Texas Health and Human Services Digest: August 6, 2020

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Previous meetings have made alternative arrangements like phone-in capability or have been canceled. These meetings are on the calendar as of today.
August 7, 2020

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Proposed Rules
Formal Comments via the Texas Register
To let the public know about a rulemaking action – such as new, amended or repealed rules – HHS publishes a notice in the Texas Register, a publication of the Texas Secretary of State. Interested parties then can review and comment on the proposed rule. The Secretary of State publishes a new issue of the Texas Register each Friday.

The Administrative Procedure Act (Texas Government Code, Chapter 2001) requires the notice published in the Texas Register to include a brief explanation of the proposed rule and a request for comments from any interested person. The notice also includes instructions for submitting comments regarding the rule to the agency, including the date by which comments must be submitted. Agencies must give interested persons “a reasonable opportunity” to submit comments. The public comment period begins on the day after the notice of a proposed rule is published in the Texas Register and lasts for a minimum of 30 calendar days.

Below is a list of proposed rules that have been published in the Texas Register. The proposed rules that are published in the Texas Register are open for public comment until the end of the comment period.

Project No.,
Comment End Date
Title 25, Chapter 73, Laboratories, and Title 25, Chapter 218, Subchapter A, Evaluation of Milk Laboratories, and Subchapter B, Evaluation of Shellfish Laboratories#19R014: Evaluation of Milk and Shellfish LaboratoriesDSHS Milk and
Dairy Unit
Title 1, Chapter 370, Subchapter G, Standards for CHIP Managed Care#19R057: CHIP Appeals ProcessHHS Rules Coordination Office8/24/20
Title 40, Chapter 51, Medically Dependent Children Program#18R006: Repeal of MDCP Rules in Title 40HHS Rules Coordination Office8/24/20
Title 25, Chapter 265, General Sanitation#19R043: Public Swimming Pools and SpasDSHS Consumer Protection Division8/24/20
Title 1, Chapter 354, Subchapter D, Division 8 DSRIP Program Demonstration Years 9-10#19R067: Delivery System Reform Incentive Payment (DSRIP) Program DY 9-10HHS Texas Healthcare Transformation and Quality Improvement Program8/17/20
Title 26, Chapter 567 Certificate of Public Advantage#20R041: Certificate of Public Advantage (COPA)HHS Health Care Regulation’s Policy, Rules, and Training8/10/20
Title 25, Chapter 98, Subchapter C, Division 2 Advisory Committee#20R052: Texas HIV Medication Advisory CommitteeDSHS HIV-STD Program8/10/20
Title 26, Chapter 746, Subchapter B, Division 2 Required Notification#20R025: Annual Reporting of Employees Leaving Child-Care CentersHHS Child Care Regulation8/10/20

Draft Rules Informal Comments

Informal opportunities to comment occur before a rule is published in the Texas Register. HHS staff may solicit informal public and stakeholder input by:

  • inviting stakeholders to submit comments on potential rule changes during rule development.
  • sharing a draft rule with stakeholders for review.
  • using existing HHS advisory committees to comment on rules.

There are currently no draft rules available for comment.

NIH-funded researchers have developed a new system(link is external) for classifying severe maternal morbidity — life-threatening complications associated with childbirth — across U.S. hospitals. The system relies on patient discharge data to compare rates of severe maternal morbidity between different hospitals and different groups of patients. The study was led by Stephanie A. Leonard, Ph.D., of the Stanford University School of Medicine and appears in the journal Obstetrics & Gynecology. Funding was provided in part by NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and National Institute of Nursing Research.

In the United States, rates of severe maternal morbidity are rising(link is external) for all women and are worse among racial and ethnic minorities. Researchers studying severe maternal morbidity lack reliable ways to compare rates between groups with different underlying health statuses. According to the study authors, the new scoring system offers an advantage over current approaches. It also relies on U.S. patient discharge data, which is more readily available than electronic health records.

Read the full release.

