Texas Health and Human Services Digest: December 9, 2020

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From HHSC: While every effort has been made to offer an accurate and current listing of meeting agendas and events on this calendar, the information has been compiled from a variety of sources and is subject to change without notice to the user.

December 9, 2020

December 10, 2020

December 11, 2020

December 14, 2020

December 15, 2020

December 16, 2020

December 22, 2020

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To let the public know about a rulemaking action – such as new, amended or repealed rules – HHS publishes a notice in the Texas Register, a publication of the Texas Secretary of State.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.

TitleProject No., DescriptionContactComment End Date
Title 1, Chapter 393, Informal Dispute Resolution and Informal Reconsideration#20R093: Informal Dispute ResolutionAllison Levee12/28/20
Title 26, Chapter 746, Minimum Standards for Child-Care Centers#20R024: Physical Activity, Nutrition, and Screen Time for Licensed Day Care and Registered HomesHHS Child Care Regulation12/21/20
Title 26, Chapter 747, Minimum Standards for Child-Care Homes#20R024: Physical Activity, Nutrition, and Screen Time for Licensed Day Care and Registered HomesHHS Child Care Regulation12/21/20
Title 25, Section 133.48, Patient Safety Program repeal#20R010: Medical Error ReportingHHS Policy, Rules and Training12/21/20
Title 25, Section 135.26, Reporting Requirements, and Section 135.27, Patient Safety Program repeal#20R010: Medical Error ReportingHHS Policy, Rules and Training12/21/20
Title 26, Section 510.47, Patient Safety Program repeal#20R010: Medical Error ReportingHHS Policy, Rules and Training12/21/20
Title 26, Chapter 742, Minimum Standards for Listed Family Homes#20R021: Listed Family HomesHHS Child Care Regulation12/21/20
Title 26, Chapter 744, Minimum Standards for School Age and Before or After School Programs#20R024: Physical Activity, Nutrition, and Screen Time for Licensed Day Care and Registered HomesHHS Child Care Regulation12/21/20
Title 1, Chapter 355, Subchapter J, Division 14, Section 355.8261, Federally Qualified Health Center Services Reimbursement#21R008: Federally Qualified Health Center Services ReimbursementHHS Provider Finance Department12/14/20

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.
TitleProject No.ContactComment Start DateComment End Date
Title 26, Chapter 507, End Stage Renal Disease Facilities#19R008HHS Policy, Rules and Training12/2/2012/16/20

H.R. 7539 (cbo.gov) H.R. 7539, Strengthening Behavioral Health Parity Act. H.R. 7539 would require the Secretaries of the Departments of Labor (DOL), Health and Human Services (HHS), and Treasury to request a minimum of 20 comparative analyses per year from health insurance plans. The analyses would include potential violations of parity requirements between medical and mental health and substance abuse services and would involve potential noncompliance with nonquantitative treatment limitations (NQTLs). NQTLs are practices such as prior authorization, medical management standards, step therapy, and prescription drug formulary design. H.R. 7539 also would require the Secretaries to include a summary of the comparative analyses in a report to the Congress each year and to include examples of noncompliance found through those investigations in program guidance that is issued every two years.

Under current law, DOL, HHS and Treasury jointly enforce mental health parity requirements, including analyzing potential violations of NQTLs. Because H.R. 7539 would largely codify existing practices, CBO estimates that the bill would not affect direct spending or revenues.

Based on the cost of similar reporting requirements, CBO estimates that implementing the new activities required under H.R 7539 would cost less than $1 million over the 2021-2025 period; such spending would be subject to the availability of appropriated funds.

Don’t Forget to Register for the 2018 Quality Payment Program Performance Information Published on Medicare Care Compare Webinar. The Centers for Medicare & Medicaid Services (CMS) is hosting a one-hour webinar on the 2018 Quality Payment Program performance information recently published on the Doctors & Clinicians section of Medicare Care Compare and in the Provider Data Catalog (PDC), the successor websites to Physician Compare and the Physician Compare Downloadable Database. The webinar will include a live question and answer session and discuss the 2018 doctor and clinician performance information recently added to Care Compare profile pages and in the PDC.
Register today. The webinar will be conducted at the following time:

Registration ends on December 16, 2020, at 8:00 PM ET / 5:00 PM PT. We look forward to meeting you there.

