Part 1. DEPARTMENT OF AGING AND DISABILITY SERVICES
Chapter 19. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION
Subchapter N. REHABILITATIVE SERVICES
The Health and Human Services Commission (HHSC), on behalf of the Department of Aging and Disability Services (DADS), adopts an amendment to §19.1306, in Chapter 19, Nursing Facility Requirements for Licensure and Medicaid Certification, without changes to the proposed text as published in the October 19, 2007, issue of the Texas Register (32 TexReg 7432).
The amendment is adopted to remove rule language regarding the methodology used to set reimbursement rates for specialized and rehabilitative services delivered to Medicaid-eligible individuals in nursing facilities. HHSC is the agency responsible for determining the rate-setting methodology for those services. Therefore, HHSC is adopting a related rule at 1 TAC §355.313, Reimbursement Methodology for Nursing Facility Specialized and Rehabilitative Services.
DADS received written comments from the Coalition for Nurses in Advanced Practice. A summary of the comment and the response follow.
Comment: Concerning §19.1306(b)(1) and (c)(2), a commenter requested that DADS amend these subsections to specify that a physician may delegate tasks described in those subsections to a nurse practitioner, clinical nurse specialist, or physician assistant, and include a cross reference to §19.1205(c).
Response: The agency agrees that the physician duties referenced in §19.1306(b)(1) and (c)(2) may be delegated in accordance with §19.1205(c) in Subchapter M, Physician Delegation. Section 19.1205(c) states that any required physician task in a Medicaid nursing facility may be satisfied when performed by a nurse practitioner, clinical nurse specialist, or physician assistant in accordance with applicable state laws, rules, and regulations. A statement that a physician may delegate tasks in just one section of Chapter 19 may give the impression that a physician is not allowed to delegate tasks described in other sections of the chapter. Therefore, the agency declines to make the suggested change at this time.
The amendment is adopted under Texas Government Code, §531.0055, which provides that the HHSC executive commissioner shall adopt rules for the operation and provision of services by the health and human services agencies, including DADS; Texas Human Resources Code, §161.021, which provides that the Aging and Disability Services Council shall study and make recommendations to the HHSC executive commissioner and the DADS commissioner regarding rules governing the delivery of services to persons who are served or regulated by DADS; and Texas Government Code, §531.021, which provides HHSC with the authority to administer federal funds and plan and direct the Medicaid program in each agency that operates a portion of the Medicaid program.
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 January 11, 2008.
TRD-200800134
Kenneth L. Owens
General Counsel
Department of Aging and Disability Services
Effective date: February 1, 2008
Proposal publication date: October 19, 2007
For further information, please call: (512) 438-3734