TITLE 1. ADMINISTRATION

PART 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION

CHAPTER 351. COORDINATED PLANNING AND DELIVERY OF HEALTH AND HUMAN SERVICES

SUBCHAPTER B. ADVISORY COMMITTEES

CHAPTER 353. MEDICAID MANAGED CARE

The executive commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of Subchapter L, Texas Dual Eligibles Integrated Care Demonstration Project, consisting of §353.1101, concerning Purpose; §353.1103, concerning General Provisions; §353.1105, concerning Eligibility; §353.1107, concerning Member Enrollment and Disenrollment; §353.1109, concerning Participating Providers; §353.1111, concerning Benefits; §353.1113, concerning Appeals and Fair Hearings; and §353.1115, concerning Network Adequacy for Certain Service Providers. The executive commissioner of HHSC also proposes the repeal of §353.1303, concerning Quality Incentive Payment Program for Nursing Facilities before September 1, 2019, in Subchapter O, Delivery System and Provider Payment Initiatives.

BACKGROUND AND PURPOSE

The purpose of the proposal is to repeal rules related to the Texas Dual Eligibles Integrated Care Demonstration Project (Dual Demonstration) and the Quality Incentive Payment Program for Nursing Facilities (QIPP) before September 1, 2019.

In accordance with the Centers for Medicare & Medicaid Services Contract Year 2023 Medicare Advantage and Part D Final Rule, HHSC ended the Dual Demonstration on December 31, 2025, and implemented integrated Dual Eligible Special Needs Plans on January 1, 2026. Additionally, the QIPP rule expired September 1, 2019.

SECTION-BY-SECTION SUMMARY

The proposed repeal of §§353.1101, 353.1103, 353.1105, 353.1107, 353.1109, 353.1111, 353.1113, and 353.1115 removes obsolete rules for the Dual Demonstration.

The proposed repeal of §353.1303 removes an obsolete rule that applied to QIPP before September 1, 2019.

FISCAL NOTE

Victoria Grady, Deputy Chief, Finance, has determined that for each year of the first five years the rules are repealed, enforcing or administering the repeals does not have foreseeable implications relating to costs or revenues of state or local governments.

GOVERNMENT GROWTH IMPACT STATEMENT

HHSC has determined that during the first five years that the rules will be in effect:

(1) the proposed rules will not create or eliminate a government program;

(2) implementation of the proposed rules will not affect the number of HHSC employee positions;

(3) implementation of the proposed rules will result in no assumed change in future legislative appropriations;

(4) the proposed rules will not affect fees paid to HHSC;

(5) the proposed rules will not create a new regulation;

(6) the proposed rules will repeal existing regulations;

(7) the proposed rules will not change the number of individuals subject to the rules; and

(8) the proposed rules will not affect the state's economy.

SMALL BUSINESS, MICRO-BUSINESS, AND RURAL COMMUNITY IMPACT ANALYSIS

Victoria Grady has also determined that there will be no adverse economic effect on small businesses, micro-businesses, or rural communities. The proposed repeals do not impose any costs on small businesses, micro-businesses, or rural communities because the Dual Demonstration was discontinued and the content of the QIPP rule is expired.

LOCAL EMPLOYMENT IMPACT

The proposed repeals will not affect a local economy.

COSTS TO REGULATED PERSONS

Texas Government Code §2001.0045 does not apply to these proposed repeals because the repeals do not impose a cost on regulated persons.

PUBLIC BENEFIT AND COSTS

Emily Zalkovsky, Chief Medicaid and CHIP Services Officer, has determined that for each year of the first five years the rules are repealed, the public benefit will be easier navigation and understanding of the Texas Administrative Code with the removal of obsolete rules.

Victoria Grady has also determined that for the first five years the rules are repealed, there are no anticipated economic costs to persons who are required to comply with the proposed rules because the repeals remove obsolete rules for the Dual Demonstration, which was discontinued, and for the QIPP prior to September 1, 2019.

TAKINGS IMPACT ASSESSMENT

HHSC has determined that the proposal does not restrict or limit an owner's right to the owner's property that would otherwise exist in the absence of government action and, therefore, does not constitute a taking under Texas Government Code §2007.043.

PUBLIC COMMENT

Written comments on the proposal, including information related to the cost, benefit, or effect of the proposed repeals, as well as any applicable data, research, or analysis, may be submitted to Rules Coordination Office, P.O. Box 13247, Mail Code 4102, Austin, Texas 78711-3247, or street address 4601 West Guadalupe Street, Austin, Texas 78751; or emailed to HHSRulesCoordinationOffice@hhs.texas.gov.

To be considered, comments must be submitted no later than 31 days after the date of this issue of the Texas Register. Comments must be (1) postmarked or shipped before the last day of the comment period; (2) hand-delivered before 5:00 p.m. on the last working day of the comment period; or (3) emailed before midnight on the last day of the comment period. If the last day to submit comments falls on a holiday, comments must be postmarked, shipped, or emailed before midnight on the following business day to be accepted. When emailing comments, please indicate "Comments on Proposed Rule 26R073" in the subject line.

SUBCHAPTER L. TEXAS DUAL ELIGIBLES INTEGRATED CARE DEMONSTRATION PROJECT

STATUTORY AUTHORITY

The repeals are authorized by Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services system; and Texas Human Resources Code §32.021, which provides HHSC with the authority to administer the federal medical assistance program in Texas and to adopt rules and standards for program administration.

