Texas Register, Volume 28, Number 14, Pages 2821-2988, April 4, 2003 Page: 2,829
2821-2988 p. ; 28 cm.View a full description of this periodical.
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PROPOSED
JLE S Proposed rules include new rules, amendments to existing rules, and repeals of existing rules.
LE S A state agency shall give at least 30 days' notice of its intention to adopt a rule before it
adopts the rule. A state agency shall give all interested persons a reasonable opportunity to
submit data, views, or arguments, orally or in writing (Government Code, Chapter 2001).
Symbols in proposed rule text. Proposed new language is indicated by underlined text. []Squaebraeketsand s.et -gh]
indicate existing rule text that is proposed for deletion. "(No change)" indicates that existing rule text at this level will not be
amended.TITLE 1. ADMINISTRATION
PART 15. TEXAS HEALTH AND
HUMAN SERVICES COMMISSION
CHAPTER 355. MEDICAID REIMBURSE-
MENT RATES
SUBCHAPTER J. PURCHASED HEALTH
SERVICES
The Health and Human Services Commission (HHSC) proposes
to amend 355.8401, concerning case management reimburse-
ment methodology, and to repeal 355.8481, concerning
EPSDT: Texas Health Steps medical case management, in its
Medicaid Reimbursement Rates chapter. HHSC also proposes
to re-title Division 21 from Case Management for High-Risk
Pregnant Women and High-Risk Infants to Case Management
for Children and Pregnant Women. The amendment and repeal
are necessary to reflect the consolidation by the Texas Depart-
ment of Health of two existing case management programs,
Targeted Case Management Services for Pregnant Women and
Infants and Texas Health Steps Medical Case Management, to
form one program, Case Management for Children and Preg-
nant Women. Section 355.8401 is being amended to reflect
the name of the new program and to correct organizational
references. Section 355.8481 is being repealed as it is no longer
needed. There are no changes to the methodology or rates
used to reimburse providers for covered case management
services.
Tom Suehs, Deputy Commissioner for Financial Services, has
determined that for the first five years the proposed amendment
and repeal are in effect, there will be no fiscal implications for the
state or local governments as a result of enforcing or administer-
ing the amendment and repeal. The reimbursement methodol-
ogy and rates for the new consolidated case management pro-
gram remain the same as those used in the previous programs.
Steve Lorenzen, Director of Rate Analysis, has determined that
for each year of the first five years the proposed amendment
and repeal are in effect, the public benefit anticipated as a re-
sult of enforcing the amendment and repeal is that HHSC re-
imbursement rules will be consistent with the consolidated case
management program. There is no anticipated impact on small
businesses and micro-businesses to comply with the amend-
ment and repeal as proposed as they will not be required to alter
their business practices as a result of the amendment and re-
peal. There are no anticipated economic costs to persons who
are required to comply with the proposed amendment and re-
peal. There is no anticipated impact on local employment.HHSC has determined that the proposed amended rule and
repeal are not a "major environmental rule" as defined by
2001.0225 of the Texas Government Code. "Major environ-
mental rule" is defined to mean a rule the specific intent of
which is to protect the environment or reduce risk to human
health from environmental exposure and that may adversely
affect in a material way the economy, a sector of the economy,
productivity, competition, jobs, the environment or the public
health and safety of a state or a sector of the state. The
proposed amendment and repeal are not specifically intended
to protect the environment or reduce risks to human health from
environmental exposure.
HHSC has determined that this proposed amendment and re-
peal do not restrict or limit an owner's right to their property that
would otherwise exist in the absence of governmental action and
therefore do not constitute a taking under 2007.043, Govern-
ment Code.
Written comments on the proposal may be submitted to Mr. Joe
Branton, Rate Analysis Department, Texas Health and Human
Services Commission, 1100 West 49th Street, Austin, Texas
78756, within 30 days of publication of this proposal in the Texas
Register.
DIVISION 21. CASE MANAGEMENT FOR
CHILDREN AND PREGNANT WOMEN
1 TAC 355.8401
The amendment is proposed under the Texas Government
Code, 531.033, which provides the commissioner of HHSC
with broad rulemaking authority; the Human Resources Code,
32.021, and the Texas Government Code, 531.021(a), which
provide HHSC with the authority to administer the federal
medical assistance (Medicaid) program in Texas; and the
Texas Government Code, 531.021(b), which provides HHSC
with the authority to propose and adopt rules governing the
determination of Medicaid reimbursements.
The proposed amendment affects the Human Resources Code,
Chapter 32 and the Texas Government Code, Chapter 531.
355.8401. Case Management Reimbursement Methodology.
(a) General information. The Health and Human Services
Commission (HHSC) [Texas Department of Health departmentnt] will
reimburse qualified providers for case management services provided
to Medicaid-eligible children and [individuals who are high-risk]
pregnant women [or high-risk infants]. The HHSC [department]
determines reimbursement rates at least annually for case management
services. These rates are:
(1) uniform throughout the geographic area(s) providing
the service; and
(2) cost-related.PROPOSED RULES April 4, 2003 28 TexReg 2829
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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/m1/8/: accessed June 6, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.