Texas Register, Volume 38, Number 26, Pages 4053-4242, June 28, 2013 Page: 4,098
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Program (MDCP) waiver programs administered by the Depart-
ment of Aging and Disability Services (DADS). HHSC, under its
authority and responsibility to administer and implement rates,
is proposing amendments to these rules to add reimbursement
methodologies for supported employment and employment as-
sistance.
These amendments are being proposed to comply with Section
1, S.B. 45, 83rd Legislature, Regular Session, 2013, which re-
quires DADS to add supported employment and employment as-
sistance to the CBA and MDCP programs. Because S.B. 45
is effective September 1, 2013, DADS plans to add supported
employment and employment assistance to CBA and MDCP, as
soon as possible pending required federal approval with the op-
tion of the amendment being effective September 1, 2013.
The amendments are also proposed to update cross references
and remove unnecessary language.
Section-by-Section Summary
The proposed amendments to 355.503 are as follows:
- Revise subsections (c)(1) and (c)(1)(F) to include supported
employment and employment assistance.
- Revise subsection (c)(1)(G)(ii) to correct a cross reference.
- Revise subsection (c)(2)(B) to update a cross reference.
- Revise subsection (d) to remove unnecessary language.
- Revise subsection (e)(5)(B) to update a cross reference and
remove unnecessary language.
The proposed amendments to 355.507 are as follows:
- Revise subsection (c) to update cross references and remove
unnecessary language.
- Add new subsection (f) to detail a reimbursement methodol-
ogy for supported employment and employment assistance and
renumbers the subsequent subsection.
Fiscal Note
James Jenkins, Chief Financial Officer for the Department of Ag-
ing and Disability Services, has determined that, during the first
five-year period the amended rules are in effect, there will be no
fiscal impact to state government. The proposed rules will not re-
sult in any fiscal implications for local health and human services
agencies. There are no fiscal implications for local governments
as a result of enforcing or administering the sections.
Mr. Jenkins does not anticipate that there will be any economic
cost to persons who are required to comply with the proposed
amendments during the first five years the rules will be in effect.
The amendments will not affect local employment.
Small Business and Micro-business Impact Analysis
HHSC has determined that there is no adverse economic effect
on small businesses or micro-businesses as a result of enforc-
ing or administering the amendments. The implementation of
the proposed rule amendments does not require any changes in
practice or any additional cost to the contracted provider.
Public Benefit
Pam McDonald, Director of Rate Analysis, has determined that
for each year of the first five years the amendments are in effect,
the expected public benefit is providers of employment assis-
tance and supported employment will know the reimbursementmethodology for providing these new services in the CBA and
MDCP programs.
Takings Impact Assessment
HHSC has determined that this proposal does not restrict or limit
an owner's right to his or her private real property that would
otherwise exist in the absence of government action and, there-
fore, does not constitute a taking under Texas Government Code
2007.043.
Regulatory Analysis
HHSC has determined that this proposal is not a "major environ-
mental rule" as defined by 2001.0225 of the Texas Government
Code. "Major environmental 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. This
proposal is not specifically intended to protect the environment
or reduce risks to human health from environmental exposure.
Public Comment
Questions about the content of this proposal may be directed
to Judy Myers in the HHSC Rate Analysis Department by tele-
phone at (512) 707-6085. Written comments on the proposed
amendments may be submitted to Ms. Myers by facsimile at
(512) 730-7475; by e-mail to judy.myers@hhsc.state.tx.us; or by
mail to HHSC Rate Analysis, Mail Code H-400, P.O. Box 149030,
Austin, Texas 78714-9030 within 30 days of publication of this
proposal in the Texas Register.
Statutory Authority
The amendments are proposed under the Texas Government
Code 531.033, which provides the Executive Commissioner
of HHSC with broad rulemaking authority; and the Texas Hu-
man Resource Code 32.021 and Texas Government Code
531.021(a), which provide HHSC with the authority to adminis-
ter the federal medical assistance (Medicaid) program in Texas;
and Texas Government Code 531.021(b)(2), which provides
HHSC with the authority to propose and adopt rules governing
the determination of Medicaid reimbursements.
The amendments affect the Texas Government Code Chapter
531 and Texas Human Resources Code Chapter 32. No other
statutes, articles, or codes are affected by this proposal.
355.503. Reimbursement Methodology for the Community-Based
Alternatives Waiver Program and the Integrated Care Manage-
ment-Home and Community Support Services and Assisted Living/Res-
idential Care Programs.
(a) General requirements. The Texas Health and Human Ser-
vices Commission (HHSC) applies the general principles of cost deter-
mination as specified in 355.101 of this title (relating to Introduction).
Providers are reimbursed for waiver services provided to individuals
who meet the criteria for alternatives to nursing facility care. Addition-
ally, providers are reimbursed a one-time administrative expense fee
for a pre-enrollment assessment of potential waiver participants. The
pre-enrollment assessment covers care planning for the participant.
(b) Other sources of cost information. If HHSC has deter-
mined that there is not sufficient reliable cost report data from which to
determine reimbursements and reimbursement ceilings for waiver ser-
vices, reimbursements and reimbursement ceilings will be developed
by using data from surveys; cost report data from other similar pro-38 TexReg 4098 June 28, 2013 Texas Register
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Texas. Secretary of State. Texas Register, Volume 38, Number 26, Pages 4053-4242, June 28, 2013, periodical, June 28, 2013; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth313178/m1/46/: accessed May 4, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.