Part 1. DEPARTMENT OF STATE HEALTH SERVICES
Chapter 14. COUNTY INDIGENT HEALTH CARE PROGRAM
The Executive Commissioner of the Health and Human Services Commission (commission) on behalf of the Department of State Health Services (department) adopts amendments to §§14.1, 14.2, 14.101 - 14.105, and 14.201, concerning the County Indigent Health Care Program without changes to the proposed text as published in the November 30, 2007, issue of the Texas Register (32 TexReg 8658) and, therefore, the sections will not be republished.
BACKGROUND AND PURPOSE
The amendments are necessary to assist the department in the implementation of the County Indigent Health Care Program, which is a health care program for the indigent population of Texas. The department provides technical assistance to counties, hospital districts, and public hospitals that provide health care services to eligible residents who are unable to access the same care through other funding sources or programs.
Government Code, §2001.039, requires that each state agency review and consider for re-adoption each rule adopted by that agency pursuant to the Government Code, Chapter 2001 (Administrative Procedure Act). Sections 14.1, 14.2, 14.101 - 14.105, and 14.201 have been reviewed, and the department has determined that reasons for adopting the sections continue to exist because rules on this subject are needed.
SECTION-BY-SECTION SUMMARY
An amendment to §14.1 incorporates the current department name to be consistent with the current department terminology.
An amendment to §14.2 revises language and adds an additional subsection to clarify the responsibility of the department regarding eligibility disputes.
An amendment to §14.101 revises language to provide a concise definition of program terminology regarding application processing.
An amendment to §14.102 adds a new subsection to clarify residency requirements regarding a person's dwelling.
An amendment to §14.103 adds a new subsection to define non-household members with regard to eligibility determination. The addition required the re-lettering of existing subsections.
An amendment to §14.104 adds a new subsection to provide clarification on excluded income with regard to eligibility determination.
An amendment to §14.105 reflects additional language to clarify the program definition of assets. Additionally, §14.105 has been amended by deleting detailed requirements regarding countable resources that are more appropriate for inclusion in a policy manual.
An amendment to §14.201 adds a new subsection to provide guidance and clarity to counties regarding optional health care services. Additionally, §14.201 has been amended to clarify that physician assistants may now bill Medicaid for services provided to patients independently, as well as through their supervising physicians.
COMMENTS
The department, on behalf of the commission, did not receive any comments regarding the proposed rules during the comment period.
LEGAL CERTIFICATION
The Department of State Health Services General Counsel, Lisa Hernandez, certifies that the rules, as adopted, have been reviewed by legal counsel and found to be a valid exercise of the agencies' legal authority.
Subchapter A. PROGRAM ADMINISTRATION
STATUTORY AUTHORITY
The amendments are adopted under Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001; and Health and Safety Code, §§61.006 - 61.009, that require the department to establish rules for eligibility standards and application, documentation, verification, and reporting procedures for counties in determining eligibility under this program. Review of the rules implements Government Code, §2001.039.
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 February 8, 2008.
TRD-200800790
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: February 28, 2008
Proposal publication date: November 30, 2007
For further information, please call: (512) 458-7111 x6972
STATUTORY AUTHORITY
The amendments are adopted under Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001; and Health and Safety Code, §§61.006 - 61.009, that require the department to establish rules for eligibility standards and application, documentation, verification, and reporting procedures for counties in determining eligibility under this program. Review of the rules implements Government Code, §2001.039.
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 February 8, 2008.
TRD-200800791
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: February 28, 2008
Proposal publication date: November 30, 2007
For further information, please call: (512) 458-7111 x6972
STATUTORY AUTHORITY
The amendment is adopted under Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001; and Health and Safety Code, §§61.006 - 61.009, that require the department to establish rules for eligibility standards and application, documentation, verification, and reporting procedures for counties in determining eligibility under this program. Review of the rules implements Government Code, §2001.039.
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 February 8, 2008.
