Texas Register, Volume 28, Number 14, Pages 2821-2988, April 4, 2003 Page: 2,857
2821-2988 p. ; 28 cm.View a full description of this periodical.
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TRD-200301862
Susan K. Steeg
General Counsel
Texas Department of Health
Earliest possible date of adoption: May 4, 2003
For further information, please call: (512) 458-7236
CHAPTER 33. EARLY AND PERIODIC
SCREENING, DIAGNOSIS, AND TREATMENT
The Texas Department of Health (department) proposes
amendments to 33.13-33.14, 33.61-33.63, 33.66, 33.112,
33.122-33.123, 33.125, 33.131-33.135 the repeal of 33.139,
and new 33.15 and 33.140 concerning the administration
of Medicaid Early and Periodic Screening, Diagnosis, and
Treatment (EPSDT) services.
Specifically, the proposed amendments cover program purpose;
outreach, informing and support services; recipient rights;
confidentiality of records; consent; freedom of choice; eligibility
for services; periodicity; periodic check-up due date; exceptions
to timely delivery of Texas Health Steps (THSteps) services;
medical check-up services; medical diagnosis and treatment
services; approved medical check-up providers; primary re-
sponsibilities of medical check-up providers; and claims. The
proposed new sections concern definitions and management
of complaints. The proposed repeal covers replacement of
hearing aids.
The proposed amendments will clarify program specifications,
specify the components of the program that are administered by
the department and delete obsolete terms. These amendments
will also replace the terms "early and periodic screening,
diagnosis and treatment (EPSDT)" with "Texas Health Steps
(THSteps)" and replace the term "screening" with the word
"check-up" throughout the chapter. Texas Health Steps is the
name of the EPSDT program in Texas.
In addition, the amendments to 33.122 reflect that a THSteps
medical check-up is recommended annually for adolescents,
rather than biennially, beginning at age eleven. THSteps
continues to emphasize the importance of separate counseling
and anticipatory guidance for the child and the accompany-
ing parent/guardian during the adolescent years. Currently
THSteps adolescent-aged recipients are eligible to receive a
medical check-up annually. In accordance with federal EPSDT
regulations, proposed amendments to 33.131 add, "lead
toxicity screening" as a component of a THSteps medical
check-up. Currently THSteps includes lead toxicity screening
as a component of a THSteps medical check-up. Proposed
amendments to 33.133 expand the type of providers who can
provide THSteps medical check-ups and proposed amend-
ments to 33.135 reflect the responsibilities of the Health and
Human Services Commission (HHSC) in relation to the claims
administration portion of the THSteps program.
New 33.15 adds a definition section applicable throughout sub-
chapters A, B, C, D, and E; and new 33.140 addresses com-
plaints concerning unlawful activities and quality of care issues.
Section 33.139 is being proposed for repeal because the de-
partment no longer maintains the authority to implement this sec-
tion. Authority to implement this section was moved to the HHSC
on September 1, 2001. Also, the rule should be repealed rather
than transferred to HHSC because the language in this sectionis obsolete and does not reflect requirements of the EPSDT pro-
gram under current law. Under current EPSDT law, there is no
limit on the number of replacement hearing aids for EPSDT re-
cipients as long as they are medically necessary. At this time,
HHSC does not limit the number of replacement hearing aids.
In addition, the title of Subchapter A has been changed from
Penalties to General Provisions in order to more accurately re-
flect the subchapter's content.
Government Code, 2001.039, requires that each state agency
review and consider for re-adoption each rule adopted by that
agency pursuant to the Government Code, Chapter 2001 (Ad-
ministrative Procedure Act). The department has reviewed the
sections and has determined that reasons for adopting the sec-
tions continue to exist; however, the revisions are needed in or-
der to reflect the changes to program administration and the laws
that pertain to them.
The department published a Notice of Intention to Review for
33.13-33.14, 33.61-33.63, 33.66, 33.112, 33.122-33.123,
33.125, 33.131-33.135, and 33.139, in the Texas Register on
May 12, 2000 (25 TexReg 4358). No comments were received.
Linda M. Altenhoff, D.D.S., Director, Texas Health Steps and
Medical Transportation Division, has determined that for each
year of the first five years the sections are in effect, there will be
no fiscal implications to state or local governments as a result of
enforcing or administering the rules as proposed.
Dr. Altenhoff has also determined that for each year of the first
five years the amended sections are in effect, the anticipated
benefits include program clarification and more accurate reflec-
tion of the program's operations to Texas Health Steps recipi-
ents, families and providers. There will be no costs to micro-
businesses or small businesses to comply with the sections as
proposed. This was determined after concluding that there will
be no new requirements or responsibilities imposed upon mi-
cro-businesses and small businesses. There are no anticipated
economic costs to persons who are required to comply with the
sections as proposed. There is no anticipated impact on local
employment.
Comments on the proposal may be submitted to Linda Altenhoff,
D.D.S., Director, Texas Health Steps and Medical Transportation
Division, Texas Department of Health, 1100 West 49th Street,
Austin, Texas 78756-3189, (512) 458-7745. Comments will be
accepted for 30 days following publication of the proposal in the
Texas Register.
A public hearing on the proposed sections will be held on
Thursday, April 10, 2003, at 4:00 p.m., in the Texas Department
of Health Auditorium (K-100), 1100 West 49th Street, Austin,
Texas.
SUBCHAPTER A. GENERAL PROVISIONS
25 TAC 33.13 - 33.15
The amendments and new section are proposed under the Hu-
man Resources Code, 32.021 (c), which allows the department
to establish rules governing the Medicaid program; the Health
and Safety Code, 12.001, which provides the Texas Board of
Health (board) with the authority to adopt rules for its procedures
and the performance of each duty imposed by law on the board,
the department and the Commissioner of Health; and the Gov-
ernment Code, 531.021, which provides the Health and Human
Services Commission with the authority to administer the state'sPROPOSED RULES April 4, 2003 28 TexReg 2857
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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/m1/36/: accessed June 5, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.