The repeals affect Texas Government Code §524.0151 and Texas Human Resources Code §32.021.

§353.1101. Purpose.

§353.1103. General Provisions.

§353.1105. Eligibility.

§353.1107. Member Enrollment and Disenrollment.

§353.1109. Participating Providers.

§353.1111. Benefits.

§353.1113. Appeals and Fair Hearings.

§353.1115. Network Adequacy for Certain Service Providers.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on August 27, 2026.

TRD-202603751

Karen Ray

Chief Counsel

Texas Health and Human Services Commission

Earliest possible date of adoption: October 11, 2026

For further information, please call: (512) 438-2910

SUBCHAPTER O. DELIVERY SYSTEM AND PROVIDER PAYMENT INITIATIVES

STATUTORY AUTHORITY

The repeal is authorized by Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services system; and Texas Human Resources Code §32.021, which provides HHSC with the authority to administer the federal medical assistance program in Texas and to adopt rules and standards for program administration.

The repeal affects Texas Government Code §524.0151 and Texas Human Resources Code §32.021.

§353.1303. Quality Incentive Payment Program for Nursing Facilities before September 1, 2019.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on August 27, 2026.

TRD-202603752

Karen Ray

Chief Counsel

Texas Health and Human Services Commission

Earliest possible date of adoption: October 11, 2026

For further information, please call: (512) 438-2910

CHAPTER 354. MEDICAID HEALTH SERVICES

SUBCHAPTER A. PURCHASED HEALTH SERVICES

The executive commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of Division 26, Coordinated Care, consisting of §354.1351, concerning Coordinated Care Pilot Project; and the repeal of Division 32, Texas Medicaid Wellness Program, consisting of §354.1415, concerning Vendor Requirements and Conditions for Participation; §354.1416, concerning Eligibility Criteria; and §354.1417, concerning Definitions for Wellness Services.

BACKGROUND AND PURPOSE

The purpose of the proposal is to repeal rules that established the Coordinated Care Pilot Project and the Texas Medicaid Wellness Program (TMWP).

HHSC completed the Coordinated Care Pilot Project on December 1, 1995. The TMWP, a Medicaid waiver program, ended on September 1, 2017, following implementation and expansion of managed care.

SECTION-BY-SECTION SUMMARY

The proposed repeal of §354.1351 removes an obsolete rule for the Coordinated Care Pilot Project.

The proposed repeal of §§354.1415 - 354.1417 removes obsolete rules for the TMWP.

FISCAL NOTE

Victoria Grady, Deputy Chief, Finance, has determined that for each year of the first five years the rules are repealed, enforcing or administering the repeals does not have foreseeable implications relating to costs or revenues of state or local governments.

GOVERNMENT GROWTH IMPACT STATEMENT

HHSC has determined that during the first five years that the rules will be in effect:

(1) the proposed rules will not create or eliminate a government program;

(2) implementation of the proposed rules will not affect the number of HHSC employee positions;

(3) implementation of the proposed rules will result in no assumed change in future legislative appropriations;

(4) the proposed rules will not affect fees paid to HHSC;

(5) the proposed rules will not create a new regulation;

(6) the proposed rules will repeal existing regulations;

(7) the proposed rules will not change the number of individuals subject to the rules; and

(8) the proposed rules will not affect the state's economy.

SMALL BUSINESS, MICRO-BUSINESS, AND RURAL COMMUNITY IMPACT ANALYSIS

Victoria Grady has also determined that there will be no adverse economic effect on small businesses, micro-businesses, or rural communities. The proposed repeals do not impose any costs on small businesses, micro-businesses, or rural communities because the programs have been discontinued.

LOCAL EMPLOYMENT IMPACT

The proposed repeals will not affect a local economy.

COSTS TO REGULATED PERSONS

Texas Government Code §2001.0045 does not apply to these proposed repeals because the repeals do not impose a cost on regulated persons.

PUBLIC BENEFIT AND COSTS

Emily Zalkovsky, Chief Medicaid and CHIP Services Officer, has determined that for each year of the first five years the rules are repealed, the public benefit will be easier navigation and understanding of the Texas Administrative Code with the removal of obsolete rules.

Victoria Grady has also determined that for the first five years the rules are repealed, there are no anticipated economic costs to persons who are required to comply with the proposed rules because the repeals remove obsolete rules for programs that were discontinued.

TAKINGS IMPACT ASSESSMENT

HHSC has determined that the proposal does not restrict or limit an owner's right to the owner's property that would otherwise exist in the absence of government action and, therefore, does not constitute a taking under Texas Government Code §2007.043.

PUBLIC COMMENT

Written comments on the proposal, including information related to the cost, benefit, or effect of the proposed repeals, as well as any applicable data, research, or analysis, may be submitted to Rules Coordination Office, P.O. Box 13247, Mail Code 4102, Austin, Texas 78711-3247, or street address 4601 West Guadalupe Street, Austin, Texas 78751; or emailed to HHSRulesCoordinationOffice@hhs.texas.gov.

To be considered, comments must be submitted no later than 31 days after the date of this issue of the Texas Register. Comments must be (1) postmarked or shipped before the last day of the comment period; (2) hand-delivered before 5:00 p.m. on the last working day of the comment period; or (3) emailed before midnight on the last day of the comment period. If the last day to submit comments falls on a holiday, comments must be postmarked, shipped, or emailed before midnight on the following business day to be accepted. When emailing comments, please indicate "Comments on Proposed Rule 26R073" in the subject line.