Part 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 355. REIMBURSEMENT RATES
Subchapter J. PURCHASED HEALTH SERVICES
Division 4. MEDICAID HOSPITAL SERVICES
The Texas Health and Human Services Commission (HHSC) adopts an amendment to §355.8063, Reimbursement Methodology for Inpatient Hospital Services, without changes to the proposed text as published in the December 28, 2007, issue of the Texas Register (32 TexReg 9891), and will not be republished.
The amendment to §355.8063(w) updates the Medicaid reimbursement methodology for freestanding psychiatric facilities effective January 1, 2008. HHSC was directed by the Texas Legislature in the 2008 - 2009 General Appropriations Act (Conference Committee Report, Tex. H.B. 1, 80th Leg., R.S., ch. 1428, art. II-82 (2007)) to adopt a Medicaid reimbursement methodology for freestanding psychiatric facilities that is similar to the prospective payment system used by Medicare.
The Centers for Medicare and Medicaid Services (CMS) approved the state plan amendment that updates the reimbursement methodology for freestanding psychiatric facilities on March 5, 2008. The associated rate change will be implemented on the effective date of this rule and will be made effective January 1, 2008.
The updated reimbursement methodology will allow the Medicaid program to take into account several factors used in the Medicare methodology that have an impact on the costs associated with providing inpatient psychiatric services in Texas. The methodology uses the Medicare federal base rate as the basis for computing a facility-specific per diem rate with several adjustments for factors that influence the cost of care. These adjustments include a rural adjustment, which recognizes the higher costs incurred by hospitals outside urban areas; a length of stay adjustment that takes into account the higher costs of care for hospitalizations that have a shorter length of stay; and a wage adjustment that takes into account the cost of wages specific to county location.
The 30-day comment period closed on January 27, 2008. HHSC received one comment from Timberlawn Mental Health System also on behalf of River Crest and Glen Oaks Hospitals. The comment was in support of the proposed rule as published.
The amendment is adopted under Texas Government Code §531.033, which provides the Executive Commissioner of HHSC with broad rulemaking authority; Texas Human Resources Code §32.021 and Texas Government Code §531.021(a), which provide HHSC with the authority to administer the federal medical assistance (Medicaid) program in Texas, to administer Medicaid funds, and to adopt rules necessary for the proper and efficient operation of the Medicaid program; and Texas Government Code §531.021(b), which provides HHSC with the authority to propose and adopt rules governing the determination of Medicaid reimbursement.
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 March 24, 2008.
TRD-200801549
Steve Aragón
Chief Counsel
Texas Health and Human Services Commission
Effective date: April 13, 2008
Proposal publication date: December 28, 2007
For further information, please call: (512) 424-6900