Texas Register, Volume 28, Number 14, Pages 2821-2988, April 4, 2003 Page: 2,870
2821-2988 p. ; 28 cm.View a full description of this periodical.
Extracted Text
The following text was automatically extracted from the image on this page using optical character recognition software:
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.
Government Code, 2001.039, requires that each agency review
and consider for readoption each rule adopted by that agency
pursuant to the Government Code, Chapter 2001 (Administra-
tive Procedure Act). The department has reviewed 33.501 -
33.506 and determined that the proposed repeals are necessary
because the subject of these rules will be incorporated into a new
chapter proposed for adoption as described in this preamble.
The department published a Notice of Intention to Review
33.501 - 33.506 in the Texas Register on December 10, 1999
(24 TexReg 11129). No comments have been received.
The proposed repeal of 33.501 - 33.506 is necessary in or-
der to combine services in new rules in Chapter 27, entitled
Case Management for Children and Pregnant Women, of this
title. Combining these sections in a new chapter will ensure in-
tegration of services to the eligible population for case manage-
ment services, children with a health condition/health risk birth
to 21 years and/or high-risk pregnant women of all ages. Specif-
ically, the repealed sections cover definitions; eligible recipients;
THSteps Medical Case Management services, services limita-
tions, applicant and provider qualifications; and application, re-
view and monitoring processes.
The department also proposes the repeal of 32.301 - 32.305
and 32.307, of this title concerning case management for high-
risk pregnant women and high-risk infants. Specifically these
sections cover definitions; eligible individuals; case management
services; 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32.307 were not repealed when 37.81 - 37.86 were adopted.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 at the same time is proposing the repeal of
37.81 - 37.86 of this title concerning Medicaid case manage-
ment for high-risk pregnant women and high-risk infants. Specif-
ically, these sections cover introduction; definitions; case man-
agement services; provider qualifications; application and review
process, and documents adopted by reference and will be inte-
grated in the new Chapter 27 of this title.
The department also proposes new Chapter 27, Case Manage-
ment for Children and Pregnant Women, 27.1, 27.3, 27.5,
27.7, 27.9, 27.11, 27.13 and 27.15. The new sections are pro-
posed as an effort to combine case management programs to
meet the needs of pregnant women of all ages and children with
a health condition/health risk birth to 21 years. Specifically, these
new sections cover definitions; eligible recipients; case man-
agement service provisions; service limitations; applicant and
provider qualifications; and application, review and monitoring
processes.
dren in Texas under the authority of the Hesalth 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 Medicaidprogram 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 current rules were submitted by the depart-
ment under its agreement with HHSC to operate the Early and
Periodic Screening, Diagnosis and Treatment (EPSDT) program,
and as authorized under 1 .07, Acts of the 72nd Legislature,
First Called Session (1991), Chapter 15, as mended by the Acts
of the 73rd Legislature, Chapter 747, 2. The purpose of these
sections is to make available medically necessary medical case
management services mandated by EPSDT program. In Texas,
the EPSDT program is known as Texas Health Steps (THSteps).
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 who
have 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 in the proposed new sections
of Chapter 27 with the proposed repeal of 32.301 - 32.305,
32.307, 33.501 - 33.506, and 37.81 - 37.86. The new program
will provide, through a larger provider base, more continuity of
services for all consumers who are eligible for these services.
The new program will provide a greater continuity of services
for all eligible recipients.
Ravi Rupsingh, M.P.A., Actuary, Actuary Analysis, HHSC, has
determined for the first five years the repeals are in effect, there
will be cost savings to the state through the combination of the
two programs as described in this preamble. Total cost savings
per year are $1,724,820, $6,153,493, $6,348,526, $6,549,411
and $6,745,893 in state fiscal years 2003, 2004, 2005, 2006 and
2007, respectively, for a total of $27,522,143 over these five state
fiscal years. There will be no impact on local government.
Duane Thomas, Ph.D., Texas Department of Health, Director of
Regional Case Management has also determined that for each
of the first five years the repeals are in effect, anticipated pub-
lic benefits include better access to primary care providers, pre-
ventative health services, other health services and community
resources for children and pregnant women accessing the ser-
vices. There will be costs to small businesses and micro-busi-
nesses. This was determined after concluding that the elimina-
tion of the Intake as a billable contact for Targeted Case Manage-
ment for Pregnant Women and Infants providers will decrease
the amount of reimbursement that these providers currently re-
ceive. The cost to small and micro-businesses for the first year
of implementation is estimated to be $7,327 while the cost to
large businesses for the first year of implementation is estimated
to be $7281. The estimated costs are based on the assumption
that 70% of Targeted Case Management for Pregnant Women
and Infants providers are large businesses and 30% of providers
are small or micro-businesses. There will be no anticipated eco-
nomic costs to persons who receive the services. The depart-
ment has determined that the proposed repeals do not restrict or
limit an owner's right to their property that would otherwise exist
in the absence of governmental action and therefore does not
constitute a taking under Government Code, 2007.043.28 TexReg 2870 April 4, 2003 Texas Register
Upcoming Pages
Here’s what’s next.
Search Inside
This issue can be searched. Note: Results may vary based on the legibility of text within the document.
Tools / Downloads
Get a copy of this page or view the extracted text.
Citing and Sharing
Basic information for referencing this web page. We also provide extended guidance on usage rights, references, copying or embedding.
Reference the current page of this Periodical.
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/m1/49/: accessed June 6, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.