TITLE 1.ADMINISTRATION

Part 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION

Chapter 351. COORDINATED PLANNING AND DELIVERY OF HEALTH AND HUMAN SERVICES

1 TAC §351.3

The Texas Health and Human Services Commission adopts an amendment to §351.3 concerning the purpose, task, and duration of advisory committees. Section 62.057, Health and Safety Code, establishes regional advisory committees to advise the Health and Human Services Commission on the implementation and operation of the children's health insurance program (CHIP). This amendment is adopted without changes to the proposed text as published in the December 3, 1999, Texas Register (24 TexReg 10635).

The justification for this rule is that the amendment sets out the purpose, tasks, and functions of the CHIP regional advisory committees in accordance with §62.057, Health and Safety Code, and Chapter 2110, Government Code, concerning advisory committees.

No comments were received on the proposed amendment.

The amendment is adopted under the Texas Government Code, §531.033, which provides the commissioner of HHSC with broad rulemaking authority and under Texas Health and Safety Code, Chapter 62, §62.051(d), which authorizes the commissioner to adopt rules necessary to implement the child health plan for certain low-income children.

The amendment implements Health and Safety Code, §62.057.

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 10, 2000.

TRD-200001046

Marina S. Henderson

Executive Deputy Commissioner

Texas Health and Human Services Commission

Effective date: March 1, 2000

Proposal publication date: December 3, 1999

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


Chapter 355. MEDICAID REIMBURSEMENT RATES

Subchapter F. GENERAL REIMBURSEMENT METHODOLOGY FOR ALL MEDICAL ASSISTANT PROGRAMS

1 TAC §355.721

The Texas Health and Human Services Commission (THHSC) adopts the repeal of §355.721, concerning payment category assignment and provider claims payment, of Chapter 355, Subchapter F, concerning general reimbursement methodology for all medical assistance programs, without changes to the text as proposed in the October 1, 1999, issue of the Texas Register (24 TexReg 8398).

The section is being repealed because it will conflict with level of need provisions in the new Chapter 419, Subchapter D, concerning home and community-based Services (HCS) which is published contemporaneously in this issue of the Texas Register for public review and comment.

No comments were received concerning the proposed repeal.

The repeal is adopted 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 provides 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 reimbursements.

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 9, 2000.

TRD-200000989

Marina S. Henderson

Executive Deputy Commissioner

Texas Health and Human Services Commission

Effective date: March 1, 2000

Proposal publication date: October 1, 1999

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


1 TAC §355.723, §355.775

The Texas Health and Human Services Commission (THHSC) adopts amendments to §355.723, concerning reimbursement methodology for home and community-based services (HCS), and §355.775, concerning reimbursement methodology for the MRLA program, of Chapter 355, Subchapter F, concerning general reimbursement methodology for all medical assistance programs, without changes to the text as proposed in the October 1, 1999, issue of the Texas Register (24 TexReg 8399).

Subsection (e) of §355.723 is amended to address supervised living as a new service component in the HCS program. New subsection (g) of §355.723 establishes the department's authority to adjust a modeled rate for a new HCS service component or a current HCS service component modified after the general modeled rate is adopted. Subsections (e) and (f) of §355.775 are amended to address supervised living as a new service component in the Mental Retardation Local Authority (MRLA) pilot program. New subsection (g) of §355.775 establishes the department's authority to adjust a modeled rate for a new MRLA service component or a current MRLA service component modified after the general modeled rate is adopted.

The amendments will enable the Texas Department of Mental Health and Mental Retardation (TDMHMR) to establish or adjust a model rate for a new service component developed after general modeled rates for the HCS and MRLA programs are adopted, or for an existing service component that is modified after the general modeled rate is adopted.

Written comments were submitted by EduCare, Inc., Austin.

With regard to §355.723(g), the commenter stated that effects of the fairness and potential benefit or adverse effect of the proposed rule could not be evaluated because no rates based upon the restructured HCS program had been disclosed by TDMHMR. The commenter also stated that the preliminary rates the TDMHMR has shared with stakeholders do not appear to follow the provisions of §355.723(h)(1) concerning the inflation of rates based upon the actual costs for the fiscal quarter ending during the period in which data are collected. THHSC acknowledges the commenter's concern about evaluating the proposed rule's effect without knowing the rates resulting from the new methodology. Following publication of the proposed rule amendments, rates were calculated using this methodology and a public hearing was held on January 4, 2000, to accept comments concerning the rates. In addition, TDMHMR staff have worked closely with program provider representatives to address concerns with the proposed rates and have concluded that the new methodology provides a fair and reasonable means for determining program provider reimbursement.

The amendments are adopted 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 provides 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 reimbursements.

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 9, 2000.

TRD-200000988

Marina S. Henderson

Executive Deputy Commissioner

Texas Health and Human Services Commission

Effective date: March 1, 2000

Proposal publication date: October 1, 1999

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