TRD-200800792
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: February 28, 2008
Proposal publication date: November 30, 2007
For further information, please call: (512) 458-7111 x6972
The Executive Commissioner of the Health and Human Services Commission (HHSC) on behalf of the Department of State Health Services (department) adopts the repeal of §§33.13 - 33.15, 33.61 - 33.63, 33.66, 33.112, 33.122, 33.123, 33.125, 33.131 - 33.135, 33.140, 33.301 -33.311, 33.314, 33.315, 33.317 - 33.320, 33.331, 33.334 and 33.351 - 33.358 and the new §§33.1 - 33.7, 33.20, 33.21, 33.30, 33.40, 33.41, 33.60, 33.70 - 33.72 concerning the medical and dental programs under the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program, known in Texas as the Texas Health Steps (THSteps) Program, without changes to the proposed text as published in the December 7, 2007, issue of the Texas Register (32 TexReg 9084) and, therefore, the sections will not be republished.
BACKGROUND AND PURPOSE
Texas Health Steps is the Texas name for the federally-mandated Medicaid service known as EPSDT. EPSDT provides medical and dental check-ups, diagnosis, and treatment to Medicaid clients from birth through age 20. By authorization of HHSC, the department operates and administers the outreach and informing, medical and dental screening, and dental treatment services components of EPSDT.
Government Code, §2001.039, requires that each state agency review and consider for re-adoption each rule adopted by that agency pursuant to the Government Code, Chapter 2001 (Administrative Procedure Act). Sections 33.13 - 33.15, 33.61 - 33.63, 33.66, 33.112, 33.122, 33.123, 33.125, 33.131 - 33.135, 33.140, 33.301 - 33.311, 33.314, 33.315, 33.317 - 33.320, 33.331, 33.334, and 33.351 - 33.358 have been reviewed, and the department has determined that reasons for adopting the sections continue to exist because rules on this subject are needed. Current rules are repealed and the new adopted rules represent a more succinct, understandable, and user-friendly set of rules. Additionally, the rules change the initial eligibility for a dental check-up, which will support HHSC's and the department's THSteps First Dental Home Strategic Initiative.
SECTION-BY-SECTION SUMMARY
Subchapter A. General Provisions.
Section §33.1 describes the purpose and application of the rules in this chapter. Section 33.2 sets forth the definitions used in this chapter. Section 33.3 describes the outreach and informing obligations and support services provided to clients by THSteps. Section 33.4 describes how THSteps receives and refers complaints from all sources. Section 33.5 describes the requirements for medical and dental providers to participate in THSteps. Section 33.6 describes the primary responsibilities of all THSteps providers. Section 33.7 describes exceptions to the timely delivery of THSteps services.
Subchapter B. Client Rights.
Sections 33.20 and 33.21 describe various client rights, including freedom of choice.
Subchapter C. Confidentiality.
Section 33.30 describes the laws protecting confidentiality of client records and the circumstances under which client information can be shared.
Subchapter D. Eligibility and Periodicity.
Sections 33.40 and 33.41 describe the age restrictions related to eligibility for THSteps services and the periodicity requirements and exceptions for check-ups.
Subchapter E. Medical Check-ups.
Section 33.60 describes the federally-mandated medical check-up services.
Subchapter F. Dental Services.
Section 33.70 identifies the categories of dental services that are available to clients in addition to check-ups, and the fact that prior authorization may be required for some services. Section 33.71 describes limitations and exceptions regarding orthodontic services, including prior authorization that may not be transferred. Section 33.72 describes the purpose of dental utilization reviews and the fact they may result in recoupment, administrative actions, or sanctions.
COMMENTS
The department, on behalf of HHSC, did not receive any comments regarding the proposed rules during the comment period.
LEGAL CERTIFICATION
The Department of State Health Services General Counsel, Lisa Hernandez, certifies that the rules, as adopted, have been reviewed by legal counsel and found to be a valid exercise of the agencies' legal authority.
