TITLE 1.ADMINISTRATION

Part 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION

Chapter 355. MEDICAID REIMBURSEMENT RATES

Subchapter E. COMMUNITY CARE FOR AGED AND DISABLED

1 TAC §355.503

The Texas Health and Human Services Commission (HHSC) proposes to amend §355.503, concerning reimbursement methodology for the Community-Based Alternatives waiver program, in its Medicaid Reimbursement Rates chapter. The purpose of the amendment is to correct inaccurate rule citations concerning reimbursement methodology for the Emergency Response Services (ERS) and Home-Delivered Meals (HDM) programs.

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

Ed White, Director, Rate Setting and Forecasting, 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 the section is that contracted providers can access accurate guidelines governing reimbursement methodology for the ERS and HDM programs. There is no adverse economic effect on small or micro businesses as a result of enforcing or administering the section, because the proposal is technical in nature and imposes no new requirements on businesses of any size. There is no anticipated economic cost to persons who are required to comply with the proposed section. There is no anticipated effect on local employment in geographic areas affected by this section.

Questions about the content of this proposal may be directed to Victor Perez at (512) 491- 1375 in HHSC's Rate Analysis Department. Written comments on the proposal may be submitted to Supervisor, Rules Unit-105, Texas Department of Human Services E-205, P.O. Box 149030, Austin, Texas 78714-9030, within 30 days of publication in the Texas Register .

Under §2007.003(b) of the Government Code, HHSC has determined that Chapter 2007 of the Government Code does not apply to this rule. The changes this rule makes do not implicate a recognized interest in private real property. Accordingly, HHSC is not required to complete a takings impact assessment regarding this rule.

The amendment is proposed under the Government Code, §531.033, which authorizes the commissioner of HHSC to adopt rules necessary to carry out the commission's duties, and §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.

The amendment affects the Government Code, §§531.033 and 531.021(b).

§355.503.Reimbursement Methodology for the Community-Based Alternatives Waiver Program.

(a) - (c) (No change.)

(d) Waiver reimbursement determination. Recommended reimbursements are determined in the following manner.

(1) - (2) (No change.)

(3) Monthly reimbursement ceilings. The reimbursement for Emergency Response Services will be determined as monthly reimbursement ceiling, based on the ceiling amount determined in accordance with 40 TAC §52.504 (relating to Reimbursement Methodology for Emergency Response Services (ERS) ). The reimbursement for Home-Delivered Meals will be determined on a per meal basis, based on the ceiling amount determined in accordance with 40 TAC §55.45 [ §48.9806 ] (relating to Reimbursement Methodology for Home-Delivered Meals).

(4) - (7) (No change.)

(e) - (h) (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 May 24, 2004.

TRD-200403493

Steve Aragón

General Counsel

Texas Health and Human Services Commission

Earliest possible date of adoption: July 4, 2004

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