interpreter Services, with minor grammatical changes to the proposed text as published in the April 27, 2007, issue of the Texas Register (32 TexReg 2334).
The new rule is adopted to comply with House Bill (H.B.) 3235, 79th Legislature, Regular Session, 2005. Subject to the availability of funds, H.B. 3235 requires sign language interpreter services be available to Medicaid recipients who are deaf or hard of hearing, or to a parent or guardian of a person receiving Medicaid, if the parent or guardian is deaf or hard of hearing.
The new rule outlines the benefits and limitations for sign language interpreter services. Physicians in private or group practice with 14 or fewer employees will be eligible for reimbursement for interpreter services. The physician will be responsible for arranging for and paying the sign language interpreter, and the physician will then bill Medicaid to be reimbursed for the service.
HHSC did not receive comments regarding the proposed rule during the 30-day comment period, which included a public hearing on May 24, 2007.
The new rule is adopted under the Texas Government Code, §531.033, which provides the Executive Commissioner of HHSC with broad rulemaking authority; and the Human Resources Code, §32.021 and the Texas Government Code, §531.021(a), which provide HHSC with the authority to administer the federal medical assistance (Medicaid) program in Texas.
§354.1069.Sign Language Interpreter Services.
(a) Definitions. The following words and terms, when used in this chapter, have the following meanings.
(1) Deaf--The term "deaf" is defined in the Human Resources Code, Title 4, Services for the Deaf, Chapter 81, Texas Commission for the Deaf and Hard of Hearing, §81.001, Definitions.
(2) Hard of Hearing--The term "hard of hearing" is defined in the Human Resources Code, Title 4, Services for the Deaf, Chapter 81, Texas Commission for the Deaf and Hard of Hearing, §81.001, Definitions.
(3) Interpreter--An interpreter is an individual who possesses one of the following certification levels (i.e., levels A - H) issued by either the Department of Assistive and Rehabilitative Services, Office for Deaf and Hard of Hearing Services, Board for Evaluation of Interpreters (BEI) or the National Registry of Interpreters for the Deaf (RID):
(A) Certification Level A:
(i) Level I/Ii; and
(ii) OC:B (Oral Certificate: Basic).
(B) Certification Level B:
(i) BEI Basic; and
(ii) RID NIC (National Interpreter Certificate) Certified.
(C) Certification Level C:
(i) BEI Level II/IIi;
(ii) RID CI (Certificate of Interpretation);
(iii) RID CT (Certificate of Transliteration);
(iv) RID IC, (Interpretation Certificate); and
(v) RID TC (Transliteration Certificate).
(D) Certification Level D:
(i) BEI Level III/IIIi;
(ii) BEI OC: C (Oral Certificate: Comprehensive);
(iii) BEI OC: V (Oral Certificate: Visible);
(iv) RID CSC (Comprehensive Skills Certificate);
(v) RID IC/TC (Interpretation Certificate/Transliteration Certificate);
(vi) RID CI/CT (Certificate of Interpretation/Certificate of Transliteration);
(vii) RID RSC (Reverse Skills Certificate); and
(viii) RID CDI (Certified Deaf Interpreter).
(E) Certification Level E:
(i) BEI Advanced; and
(ii) RID NIC Advanced.
(F) Certification Level F:
(i) BEI IV/IVi;
(ii) RID MCSC (Master Comprehensive Skills Certificate); and
(iii) RID SC: L (Specialist Certificate: Legal).
(G) Certification Level G is BEI V/VI.
(H) Certification Level H:
(i) BEI Master; and
(ii) RID NIC Master.
(4) Interpreting Services--The provision of voice-to-sign, sign-to-voice, gestural-to-sign, sign-to-gestural, voice-to-visual, visual-to-voice, sign-to-visual, or visual-to-sign services for communication access provided by a certified interpreter.
(b) Benefit and Limitations. Sign language interpreting services are a health care benefit of the State Medical Assistance (Medicaid) Program.
(1) Sign language interpreting services must be requested by a physician and provided by a qualified interpreter to facilitate communication between:
(A) A client who is deaf or hard of hearing and a physician during the course of a medically necessary medical examination or other medical services; or,
(B) A client's parent or guardian who is deaf or hard of hearing and a physician during the course of the client's medically necessary medical examination or other medical services.
(2) A physician's determination of the need for sign language interpreting services shall give primary consideration to the needs of the individual who is deaf or hard of hearing.
(3) The physician requesting interpreting services must maintain documentation verifying the provision of interpreting services.
(A) Documentation of the service must be included in the patient's medical record and must include the name of the sign language interpreter and the interpreter's certification level.
(B) Documentation must be made available if requested by the Commission or its designee.
(c) Physician requirements for billing of and reimbursement for sign language interpreting services.
(1) Physicians must be enrolled in the Texas Medicaid Program to be considered for reimbursement.
(2) Reimbursement for sign language interpreting services is limited to physicians or physician groups employing fewer than fifteen employees.
(3) Providers seeking reimbursement for sign language interpreting services must provide and bill for the service in the manner prescribed by the Texas Medicaid Program and in accordance with §355.8085 of this title (relating to Texas Medicaid Reimbursement Methodology (TMRM) for Physician and Certain Other Practitioners).
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 July 30, 2007.
