TITLE 1. ADMINISTRATION

PART 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION

CHAPTER 355. REIMBURSEMENT RATES

The Texas Health and Human Services Commission (HHSC) adopts amendments to §355.102, concerning General Principles of Allowable and Unallowable Costs; §355.105, concerning General Reporting and Documentation Requirements, Methods, and Procedures; §355.112, concerning Attendant Compensation Rate Enhancement; §355.456, concerning Reimbursement Methodology; §355.722, concerning Reporting Costs by Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Providers; and §355.723, concerning Reimbursement Methodology for Home and Community-Based Services and Texas Home Living Programs without changes to the proposed text as published in the November 10, 2017, issue of the Texas Register (42 TexReg 6259). Therefore, the rules will not be republished.

BACKGROUND AND JUSTIFICATION

Effective March 1, 2018, HHSC will implement a cost report reform initiative for HCS/TxHmL and intermediate care facilities for individuals with an intellectual disability or related conditions (ICF/IID) providers by requiring only even-year cost reports beginning with providers' 2018 fiscal year cost reports. These amendments are at §355.105(c) for ICF/IID providers and at §355.722(a) for HCS/TxHmL providers.

As part of this initiative, HHSC adopts amendments to §355.102(d) so that all providers attend state-sponsored cost report training every other year for the even-year cost report. Previously, providers attended cost report training for odd-year cost reports.

Section 355.112(h)(2)(B) is also amended to require Attendant Compensation Reports for odd years beginning with the rate year that starts September 1, 2017. The report must reflect the activities of the provider while delivering contracted services from the first day of the rate year through the last day of the rate year, and it is due no later than 90 days following the end of the provider entity's fiscal year or 90 days from the transmittal date of the Attendant Compensation Report forms, whichever due date is later.

Finally, HHSC deleted the Total Medicaid Spending Requirement in the ICF/IID reimbursement methodology at §355.456(j)(8) and in the HCS/TxHmL reimbursement methodology at §355.723(f)(10) beginning September 1, 2017. Providers who chose to receive the Medicaid rates in effect on August 31, 2015, (i.e., providers who chose to "opt out" of the September 1, 2015, rate increases in order to be exempt from the Total Medicaid Spending Requirement) will receive the rates that were adopted effective September 1, 2015, effectively eliminating the rate differential between providers who "opted in" and providers who "opted out."

COMMENTS

The 30-day comment period ended December 10, 2017. During this period, HHSC did not receive any comments regarding the proposed rules.

SUBCHAPTER A. COST DETERMINATION PROCESS

1 TAC §§355.102, 355.105, 355.112

STATUTORY AUTHORITY

The amended rules are adopted under Texas Government Code §531.033, which provides the Executive Commissioner of HHSC with broad rulemaking authority; Texas Human Resources Code §32.021 and Texas Government Code §531.021(a), which provide HHSC with the authority to administer the federal medical assistance (Medicaid) program in Texas; and Texas Government Code §531.021(b), which establishes HHSC as the agency responsible for adopting reasonable rules governing the determination of fees, charges, and rates for medical assistance (Medicaid) payments under Texas Human Resources Code Chapter 32.

The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on January 8, 2018.

TRD-201800050

Karen Ray

Chief Counsel

Texas Health and Human Services Commission

Effective date: March 1, 2018

Proposal publication date: November 10, 2017

For further information, please call: (512) 462-6223


SUBCHAPTER D. REIMBURSEMENT METHODOLOGY FOR INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS (ICF/IID)

1 TAC §355.456

STATUTORY AUTHORITY

The amended rule is adopted under Texas Government Code §531.033, which provides the Executive Commissioner of HHSC with broad rulemaking authority; Texas Human Resources Code §32.021 and Texas Government Code §531.021(a), which provide HHSC with the authority to administer the federal medical assistance (Medicaid) program in Texas; and Texas Government Code §531.021(b), which establishes HHSC as the agency responsible for adopting reasonable rules governing the determination of fees, charges, and rates for medical assistance (Medicaid) payments under Texas Human Resources Code Chapter 32.

The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on January 8, 2018.

TRD-201800051

Karen Ray

Chief Counsel

Texas Health and Human Services Commission

Effective date: March 1, 2018

Proposal publication date: November 10, 2017

For further information, please call: (512) 462-6223


SUBCHAPTER F. REIMBURSEMENT METHODOLOGY FOR PROGRAMS SERVING PERSONS WITH MENTAL ILLNESS OR INTELLECTUAL OR DEVELOPMENTAL DISABILITY

1 TAC §355.722, §355.723

STATUTORY AUTHORITY

The amended rules are adopted under Texas Government Code §531.033, which provides the Executive Commissioner of HHSC with broad rulemaking authority; Texas Human Resources Code §32.021 and Texas Government Code §531.021(a), which provide HHSC with the authority to administer the federal medical assistance (Medicaid) program in Texas; and Texas Government Code §531.021(b), which establishes HHSC as the agency responsible for adopting reasonable rules governing the determination of fees, charges, and rates for medical assistance (Medicaid) payments under Texas Human Resources Code Chapter 32.

The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on January 8, 2018.

TRD-201800052

Karen Ray

Chief Counsel

Texas Health and Human Services Commission

Effective date: March 1, 2018

Proposal publication date: November 10, 2017

For further information, please call: (512) 462-6223