Texas Register, Volume 28, Number 14, Pages 2821-2988, April 4, 2003 Page: 2,851
2821-2988 p. ; 28 cm.View a full description of this periodical.
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the written signature. If the therapeutic optometrist does not clearly
indicate [that the prescription drug shall be dispensed as ordered by
writing across the face of the written p e cri tion. in the therapeu-
tie optometrist's own handwring the phrase] "brand necessary" or
"brand medically necessary," when communicating the prescription to
the pharmacist, the pharmacist may substitute a generically equivalent
drug product in compliance with the Texas Pharmacy Act and 309.3
of this title.
(e) - (j) (No change.)
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal author-
ity to adopt.
Filed with the Office of the Secretary of State on March 18, 2003.
TRD-200301799
Chris Kloeris
Executive Director
Texas Optometry Board
Earliest possible date of adoption: May 4, 2003
For further information, please call: (512) 305-8502
TITLE 25. HEALTH SERVICESPART 1.
HEALTHTEXAS DEPARTMENT OF
CHAPTER 27. CASE MANAGEMENT FOR
CHILDREN AND PREGNANT WOMEN
25 TAC 27.1, 27.3, 27.5, 27.7, 27.9, 27.11, 27.13, 27.15
The Texas Department of Health (department) proposes new
27.1, 27.3, 27.5, 27.7, 27.9, 27.11, 27.13 and 27.15, concern-
ing case management for children and pregnant women. Specif-
ically, these new sections cover definitions; eligible recipients;
case management service provisions; service limitations; appli-
cant and provider qualifications; application; case management
provider review and monitoring processes.
The proposed new rules for Case Management for Children
and Pregnant Women will provide case management services
to Medicaid eligible women of all ages who have a high risk
pregnancy and to children from birth to 21 years of age with
a health condition/health risk. The programs, Medicaid Case
Management for High Risk Pregnant Women and High Risk
Infants and the Texas Health Steps Medical Case Manage-
ment will become one program due to the proposed repeal
of 32.301 - 32.305, 32.307, 33.501 - 33.506, and 37.81 -
37.86 of this title and will become proposed new sections of
Chapter 27. The new program will provide a greater continuity
of services for all eligible recipients.
New 27.1 covers definitions and includes language from
proposed repealed 33.501 and proposed repealed 37.82.
New 27.3 covers eligible recipients and includes language
from proposed repealed 33.502 and proposed repealed
37.82. New 27.5 covers Case Management for Children
and Pregnant Women's services and includes language from
proposed repealed 33.503 and proposed repealed 37.83.
New 27.7 covers service limitations and includes language
from proposed repealed 33.504. New 27.9 covers applicant
qualifications and includes language from proposed repealed33.505 and proposed repealed 37.84. New 27.11 covers
provider requirements and includes language from proposed
repealed 33.505 and proposed repealed 37.84. New 27.13
covers application processes and includes language from
proposed repealed 33.506 and proposed repealed 37.85.
New 27.15 covers case management provider review and
monitoring process and includes language from proposed
repealed 33.506 and proposed repealed 37.85.
The department also proposes the repeal of 32.301 - 32.305
and 32.307, concerning case management for high risk preg-
nant women and high risk infants. Specifically these sections
cover definitions; eligible individuals; case management ser-
vices; service limitations; provider qualifications and the right to
appeal. These sections are being proposed for repeal as they
are repeated in 37.81 - 37.86. Sections 32.301 - 32.305 and
32.307 were not repealed when 37.81 - 37.86 were adopted.
The department further proposes repeal of Early and Periodic
Screening, Diagnosis, and Treatment, Subchapter J, Texas
Health Steps Medical Case Management 33.501 - 33.506.
Specifically, these sections cover definitions; eligible recipi-
ents; THSteps Medical Case Management Services; service
limitations; applicant and provider qualifications; application,
review and monitoring process. These sections are being
proposed for repeal in an effort to integrate services to the
eligible population for case management services: children with
a health condition/health risk birth to 21 years and/or high risk
pregnant women of all ages.
The department at the same time is proposing the repeal of
37.81 - 37.86, concerning Medicaid case management for
high risk pregnant women and high risk infants. Specifically,
these sections cover introduction; definitions; case manage-
ment services; provider qualifications; application and review
process; and documents adopted by reference. Pertinent
portions of the proposed repealed sections will be integrated in
proposed new Chapter 27 of this title.
The department provides health services to women and chil-
dren in Texas under the authority of the Health and Safety Code,
Chapter 32; the State Appropriations Act; and the Social Security
Act, Title V. The Targeted Case Management Program for High
Risk Pregnant Women and High Risk Infants was established un-
der the authority of the Social Security Act, Title XIX, 1915(g).
Section 1915(g) authorized states to provide case management
as a distinct service to targeted populations, through a waiver
from the Health Care Financing Administration (HCFA), now the
Centers for Medicare and Medicaid Services or CMS. The Health
and Human Services Commission (HHSC) provides authority to
the department to propose rules to administer certain Medicaid
program services in Texas. Human Resources Code, 22.0031,
mandates case management for high-risk pregnant women and
high-risk children to age one as provided under 1915(g) of the
federal Social Security Act (42 U.S.C. 1396n). Case manage-
ment for children up to age 21 is authorized under 42 U.S.C.
1396d.
The Government Code, 531.021, provides HHSC with the au-
thority to propose rules to administer the state's medical assis-
tance program. The Texas Department of Health submitted the
current rules under its agreement with HHSC to operate the Early
and Periodic Screening, Diagnosis, and Treatment (EPSDT) pro-
gram, and as authorized under Acts 1991, 72nd Legislature,
First Called Session, Chapter 15, 1.07. In Texas, the EPSDT
program is known as Texas Health Steps (THSteps). The pur-
pose of these sections is to make available medically necessaryPROPOSED RULES April 4, 2003 28 TexReg 2851
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Texas. Secretary of State. Texas Register, Volume 28, Number 14, Pages 2821-2988, April 4, 2003, periodical, April 4, 2003; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth101027/m1/30/: accessed June 6, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.