National Institutes of Health Director Francis S. Collins, M.D., Ph.D., has selected Lindsey A. Criswell, M.D., M.P.H., D.Sc., as director of NIH’s National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). A rheumatologist, Dr. Criswell is currently the vice chancellor of research at the University of California, San Francisco (UCSF). She is a professor of rheumatology in UCSF’s Department of Medicine, as well as a professor of orofacial sciences in its School of Dentistry. She is expected to begin her new role as the NIAMS director in early 2021. She will succeed long-time director Stephen I. Katz, M.D., Ph.D., who passed away suddenly in December 2018.

Read the full release.

Skilled Nursing Facility (SNF) Provider Preview Reports have been updated and are now available. The data contained within the Preview Reports is based on quality data submitted by SNFs between Q1 2019 – Q4 2019 (1/01/19 – 12/31/19) (for assessment-based measures) and Q4 2017 and Q3 2019 (10/01/17 – 9/30/19) (for claims-based measures). The data reflects what will be published on Nursing Home Compare during the October 2020 refresh of the website.  Providers have until August 30, 2020 to review their performance data. Corrections to the underlying data will not be permitted during this time; however, providers can request CMS review of their data during the preview period if they believe the quality measure scores that are displayed within their Preview Reports are inaccurate.

Beginning with the October 2020 refresh, CMS will publicly display six new measures on the Nursing Home Compare website:

  • Changes in Skin Integrity Post-Acute Care: Pressure Ulcer/Injury,
  • Drug Regimen Review Conducted with Follow-Up for Identified Issues – PAC SNF QRP,
  • Application of IRF Functional Outcome Measure: Change in Self-Care (NQF #2633),
  • Application of IRF Functional Outcome Measure: Change in Mobility (NQF #2634),
  • Application of IRF Functional Outcome Measure: Discharge Self-Care Score (NQF #2635), and
  • Application of IRF Functional Outcome Measure: Discharge Mobility Score (NQF #2636)

SNF performance data for these measures will be included for the first time on this preview report.

The following existing measures will continue to be reported as part of the October 2020 refresh

  • Application of Percent of Residents Experiencing One or More Falls with Major Injury (Long Stay),
  • Application of Percent of Long-Term Care Hospital (LTCH) Patients With an Admission and Discharge Functional Assessment and a Care Plan That Addresses Function,
  • Medicare Spending Per Beneficiary – PAC SNF QRP,
  • Discharge to Community – PAC SNF QRP, and
  • Potentially Preventable 30-Day Post-Discharge Readmission Measure – SNF QRP

We are implementing the annual refresh of the SNF QRP claims-based measures during the October 2020 refresh of NH Compare. The annual refresh will include updates to the Medicare Spending per Beneficiary (MSPB), Discharge to Community (DTC) measure, and the Potentially Preventable Readmissions (PPR) measure.

For more information please visit:
SNF Quality Reporting Public Reporting webpage, and/or Nursing Home Compare

The Centers for Medicare & Medicaid Services (CMS) provides a web-based training course for hospices wanting a resource to the many trainings offered related to the Hospice Quality Reporting Program (HQRP). The goal is to assist hospice staff to better determine and access those trainings and documents that meet their learning needs. This course is designed to provide a general overview of the HQRP and direct learners to a variety of hotlinks and resources from the HQRP website and especially the Education and Training Library webpage to access specific information by topic. Please navigate to the HQRP Training and Education Library webpage to access the Web-Based Course on Hospice QRP Education and Training Resources by Topic with Hotlinks for Easy Access.

The Centers for Medicare & Medicaid Services (CMS) has posted two new informational presentations focused on the Physician Compare Preview Period that began on June 22 and will close on August 20. The period gives clinicians and groups an opportunity to preview their 2018 Quality Payment Program performance information before it is publicly reported. The performance information is targeted for public reporting on Physician Compare and/or successor website during the fall of 2020. A subset of the 2018 performance information will be displayed on profile pages on the website, and all of the 2018 performance information that meets public reporting standards will be available in the Downloadable Database after the Preview Period. Clinicians and groups can access their 2018 performance information through the secured Preview tool on the Quality Payment Program website.

