TITLE 1.ADMINISTRATION

Part 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION

Chapter 355. MEDICAID REIMBURSEMENT RATES

Subchapter A. COST DETERMINATION PROCESS

1 TAC §355.110, §355.112

The Texas Health and Human Services Commission (HHSC) proposes to amend §355.110, concerning informal reviews and formal appeals, and §355.112, concerning attendant compensation rate enhancement, in its Medicaid Reimbursement Rates chapter.

The purpose of the amendment to §355.110 is to modify the amount of time a provider is allowed to submit a request for an informal review. The amendment grants providers an additional 15 calendar day extension beyond the 30 calendar day deadline to submit required information related to the provider's request for an informal review.

The purpose of the amendment to §355.112 is to lower the spending requirement for participating providers by amending the calculation used to determine the adjusted attendant compensation per unit of service. Beginning September 1, 2003, the attendant compensation spending per unit of service has been multiplied by 1.10 to determine the adjusted attendant compensation per unit of service.

The Texas Department of Human Services (DHS) is proposing related policy in its Chapter 20 in this issue of the Texas Register .

Tom Suehs, Deputy Commissioner for Financial Services, has determined that for the first five-year period the proposed sections are in effect, there are no fiscal implications for state government or local government as a result of enforcing or administering the sections.

David Palmer, Director, Rate Analysis, has determined that for each year of the first five years the section is in effect, the public benefit anticipated as a result of enforcing §355.110 is that providers will be allowed additional time, if it proves necessary, to collect the necessary information and evidence to support an efficient resolution of matters in dispute. The public benefit anticipated as a result of enforcing §355.112 is that participating providers will be allowed more flexibility in spending in other cost areas of the total reimbursement rate.

There is no adverse economic effect on small or micro businesses as a result of enforcing or administering the sections, because the proposal increases flexibility for providers and does not add any new requirements for businesses. There is no anticipated economic cost to persons who are required to comply with the proposed sections. There is no anticipated effect on local employment in geographic areas affected by these sections.

Questions about the content of this proposal may be directed to Carolyn Pratt at (512) 685-3127 in HHSC's Rate Analysis Department. Written comments on the proposal may be submitted to Supervisor, Rules and Handbooks Unit-009, Texas Department of Human Services E-205, P.O. Box 149030, Austin, Texas 78714-9030, within 30 days of publication in the Texas Register . For further information regarding the proposal or to make the proposal available for public review, contact local offices of DHS or Carolyn Pratt at (512) 685-3127 in HHSC's Rate Analysis Department.

Under §2007.003(b) of the Government Code, HHSC has determined that Chapter 2007 of the Government Code does not apply to these rules. Accordingly, HHSC is not required to complete a takings impact assessment regarding these rules.

The amendments are proposed under the Government Code, §531.033, which authorizes the commissioner of HHSC to adopt rules necessary to carry out the commission's duties; §531.021(b), which establishes HHSC as the agency responsible for adopting reasonable rules governing the determination of fees, charges, and rates for medical assistance payments under the Human Resources Code, Chapter 32; and Government Code, §2001.006(b), which allows state agencies to adopt rules in preparation for the implementation of legislation.

The amendments affect the Government Code, §531.033 and §531.021(b).

§355.110.Informal Reviews and Formal Appeals.

(a) - (b) (No change.)

(c) Informal review.

(1) An interested party who disputes an action or determination under this chapter may request an informal review under this section. The purpose of an informal review is to provide for the informal and efficient resolution of the matters in dispute. An informal review is not a formal administrative hearing, but is a prerequisite to obtaining a formal administrative hearing and is conducted according to the following procedures:

(A) HHSC Rate Analysis must receive a written request for an informal review by hand delivery, United States ( U.S. ) mail, or special mail delivery no later than 30 calendar days from the date on the written notification of the adjustments. If the 30th calendar day is a weekend day, national holiday, or state holiday, then the first business day following the 30th calendar day is the final day the receipt of the written request will be accepted. HHSC Rate Analysis will extend this deadline if it receives a written request for the extension by hand delivery, U.S. mail, or special mail delivery no later than 30 calendar days from the date of the written notice of adjustments. The extension gives the requester a total of 45 calendar days from the date of the written notice of adjustment to file a request for an informal review. If the 45th calendar day is a weekend day, national holiday, or state holiday, then the 45th day is considered the next business day following the 45th calendar day. A request for an informal review or extension that is not received by the stated deadline will not be accepted.

(B) - (C) (No change.)

(2) (No change.)

(d) - (e) (No change.)

§355.112.Attendant Compensation Rate Enhancement.

(a) - (r) (No change.)

(s) Spending requirements for participating contracts. HHSC will determine from the Attendant Compensation Report, as specified in subsection (h) of this section and other appropriate data sources, the amount of attendant compensation spending per unit of service delivered. The provider's compliance with the spending requirement is determined based on the total attendant compensation spending as reported on the Attendant Compensation Report for each participating contract if the provider requested participation individually for each contract. A participating contract that has been terminated in accordance with subsection (v) of this section or that has undergone a contract assignment in accordance with subsection (w) of this section will be considered to have participated on an individual basis for compliance with the spending requirement for the owner prior to the termination or contract assignment. If the provider specified that he wished to have all participating contracts be considered as a group for purposes related to the attendant compensation rate enhancement, as specified in subsection (f) of this section, compliance with the spending requirement is based on the total attendant compensation as reported on the single aggregate Attendant Compensation Report described in subsection (h) of this section. Compliance with the spending requirement is determined separately for each program specified in subsection (a) of this section, except for providers delivering services to both RC and CBA AL/RC clients in the same facility whose compliance is determined by combining both programs. HHSC will calculate recoupment, if any, as follows.

(1) For the rate year beginning September 1, 2000, the attendant compensation spending per unit of service is [ will be ] multiplied by 1.09 to determine the adjusted attendant compensation per unit of service. For the rate years [ year ] beginning September 1, 2001, and September 1, 2002 [ thereafter ], the attendant compensation spending per unit of service is [ will be ] multiplied by 1.07 to determine the adjusted attendant compensation per unit of service. For the rate year beginning September 1, 2003, and thereafter, the attendant compensation spending per unit of service is multiplied by 1.10 to determine the adjusted attendant compensation per unit of service.

(2) - (3) (No change.)

(t) - (dd) (No change.)

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 December 22, 2003.

TRD-200308853

Steve Aragón

General Counsel

Texas Health and Human Services Commission

Earliest possible date of adoption: February 8, 2004

For further information, please call: (512) 438-3734