If you have any questions about public reporting for doctors and clinicians on Care Compare, visit the Physician Compare Initiative page or contact us at PhysicianCompare-Helpdesk@AcumenLLC.com.

Important! Physician Compare has sunset as of December 1, 2020, but you’ll still be able to find the same information about doctors and clinicians and other health care providers on Care Compare on Medicare.gov. The Provider Data Catalog on CMS.gov also makes it easier for you to search and download our publicly reported data. Start using these tools today.

December 2020 Quarterly Refresh of LTCH QRP. The December 2020 quarterly refresh of LTCH QRP is now available on LTCH Compare as well as the Long-term care hospitals web pages within Care Compare (CCXP) and Provider Data Catalog (PDC).

The data for assessment-based measures are based on quality assessment data submitted by LTCHs to CMS from Quarter 1 2019 through Quarter 4 2019 (01/01/2019 –12/31/2019), with the exception of Functional Outcome Measure: Change in Mobility Among Long-Term Care Hospital Patients Requiring Ventilator Support (NQF #2632), which uses a two-year performance period and includes quality assessment data from Quarter 1 2018 through Quarter 4 2019 (01/01/2018 –12/31/2019).

This refresh also reflects data from the annual update of the claims-based measures data from Quarter 4 2017 through Quarter 3 2019 (10/01/2017 – 9/30/2019). Additionally, the Centers for Disease Control and Prevention (CDC) infections measures reflect data from Quarter 4 2018 through Quarter 3 2019 (10/01/2018-9/30/2019) and Quarter 4 2017 through Quarter 1 2018 (10/01/2017 – 3/31/2018) for the influenza measure.

Starting in December 2020, three additional LTCH QRP measures will be publicly reported on LTCH Compare, CCXP and PDC:

  • Changes in Skin Integrity Post-Acute Care: Pressure Ulcer/Injury,
  • Functional Outcome Measure: Change in Mobility Among Long-Term Care Hospital Patients Requiring Ventilator Support (NQF #2632)
  • Drug Regimen Review Conducted with Follow-Up for Identified Issues – – Post-Acute Care (PAC) Long-Term Care Hospital (LTCH) Quality Reporting Program (QRP)

CMS will no longer publicly display the measure Percent of Residents or Patients with Pressure Ulcers That Are New or Worsened (NQF #0678) as finalized in the FY 2018 LTCH PPS/IPPS Final Rule.

Please visit LTCH Compare, as well as the Long-term care hospitals web pages within the Care Compare (CCXP) and Provider Data Catalog (PDC) websites, to view the updated quality data.

Note: The December 2020 refresh of the LTCH QRP data on Nursing Home Compare/Care Compare Sites is the last scheduled refresh of this data until the December 2021 refresh. For additional information, please review the available LTCH QRP Public Reporting Tip Sheet.

Important! LTCH Compare will be going away soon, but you’ll still be able to find the same information about Long-Term Care Hospitals and other health care providers on Care Compare on Medicare.gov. The Provider Data Catalog on CMS.gov also makes it easier for you to search & download our publicly reported data. Start using these tools today.

For questions about LTCH QRP Public Reporting, please email LTCHPRQuestions@cms.hhs.gov.

December 2020 Quarterly Refresh of IRF QRP Data. The December 2020 quarterly refresh of IRF QRP data is now available on IRF Compare, as well as the Inpatient rehabilitation facilities web pages within Care Compare (CCXP) and Provider Data Catalog (PDC).

The data are based on quality assessment data submitted by IRFs to CMS from Quarter 1 2019 through Quarter 4 2019 (01/01/2019 –12/31/2019); and the annual update of the claims-based measures data from Quarter 4 2017 through Quarter 3 2019 (10/01/2017 – 9/30/2019). Additionally, the Centers for Disease Control and Prevention (CDC) infections measures reflect data from Quarter 4 2018 through Quarter 3 2019 (10/01/2018 – 9/30/2019) and Quarter 4 2017 through Quarter 1 2018 (10/01/2017 – 3/31/2018) for the influenza measure.

Starting in December 2020, six additional IRF QRP measures will be publicly reported on IRF Compare, CCXP and PDC:

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

CMS will no longer publicly display the measure Percent of Residents or Patients with Pressure Ulcers That Are New or Worsened (NQF #0678) as finalized in the FY 2018 IRF PPS Final Rule.

