TITLE administration

Part XV. Texas Health and Human Services Commission

Chapter 355. Medicaid Reimbursement Rates

Subchapter F. General Reimbursement Methodology for all Medical Assistant Programs

1 TAC §355.781

The Texas Health and Human Services Commission (THHSC) proposes amendments to §355.781 of 1 TAC Chapter 355, Medicaid Reimbursement Rates, Subchapter F, General Reimbursement Methodology for all Medical Assistance Programs, regarding reimbursement methodology for the rehabilitative services program operated by the Texas Department of Mental Health and Mental Retardation (TDMHMR).

The amendments would create a new subsection (f) to include a definition of "unit of service" or "unit of rehabilitative service" as used in 1 TAC §355.781(e)(2) and (e)(3)(B).

Don Green, Chief Financial Officer, has determined that for each year of the first five years the proposed amendments are in effect enforcing or administering the amendments does not have foreseeable implications relating to cost or revenues of the state or local governments.

Mr. Green has also determined that for each year of the first five years the proposed amendments are in effect the public benefit expected as a result of the adoption of the amendments is the clear definition of a term used in the rule. It is anticipated that there would be no economic cost to persons required to comply with the proposed amendments.

It is anticipated that the proposed amendments will not affect a local economy.

It is anticipated that the proposed amendments will not have an adverse economic effect on small businesses because the amendments do not alter the method by which reimbursement for rehabilitative services is currently made.

Comments on the proposal may be submitted to Linda Logan, director, Policy Development, Texas Department Mental Health and Mental Retardation, P.O. Box 12668, Austin, TX 78711-2668, within 30 days of publication of this notice.

The amendments are proposed under the Texas Government Code, §531.033, which provides the commissioner of THHSC with broad rulemaking authority; the Texas Human Resources Code, §32.021, and the Texas Government Code, §531.021(a), which provide THHSC with the authority to administer the federal medical assistance (Medicaid) program in Texas; and the Texas Government Code, §531.021(b), which provides THHSC with the authority to adopt rules governing the determination of Medicaid rates.

The proposal affects the Texas Human Resources Code, §32.021, and the Texas Government Code, §531.021(a) and §531.033.

§355.781.Rehabilitative Services Reimbursement Methodology.

(a)-(e)

(No change.)

(f)

Definition. "Unit of service" or "unit of rehabilitative service" means:

(1)

for community support services--a direct contact (as defined in §409.353 of title 25 (relating to Definitions)) lasting up to 30 minutes including the time spent by the staff person traveling to and from the location at which the direct contact occurs;

(2)

for day programs--one hour; and

(3)

for rehabilitative plan oversight--one direct contact (as defined in §409.353 of title 25 (relating to Definitions)).

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State, on July 20, 1999.

TRD-9904375

Marina S. Henderson

Executive Deputy Commissioner

Texas Health and Human Services Commission

Earliest possible date of adoption: September 5, 1999

For further information, please call: (512) 424-6576


1 TAC §355.783

(Editor's note: The text of the following section proposed for repeal will not be published. The section may be examined in the offices of the Texas Health and Human Services Commission or in the Texas Register office, Room 245, James Earl Rudder Building, 1019 Brazos Street, Austin.)

The Texas Health and Human Services Commission (THHSC) proposes the repeal of §355.783 of 1 TAC Chapter 355, Medicaid Reimbursement Rates, Subchapter F, General Reimbursement Methodology for all Medical Assistance Programs, regarding right to appeal for the rehabilitative services program operated by the Texas Department of Mental Health and Mental Retardation (TDMHMR).

The section is proposed for repeal because provisions regarding fair hearings for Medicaid recipients and appeals concerning cost reports for Medicaid providers of rehabilitative services are described in 25 TAC §419.464 and 1 TAC §355.781(e)(3)(D), respectively.

Don Green, Chief Financial Officer, has determined that for each year of the first five years the proposed repeal is in effect enforcing or administering the rule does not have foreseeable implications relating to cost or revenues of the state or local governments.

Mr. Green has also determined that for each year of the first five years the proposed repeal is in effect the public benefit expected is the elimination of an unnecessary rule provision and there would be no economic cost to persons required to comply with the rule.

It is anticipated that the proposed repeal will not affect a local economy.

It is anticipated that the proposed repeal will not have an adverse economic effect on small businesses because the repeal does not affect the process regarding fair hearings for Medicaid recipients or appeals concerning cost reports for Medicaid providers of rehabilitative services.

Comments on the proposal may be submitted to Linda Logan, director, Policy Development, Texas Department Mental Health and Mental Retardation, P.O. Box 12668, Austin, Texas, 78711-2668, within 30 days of publication of this notice.

The repeal is proposed under the Texas Government Code, §531.033, which provides the commissioner of THHSC with broad rulemaking authority; the Texas Human Resources Code, §32.021, and the Texas Government Code, §531.021(a), which provide THHSC with the authority to administer the federal medical assistance (Medicaid) program in Texas; and the Texas Government Code, §531.021(b), which provides THHSC with the authority to adopt rules governing the determination of Medicaid rates.

The proposal affects the Texas Human Resources Code, §32.021, and the Texas Government Code, §531.021(a) and §531.033.

§355.783.Right to Appeal.

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State, on July 20, 1999.

TRD-9904374

Marina S. Henderson

Executive Deputy Commissioner

Texas Health and Human Services Commission

Earliest possible date of adoption: September 5, 1999

For further information, please call: (512) 424-6576