TITLE 1.ADMINISTRATION

Part 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION

Chapter 355. MEDICAID REIMBURSEMENT RATES

Subchapter J. PURCHASED HEALTH SERVICES

2. MEDICAID HOME HEALTH PROGRAM

1 TAC §355.8021

The Health and Human Services Commission (HHSC) adopts an amendment to §355.8021 concerning reimbursement methodology for home health services without changes to the proposed text published in the January 5, 2001, issue of the Texas Register (26 TexReg 13).

Section 355.8021 is amended to continue the current reimbursement methodology for skilled nursing visits, home health aide visits, physical therapy, and occupational therapy services provided by Texas Medicaid enrolled home health agencies. Medicaid enrolled home health agencies will be reimbursed the reasonable cost of supplying the service, applying the same standards, cost reporting period, and cost reimbursement principles used in computing reimbursement for comparable services under Title XVIII Medicare prior to October 1, 2000. Effective October 1, 2000, the Medicare program began reimbursing home health services utilizing a prospective payment system (PPS).

A public hearing was held on January 22, 2001, to accept comments concerning the proposal. The following comments were received from the Texas Hospital Association and Texas Children's Hospital Home Health concerning the proposed rules.

Comment: Concerning the rules in general, both commenters support continuing the current reimbursement methodology for services provided by Medicaid enrolled home health agencies.

Response: Commission agrees with the commenters and will not make any changes to the proposed rule amendment.

The amendment is adopted under the Texas Government Code, §531.033, which provides the commissioner of HHSC with broad rulemaking authority; Human Resources Code, §32.021 and the Texas Government Code, §531.021(a), which provide the Health and Human Services Commission (HHSC) with the authority to administer the federal medical assistance (Medicaid) program in Texas; and the Texas Government Code, §531.021(b), which provides HHSC 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 March 20, 2001.

TRD-200101597

Marina Henderson

Executive Deputy Commissioner

Texas Health and Human Services Commission

Effective date: April 9, 2001

Proposal publication date: January 5, 2001

For further information, please call: (512) 458-7236