TITLE 1.ADMINISTRATION

Part 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION

Chapter 355. MEDICAID REIMBURSEMENT RATES

Subchapter J. PURCHASED HEALTH SERVICES

The Health and Human Services Commission (HHSC) proposes to amend §355.8401, concerning case management reimbursement methodology, and to repeal §355.8481, concerning EPSDT: Texas Health Steps medical case management, in its Medicaid Reimbursement Rates chapter. HHSC also proposes to re-title Division 21 from Case Management for High-Risk Pregnant Women and High-Risk Infants to Case Management for Children and Pregnant Women. The amendment and repeal are necessary to reflect the consolidation by the Texas Department of Health of two existing case management programs, Targeted Case Management Services for Pregnant Women and Infants and Texas Health Steps Medical Case Management, to form one program, Case Management for Children and Pregnant Women. Section 355.8401 is being amended to reflect the name of the new program and to correct organizational references. Section 355.8481 is being repealed as it is no longer needed. There are no changes to the methodology or rates used to reimburse providers for covered case management services.

Tom Suehs, Deputy Commissioner for Financial Services, has determined that for the first five years the proposed amendment and repeal are in effect, there will be no fiscal implications for the state or local governments as a result of enforcing or administering the amendment and repeal. The reimbursement methodology and rates for the new consolidated case management program remain the same as those used in the previous programs.

Steve Lorenzen, Director of Rate Analysis, has determined that for each year of the first five years the proposed amendment and repeal are in effect, the public benefit anticipated as a result of enforcing the amendment and repeal is that HHSC reimbursement rules will be consistent with the consolidated case management program. There is no anticipated impact on small businesses and micro-businesses to comply with the amendment and repeal as proposed as they will not be required to alter their business practices as a result of the amendment and repeal. There are no anticipated economic costs to persons who are required to comply with the proposed amendment and repeal. There is no anticipated impact on local employment.

HHSC has determined that the proposed amended rule and repeal are not a "major environmental rule" as defined by §2001.0225 of the Texas Government Code. "Major environmental rule" is defined to mean a rule the specific intent of which is to protect the environment or reduce risk to human health from environmental exposure and that may adversely affect in a material way the economy, a sector of the economy, productivity, competition, jobs, the environment or the public health and safety of a state or a sector of the state. The proposed amendment and repeal are not specifically intended to protect the environment or reduce risks to human health from environmental exposure.

HHSC has determined that this proposed amendment and repeal do not restrict or limit an owner's right to their property that would otherwise exist in the absence of governmental action and therefore do not constitute a taking under §2007.043, Government Code.

Written comments on the proposal may be submitted to Mr. Joe Branton, Rate Analysis Department, Texas Health and Human Services Commission, 1100 West 49th Street, Austin, Texas 78756, within 30 days of publication of this proposal in the Texas Register .

21. CASE MANAGEMENT FOR CHILDREN AND PREGNANT WOMEN

1 TAC §355.8401

The amendment is proposed under the Texas Government Code, §531.033, which provides the commissioner of HHSC with broad rulemaking authority; the Human Resources Code, §32.021, and the Texas Government Code, §531.021(a), which provide 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 propose and adopt rules governing the determination of Medicaid reimbursements.

The proposed amendment affects the Human Resources Code, Chapter 32 and the Texas Government Code, Chapter 531.

§355.8401.Case Management Reimbursement Methodology.

(a) General information. The Health and Human Services Commission (HHSC) [ Texas Department of Health (department) ] will reimburse qualified providers for case management services provided to Medicaid-eligible children and [ individuals who are high-risk ] pregnant women [ or high-risk infants ]. The HHSC [ department ] determines reimbursement rates at least annually for case management services. These rates are:

(1) uniform throughout the geographic area(s) providing the service; and

(2) cost-related.

(b) Basis for rate analysis.

(1) For the initial reimbursement period, providers are reimbursed based on rates set as a result of modeling other rates for case management services, and cost information provided by the Texas Department of Health [ department ].

(2) At some future date, as yet unspecified, reimbursements will be based on cost-based prospective rates.

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 March 24, 2003.

TRD-200301884

Steve Aragon

General Counsel

Texas Health and Human Services Commission

Earliest possible date of adoption: May 4, 2003

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


25. EPSDT: TEXAS HEALTHSTEPS MEDICAL CASE MANAGEMENT

1 TAC §355.8481

(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 repeal is proposed under the Texas Government Code, §531.033, which provides the commissioner of HHSC with broad rulemaking authority; the Human Resources Code, §32.021, and the Texas Government Code, §531.021(a), which provide 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 propose and adopt rules governing the determination of Medicaid reimbursements.

The proposed repeal affects the Human Resources Code, Chapter 32 and the Texas Government Code, Chapter 531.

§355.8481.THSteps Medical Case Management Reimbursement Methodology.

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 March 24, 2003.

TRD-200301883

Steve Aragon

General Counsel

Texas Health and Human Services Commission

Earliest possible date of adoption: May 4, 2003

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