Subchapter A. GENERAL PROVISIONS
STATUTORY AUTHORITY
The new rules are authorized by Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001. The review of the rules implements Government Code, §2001.039.
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 February 8, 2008.
TRD-200800766
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: February 28, 2008
Proposal publication date: December 7, 2007
For further information, please call: (512) 458-7111 x6972
STATUTORY AUTHORITY
The new rules are authorized by Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001. The review of the rules implements Government Code, §2001.039.
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 February 8, 2008.
TRD-200800768
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: February 28, 2008
Proposal publication date: December 7, 2007
For further information, please call: (512) 458-7111 x6972
STATUTORY AUTHORITY
The new rule is authorized by Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001. The review of the rule implements Government Code, §2001.039.
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 February 8, 2008.
TRD-200800770
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: February 28, 2008
Proposal publication date: December 7, 2007
For further information, please call: (512) 458-7111 x6972
STATUTORY AUTHORITY
The new rules are authorized by Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001. The review of the rules implements Government Code, §2001.039.
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 February 8, 2008.
TRD-200800772
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: February 28, 2008
Proposal publication date: December 7, 2007
For further information, please call: (512) 458-7111 x6972
STATUTORY AUTHORITY
The new rule is authorized by Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001. The review of the rule implements Government Code, §2001.039.
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 February 8, 2008.
TRD-200800774
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: February 28, 2008
Proposal publication date: December 7, 2007
For further information, please call: (512) 458-7111 x6972
STATUTORY AUTHORITY
The new rules are authorized by Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001. The review of the rules implements Government Code, §2001.039.
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 February 8, 2008.
TRD-200800776
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: February 28, 2008
Proposal publication date: December 7, 2007
For further information, please call: (512) 458-7111 x6972
STATUTORY AUTHORITY
The repeals are authorized by Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001. The review of the rules implements Government Code, §2001.039.
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 February 8, 2008.
TRD-200800767
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: February 28, 2008
Proposal publication date: December 7, 2007
For further information, please call: (512) 458-7111 x6972
STATUTORY AUTHORITY
The repeals are authorized by Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001. The review of the rules implements Government Code, §2001.039.
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 February 8, 2008.
TRD-200800769
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: February 28, 2008
Proposal publication date: December 7, 2007
For further information, please call: (512) 458-7111 x6972
STATUTORY AUTHORITY
The repeal is authorized by Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001. The review of the rule implements Government Code, §2001.039.
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 February 8, 2008.
TRD-200800771
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: February 28, 2008
Proposal publication date: December 7, 2007
For further information, please call: (512) 458-7111 x6972
25 TAC §§33.122, 33.123, 33.125
STATUTORY AUTHORITY
The repeals are authorized by Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001. The review of the rules implements Government Code, §2001.039.
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 February 8, 2008.
TRD-200800773
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: February 28, 2008
Proposal publication date: December 7, 2007
For further information, please call: (512) 458-7111 x6972
25 TAC §§33.131 - 33.135, 33.140
STATUTORY AUTHORITY
The repeals are authorized by Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001. The review of the rules implements Government Code, §2001.039.
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 February 8, 2008.
TRD-200800775
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: February 28, 2008
Proposal publication date: December 7, 2007
For further information, please call: (512) 458-7111 x6972
25 TAC §§33.301 - 33.311, 33.314, 33.315, 33.317 - 33.320
STATUTORY AUTHORITY
The repeals are authorized by Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001. The review of the rules implements Government Code, §2001.039.
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 February 8, 2008.
TRD-200800777
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: February 28, 2008
Proposal publication date: December 7, 2007
For further information, please call: (512) 458-7111 x6972
25 TAC §§33.331, 33.334, 33.351 - 33.358
STATUTORY AUTHORITY
The repeals are authorized by Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001. The review of the rules implements Government Code, §2001.039.
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 February 8, 2008.
TRD-200800778
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: February 28, 2008
Proposal publication date: December 7, 2007
For further information, please call: (512) 458-7111 x6972