Meeting. The Texas Health and Human Services Commission (HHSC) Provider Finance Department (PFD) conducted a provider engagement meeting on December 3, 2025, to receive comments on Medicaid and Non-Medicaid reimbursement methodologies that may be addressed at the May 2026 rate hearings.
Note: HHSC has not publish proposed rates at this time. The provider engagement meeting is solely to receive commentary on the topics listed below.
Topics. The topics for the Provider Engagement Meeting are listed below. Please note that the topics listed in this notice comprise a provisional list of topics to be presented at the May 2026 rate hearing. However, HHSC will determine the final list of topics to be presented at the May 2026 rate hearing.
Long-Term Supports and Services – Calendar Fee Review:
- Nursing Facility (NF) rates, including rehabilitation and specialized services
- Nursing Aid Training and Competency Evaluation Program (NATCEP)
- Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID)
- Emergency Response Services (ERS)
- Home-Delivered Meals (HDM)
- Prescribed Pediatric Extended Care Center (PPECC)
Written comments regarding the proposed topics may be submitted in lieu of, or in addition to, oral comments until 5:00 p.m. on the Friday following the meeting, December 5, 2025. Written comments may be sent by U.S. mail, overnight mail, fax, or email.
| U.S. Mail Texas Health and Human Services Commission Attention: Provider Finance Department Mail Code H-400 P.O. Box 149030 Austin, Texas 78714-9030 Overnight Mail or Special Delivery Mail |
Fax Attention: Provider Finance at (512) 730-7475 Email Subject line as “December 2025 LTSS Provider Engagement Meeting”
Preferred Communication. Email or telephone communication is preferred |
Meeting Comments
Nursing Facility (NF) rates, including rehabilitation and specialized services (though people addressed PPEC services instead)
David Maymon, Sunshine Pediatric Day Center submitted a summary of transportation costs for PPEC. The current rate of $38 dollar is causing them to lose money. The cost is closer to $80 per trip. PPECCs provide services at less cost than other services providers. A rate study and analysis demonstrated the savings offered to the state through PPECCs. Sunshine Pediatric Day Center | Special Needs Childcare & Therapy in Dallas, TX
Jeffrey Sopin Joy Care Pediatric Center also commented on PPECC related transportation costs and inadequate rates. Without transportation, the children can’t get to the centers. In addition to staffing costs on the buses are the bus themselves and the adaptations that must be made to vans to accommodate children with special needs. Joycare Pediatric Day Health Center gives the care children need | khou.com
Nursing Aid Training and Competency Evaluation Program (NATCEP). No comments
Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID)
Sandra Battan, Provider Alliance for community services ( PACSTX) stated the practical reality is that there are limited providers for dental services. While there was a rate increase, the reimbursement is less than a dollar per day. She raised issues with clinical service mismatches—especially dental care, where Medicaid’s practical coverage is limited, leading to out-of-pocket provider costs. She requested even modest reimbursement changes for clinical services. She highlighted the minimal impact of recent rate increases and urged adoption of Bureau of Labor Statistics (BLS) wage data for more accurate direct support professional (DSP) wage assumptions, as used by at least 20 other states. PACSTX – Providers Alliance for Community Services of Texas
Emergency Response Services (ERS), No comments offered
Home-Delivered Meals (HDM).
Adam Arndwine, Mom’s Meals commented on the HDM rates. They stated that the meals are medically tailored and this improves all aspects of a recipients lives. HDM is now an in lieu of service and he requested a 27% HDM rate adjustment to keep pace with inflation and growing demand—especially as new maternal health programs increase utilization. He cited cost increases in ingredients, labor, and logistics, and emphasized the importance of updated rates to maintain service quality and competitiveness with other states. They are facing a rate challenge with the rate being at $6.46 and again requested a 27% rate adjustment, keeping Texas competitive with other states. Nutritious, Home-Delivered Meals | Mom’s Meals
Prescribed Pediatric Extended Care Center (PPECC)
Two commentors commented about this topic above under Nursing Facility Rates
Kristen Robison, Angels of Care Pediatric Home Health Angels of Care stated that there is a need for PPECCs in rural areas. Th daily rate and transportation rate should accommodate rural care. Without cost of living adjustments, they get very far behind in where the rates ser testimony emphasized the particular challenges of serving rural areas and the critical need for cost-of-living adjustments in rates and potential grants for facility construction. She advocated for annual rate reviews to prevent falling far behind industry norms.
Rob Maun, Healthcare for Kids, Healthcare for Kids | Centers for Medically Fragile Children stated his concerns are mainly in the transportation area. Their transportation rates are $37.94 per child per day while the costs exceed $100,000 making trips cost $88 per child per day. He also commented on nursing shortages. His testimony echoed transportation cost concerns and pointed out Texas’ rates lag behind other states, impacting the ability to offer necessary services and comply with regulations regarding transportation times and staffing ratios.
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