Please visit IRF Compare, as well as the Inpatient rehabilitation facility web pages within the Care Compare (CCXP) and Provider Data Catalog (PDC) websites, to view the updated quality data.

Note that the December 2020 refresh of the IRF QRP data on IRF Compare/Care Compare Sites is the last scheduled refresh of this data until the December 2021 refresh. For additional information, please review the available IRF QRP Public Reporting Tip Sheet.

Important! IRF Compare will be going away soon, but you’ll still be able to find the same information about Inpatient Rehabilitation Facilities and other health care providers on Care Compare on Medicare.gov. The Provider Data Catalog on CMS.gov also makes it easier for you to search & download our publicly reported data. Start using these tools today.

For questions about IRF QRP Public Reporting please email IRFPRQuestions@cms.hhs.gov.

National Influenza Vaccination Week: It’s Not Too Late to Get the Flu Shot. It’s more important than ever for everyone to do their part to help prevent the spread of illnesses like the flu. Because of the COVID-19 pandemic, fewer people are getting vaccines which puts their communities at greater risk for other preventable diseases, like the flu. When people get the flu shot, it helps protect them and keeps them from spreading the flu to others.

Racial and ethnic minority groups are disproportionately affected when it comes to receiving recommended vaccines, due to such factors as vaccination safety concerns and limited access to care and coverage. During National Influenza Vaccination Week, the Centers for Medicare & Medicaid Service Office of Minority Health (CMS OMH), is highlighting vaccination disparities and reminding patients and their families that it’s not too late to get the flu vaccine.

CMS has developed new flu vaccination resources for partners, patients, providers, states, territories, tribes, and others who can share our message and help combat vaccine disparities. Please use our resources to encourage your patients to get their flu shot so they and their communities can stay healthy.
Resources

  • Find vaccination resources for racial and ethnic minority patients, as well as resources for providers and partners that serve these populations at cms.gov/omhflu.
  • Visit cms.gov/flu for a one-stop shop to help you find CMS’s flu vaccination information and resources.
  • Looking for additional languages? Find postcards in 18 languages.
  • Review our From Coverage to Care (C2C) resources to learn more about health coverage and find preventive resources.
  • Visit the Beneficiary Care Management Program immunization webpage.

CMS Updates

State Phased-Down Billing Manual Release for Public Comment. CMS has posted for public comment a draft updated State Phased-Down Billing Manual.

The prior version of this manual had not been fully updated since the early 2000s and was not available online. The draft updates information and instructions for states on operations concerning the phased down contribution process.  Through this process, states make monthly payments to CMS, representing a portion of the Medicare Part D drug expenditures for dually eligible beneficiaries.

Please use this table to submit comments on the draft manual.  Send comments to MMCO_MMA@cms.hhs.gov. We will welcome comments through 5:00 pm ET on January 29, 2021.
The draft manual is available at: https://www.cms.gov/medicare-medicaid-coordination/medicare-medicaid-coordination-office/state-phased-down-billing.

Five Key Policy Topics from the Updated Manual on State Payment of Medicare Premiums Webinar. In November, CMS posted a webinar on Five Key Policy Topics from the Updated Manual on State Payment of Medicare Premiums.  We designed this webinar for state policy staff to introduce five key policy topics addressed in the updated Manual for State Payment of Medicare Premiums (formerly called “State Buy-in Manual”) released on September 8, 2020. The manual updates information and instructions to states on federal policy, operations, and systems concerning the payment of Medicare Parts A and B premiums (or buy-in) for individuals dually eligible for Medicare and Medicaid. The manual and other technical assistance products are part of CMS’ ongoing work to improve access to care and customer experiences.

The webinar can be viewed on YouTube at https://youtu.be/tNTBO3I0LFw.
The manual and other training material is available at: https://www.cms.gov/medicare-medicaid-coordination/medicare-medicaid-coordination-office/state-payment-medicare-premiums.

Some postmenopausal women with common breast cancer may forgo chemotherapy. Postmenopausal women with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer that has spread to a limited number of lymph nodes, and whose recurrence risk is relatively low, do not benefit from chemotherapy when it is added to hormone therapy, according to initial results from a clinical trial presented at the 2020 San Antonio Breast Cancer Symposium(link is external). These findings may save tens of thousands of postmenopausal women each year the time, money, and harmful side effects that come with chemotherapy infusions.