The pre-recorded presentations are now available on the Physician Compare Initiative page and on CMS’s YouTube channel (Part I and Part II). The first presentation provides background information about Physician Compare and what will be publicly reported, while the second presentation offers clinicians and groups detailed guidance on when and how to preview their data. Both presentations are available on demand so doctors and clinicians can access them at their convenience.

In addition to the pre-recorded presentations, CMS previously posted other informational materials on the Physician Compare Initiative page. The in-depth materials include details about the 2018 performance information for participating clinicians, groups and ACOs collected under the Merit-based Incentive Payment System (MIPS). If you have any questions about public reporting on Physician Compare, visit the Physician Compare Initiative page or contact us at PhysicianCompare-Helpdesk@AcumenLLC.com.

Electronic Prescribing of Controlled Substances in Medicare Part D: Request for Information.CMS released a Request for Information (RFI) for Electronic Prescribing of Controlled Substances in Medicare Part D. The RFI seeks input from stakeholders around implementation of Section 2003 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act), which generally requires that prescriptions for controlled substances covered under a Medicare Part D prescription drug plan be transmitted by a health care practitioner electronically.

Comments are due by October 5.

Release of the IRF Web Pricer. Providers and other payers use PC Pricer applications to estimate Medicare payments. Over the next year, CMS will stop producing new versions of the downloadable PC Pricers and issue them as web-based applications.

The first web application to be released is the Inpatient Rehabilitation Facility (IRF) Web Pricer. For the best user experience, access this Web Pricer through Google Chrome. You may also access it through Microsoft Edge or Mozilla Firefox. Microsoft Internet Explorer is not supported.

Subsequent Nursing Facility E/M Services: Comparative Billing Report. CMS issued a Comparative Billing Report (CBR) on Subsequent Nursing Facility Evaluation and Management (E/M) Services, focusing on providers who submit Medicare Part B claims. These reports contain data-driven tables with an explanation of findings that compare your billing and payment patterns to those of your peers in your state and across the nation.

CBRs are not publicly available. Look for an email from cbrpepper.noreply@religroupinc.com to access your report. Update your email address in the Provider Enrollment, Chain, and Ownership System to ensure accurate delivery.
For More Information:

Nursing Home Compare Refresh. The July 2020 Nursing Home Compare refresh is available, including quality measure results based on Skilled Nursing Facility (SNF) Quality Reporting Program data. Visit the Nursing Home Compare website to view the data.

For More Information:

Medicare Ground Ambulance Data Collection System: Updated Documents. On July 31, CMS posted updated versions of the following Medicare Ground Ambulance Data Collection System resources:

For more information, see the Ambulances Services Center website.

MACs Resume Medical Review on a Post-Payment Basis. To protect the Medicare Trust Fund against inappropriate payments, Medicare Administrative Contractors (MACs) are resuming fee-for-service medical review activities. Beginning August 17, the MACs are resuming with post-payment reviews of items/services provided before March 1, 2020. The Targeted Probe and Educate program (intensive education to assess provider compliance through up to three rounds of review) will restart later. The MACs will continue to offer detailed review decisions and education as appropriate.

Renewed ABN: Deadline Extended to January 1. Due to COVID-19, CMS extended the deadline for using the renewed Advance Beneficiary Notice of Noncoverage (ABN) until January 1, 2021. You may use the renewed form prior to the mandatory deadline.

Protect Your Patients Against Vaccine-Preventable Diseases. National Immunization Awareness Month (NIAM) is an annual observance, highlighting the importance of vaccinations. Protect your Medicare patients:

  • You have the power to protect your patients against serious diseases like pneumococcal disease and seasonal flu
  • Your recommendation can make a difference. You are the most valued and trusted source of health information for adults.
  • Even if your practice does not administer or stock certain vaccines, make a strong recommendation and refer patients to other vaccine providers. Follow up to ensure vaccination.

Medicare Part B covers the following vaccines:

More Information:

Visit the Preventive Services website to learn more about Medicare-covered services.