Proposed Alternative Payment Methodology for Certain Services Related to Medicaid Renal Dialysis

Hearing. The Texas Health and Human Services Commission (HHSC) conducted  a public hearing on August 16, 2023, at 11:00 a.m. (CDT), to receive public comments on the proposed payment methodology for certain procedure codes related to renal dialysis services. The Texas Health and Human Services Commission (HHSC) intends to submit an amendment to the Texas State Plan for Medical Assistance under Title XIX of the Social Security Act to clarify coverage under an alternative payment methodology for certain services, such as durable medical equipment and drugs for renal dialysis as payable outside of the current composite rate due to new and/or expensive technology and high-cost drugs. The proposed changes are to be effective July 1, 2023. Proposal. HHSC proposes an effective date of July 1, 2023, for the alternative payment methodology for services payable outside of the current composite rate for renal dialysis. Methodology and Justification. The proposed payment rates were calculat