This is the first evidence in a randomized phase III trial that postmenopausal women with HRpositive, HER2-negative breast cancer that has spread to one to three lymph nodes can safely forgo chemotherapy if their recurrence score on a genomic tumor tissue test is 25 or less. The trial also demonstrated, after a median of five years of follow-up, that premenopausal women with the same disease characteristics benefited from chemotherapy.

The study, SWOG S1007, known as RxPONDER, was supported by the National Cancer Institute (NCI), part of the National Institutes of Health; designed and led by SWOG Cancer Research Network(link is external); and conducted by the NCI National Clinical Trials Network. RxPONDER was an international effort, conducted at 632 sites in nine countries — the United States, Canada, Mexico, Colombia, Ireland, France, Spain, Korea, and Saudi Arabia.

Read the full release.

Stay Informed about HHSC Hospital Finance News & Funding Opportunities. Learning about the latest Health and Human Services Commission (HHSC) news and program information affecting hospital finance programs just got easier. Stakeholders have a new option to receive HHSC email and text updates by subscribing to the “Hospital Finance” topic on the HHSC web site. This new topic is for stakeholders who are interested in receiving timely information about hospital finance program updates, training and webinar opportunities, and related federal and state reporting requirements and deadlines.

While HHSC already has subscription topics for each of its current supplemental and directed payment programs, this new topic, Hospital Finance, is meant to attract stakeholders involved in financing at hospitals and communities that may not participate in current HHSC supplemental and directed payment programs, like Uniform Hospital Rate Increase Program (UHRIP), Disproportionate Share Hospital Program (DSH), Uncompensated Care Program (UC), and Graduation Medical Education (GME). Creating the Hospital Finance subscription topic improves HHSC’s ability to reach the widest possible audience with relevant news and information related to hospital financing in Texas.

Rural Hospital Funding Opportunities
HHSC will also use the new Hospital Finance topic to communicate new potential funding opportunities. For example, HHSC staff are currently working to identify federal grant opportunities for rural hospitals and health care providers. This work is in response to HHSC’s Rural Hospital Services Strategic Plan. As new funding opportunities are identified for rural hospitals and communities, HHSC will inform stakeholders about them through the new “Hospital Finance” topic.

How to Sign Up 
If you are interested in receiving additional information about hospital finance topics, please sign up, here and follow the instructions below:

  1. Enter your email address
  2. After you click “Finish,” you will have a chance to choose subscription topics.
  3. Look for the subscription topic heading “Health and Human Services Commission” and then scroll down the page to find “Financial Services
  4. Select “Hospital Finance
  5. You may select as many topics as you wish.
  6. Scroll to bottom of the page and click “Submit.”
  7. Congratulations, you are signed up!

RSV Data Update. This information has recently been updated and is now available.

Gestational Diabetes, Your Baby and YouGestational diabetes is a type of diabetes that some women develop during pregnancy. When blood glucose (sugar) is higher than normal because of gestational diabetes, this can affect both you and your baby.

Have you been diagnosed with gestational diabetes?
You can take steps to manage your and your baby’s health as follows:

  • Eat healthy foods.
  • Exercise regularly.
  • Monitor blood sugar often.
  • Take insulin, if directed by your doctor.
  • Get tested for diabetes after pregnancy.

Read the Diabetes and Pregnancy publication (pdf) for more information.

Dyslexia Rules. The Texas Department of Licensing and Regulation proposes amendments to existing rules to the Dyslexia Therapy Program at 16 Texas Administrative Code, Chapter 120, §§ 120.21, 120.22, 120.23, 120.25, and 120.90. The proposed rules make changes recommended by Department staff to allow individuals certified by the Academic Language Therapy Association (ALTA) to apply for a license without providing documentation of their education; to clarify courses that qualify for continuing education credit; to allow telehealth services without an initial in-person meeting; and to correct cross-references.

The proposed rules were published in the December 4, 2020, issue of the Texas Register (45 TexReg 8687). The Department will accept comments on the proposal until January 4, 2021.

The Department encourages anyone interested in the Dyslexia Therapy Program to review the rule proposal online. Comments may be submitted electronically on the Department’s website at https://ga.tdlr.texas.gov:1443/form/gcerules