TRD-200703308
Steve Aragón
Chief Counsel
Texas Health and Human Services Commission
Effective date: August 19, 2007
Proposal publication date: April 27, 2007
For further information, please call: (512) 424-6900
1 TAC §§354.1430, 354.1432, 354.1434
The Texas Health and Human Services Commission (HHSC) adopts amendments to §354.1430, Definitions; §354.1432, Benefits and Limitations; and §354.1434, Requirements for Telemedicine Providers, without changes to the proposed text as published in the April 27, 2007, issue of the Texas Register (32 TexReg 2336) and will not be republished.
These amendments add state schools and state hospitals throughout the state to the list of remote sites where a Medicaid recipient can receive telemedicine services. The amendments also replace the references to "local mental health authorities" with "community centers" to clarify that all community centers contracted with the Department of State Health Services are allowable telemedicine hub sites, and those in rural or underserved areas are allowable remote sites. Lastly, the amendments update language concerning the requirements for release of confidential patient information.
HHSC did not receive comments regarding the proposed rules during the 30-day comment period, which included a public hearing on May 24, 2007.
The amendments are adopted under the Texas Government Code, §531.033, which provides the Executive Commissioner of HHSC with broad rulemaking authority; and the Human Resources Code, §32.021 and the Texas Government Code, §531.021(a), which provide HHSC with the authority to administer the federal medical assistance (Medicaid) program in Texas.
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 July 30, 2007.
TRD-200703309
Steve Aragón
Chief Counsel
Texas Health and Human Services Commission
Effective date: August 19, 2007
Proposal publication date: April 27, 2007
For further information, please call: (512) 424-6900
Subchapter J. PURCHASED HEALTH SERVICES
Division 3. PHYSICIAN SERVICES
The Health and Human Services Commission (HHSC) adopts new §355.8043, Supplemental Payments to Certain Physicians, without changes to the proposed text as published in the May 4, 2007, issue of the Texas Register (32 TexReg 2433) and will not be republished.
Section 355.8043 establishes the methodology that HHSC will use to distribute supplemental upper payment limit funds to state-affiliated physician group practices.
HHSC requested approval from the Centers for Medicare and Medicaid Services (CMS) to implement a supplemental payment program to state-affiliated physician group practices through the submission of a State Plan Amendment (SPA) on June 30, 2004. The change in reimbursement practice recognizes the unique role state-affiliated physician group practices play in providing services to Medicaid recipients. As a result of this change in methodology, the State will obtain additional federal revenue for state-owned medical schools that bill Medicaid. The state matching funds required to draw down federal dollars will be provided by the state-owned medical schools. The effective date of this SPA is May 1, 2004.
HHSC did not receive comments regarding the proposed rules during the 30-day comment period.
The new rule is adopted under the Texas Government Code, §531.033, which provides the Executive Commissioner of HHSC with broad rulemaking authority; and the Human Resources Code, §32.021, and the Texas Government Code, §531.021(a), which provide HHSC with the authority to administer the federal medical assistance (Medicaid) program in Texas.
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 July 30, 2007.
TRD-200703310
Steve Aragón
Chief Counsel
Texas Health and Human Services Commission
Effective date: August 19, 2007
Proposal publication date: May 4, 2007
For further information, please call: (512) 424-6900
The Health and Human Services Commission (HHSC) adopts the repeal of §355.8301, concerning Reimbursement and replaces it with new §355.8443 to correspond with the language approved by the Centers for Medicare and Medicaid Services (CMS) in the Texas Medicaid State Plan Amendment (06-005-723) related to covered services and reimbursement methodology for School Health and Related Services (SHARS). The repeal and new rule are adopted without changes to the proposed text as published in the May 11, 2007, issue of the Texas Register (32 TexReg 2524) and will not be republished.
Section 355.8443 provides the covered services and reimbursement methodology approved by CMS for school districts effective retroactively to September 1, 2006.
CMS no longer allows school districts, as public entities, to receive reimbursement that is greater than the Medicaid-allowable cost for delivering SHARS. The Health and Human Services Commission (HHSC) has been working with CMS for more than a year to agree upon the covered services and related reimbursement methodology for SHARS. The resulting methodology is contained in §355.8443. Since §355.8301 explained the processes for reimbursement under SHARS, as they existed under the Texas Medicaid State Plan prior to September 1, 2006, HHSC proposed to repeal it and replace it with §355.8443.
HHSC did not receive comments regarding the proposed rule during the 30-day comment period.
Division 16. SCHOOL HEALTH AND RELATED SERVICES
The repeal is adopted under the Texas Government Code, §531.033, which provides the Executive Commissioner of HHSC with broad rulemaking authority; and the Human Resources Code, §32.021 and the Texas Government Code, §531.021(a), which provide HHSC with the authority to administer the federal medical assistance (Medicaid) program in Texas.
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 July 30, 2007.
TRD-200703311
Steve Aragón
Chief Counsel
Texas Health and Human Services Commission
Effective date: August 19, 2007
Proposal publication date: May 11, 2007
For further information, please call: (512) 424-6900
The new rule is adopted under the Texas Government Code, §531.033, which provides the Executive Commissioner of HHSC with broad rulemaking authority; and the Human Resources Code, §32.021 and the Texas Government Code, §531.021(a), which provide HHSC with the authority to administer the federal medical assistance (Medicaid) program in Texas.
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 July 30, 2007.
TRD-200703333
Steve Aragón
Chief Counsel
Texas Health and Human Services Commission
Effective date: August 19, 2007
Proposal publication date: May 11, 2007
For further information, please call: (512) 424-6900