Texas Health and Human Services Digest: January 13, 2021

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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.

January 13, 2021

January 14, 2021

January 15, 2021

January 20, 2021

January 21, 2021

January 22, 2021

January 25, 2021

January 26, 2021

January 27, 2021

January 29, 2021

February 5, 2021

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To let the public know about a rulemaking action – such as new, amended or repealed rules – HHS publishes a notice in the Texas Register, a publication of the Texas Secretary of State.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 25, Chapter 411, Subchapter J, Standards of Care and Treatment in Psychiatric Hospitals#20R008: Voluntary Admission for Psychological ServicesHHS Policy, Rules and Training2/1/21
Title 26, Chapter 568, Standards of Care and Treatment in Psychiatric Hospitals#20R008: Voluntary Admission for Psychological ServicesHHS Policy, Rules and Training2/1/21
Title 25, Chapter 289, Subchapter E, Section 289.233, Radiation Control Regulations for Veterinary Radiation Machines#20R030: Veterinary Radiation MachinesDSHS Consumer Protection Division2/1/21
Title 26, Chapter 368, Intellectual and Developmental Disabilities (IDD) Habilitative Specialized Services#20R055: IDD Habilitative Specialized ServicesHHS IDD Services2/1/21
Title 1, Chapter 353, Sections 353.1305, 353.1306, and 353.1307, concerning Uniform Hospital Rate Increase Program#21R027: Uniform Hospital Rate Increase ProgramHHSC2/1/21
Title 1, Chapter 353, Subchapter O, Sections 353.1309 and 353.1311, concerning Physician Directed Payment Program#21R028: Physician Directed Payment ProgramHHSC1/25/21
Title 26, Chapter 748, Minimum Standards for General Residential Operations#20R039: Legislative and Other Updates to Chapters 745 and 748Gerry Williams1/19/21
Title 25, Chapters 133, 135, 137, 139, and 229, concerning Medical and Health Care Billing#20R045: Medical and Health Care BillingHHS Policy, Rules and Training1/19/21
Title 26, Chapters 506, 507, 509, 510, and 564, concerning Medical and Health Care Billing#20R045: Medical and Health Care BillingHHS Policy, Rules and Training1/19/21
Title 25, Chapter 217, Subchapters A and B, concerning Milk and Diary#20R051: Milk and DairyDSHS Milk and Dairy Unit1/19/21
Title 26, Chapter 280, Pediatric Teleconnectivity Resource Program for Rural Texas#20R081: Pediatric Teleconnectivity Resource Program for Rural TexasHHS Rules Coordination Office1/19/21
Title 40, Chapter 109, Subchapter C repeal, concerning Specialized Telecommunications Assistance Program#18R061: Specialized Telecommunications Assistance ProgramBryant Robinson1/19/21
Title 26, Chapter 360 Subchapter C, concerning Specialized Telecommunications Assistance Program#18R061: Specialized Telecommunications Assistance ProgramBryant Robinson1/19/21
Title 25, Chapter 411, Subchapter M repeal, concerning Standards of Care in Crisis Stabilization Units#18R040: Standards of Care in Crisis Stabilization UnitsHHS Rules Coordination Office1/19/21
Title 26, Chapter 306, Subchapter B, concerning Standards of Care in Crisis Stabilization Units#18R040: Standards of Care in Crisis Stabilization UnitsHHS Rules Coordination Office1/19/21
Title 26, Chapter 558, Licensing Standards for Home and Community Support Services Agencies#19R069: Legislative Implementation and TULIP Process UpdateJoyce Stamatis1/19/21
Title 26, Chapter 744, Minimum Standards for School-Age and Before or After-School Programs#20R026: Regulation of Child-Care FacilitiesAimee Belden1/19/21
Title 26, Chapter 746, Minimum Standards for Child-Care Centers#20R026: Regulation of Child-Care FacilitiesAimee Belden1/19/21
Title 26, Chapters 747, 748, & 749, Minimum Standards for Child-Care Homes, General Residential Operations, and Child-Placing Agencies#20R026: Regulation of Child-Care FacilitiesAimee Belden1/19/21
Title 26, Chapter 745, Licensing#20R039: Legislative and Other Updates to Chapters 745 and 748Gerry Williams1/19/21

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 1, Chapter 353, Subchapter Q, Process to Recoup Certain Overpayments#20R082Marina Hench1/14/211/27/21
Title 26, Chapter 925, Research Involving Health and Human Services Commission Services#20R104HHSC Health and Specialty Care System1/11/211/25/21
Title 26, Chapter 304, Diagnostic Assessment#20R124Lisa Habbit1/8/211/22/21
Title 25, Chapter 295, Subchapter I, Texas Environmental Lead Reduction#21R034DSHS Environmental Hazards Branch1/4/211/19/21
Title 26, Chapter 551, Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions#19R072HHS Policy, Rules and Training1/4/211/19/21

2021 Schedule
As HHSC has received a waiver to Rate Hearing Requirements, there will not be a rate hearing conducted on many of these rates.

TitleProposed Effective DatePacket
Updated
Documents
Notice Of Proposed Prospective Reimbursement For Rural Hospitals Participating In MedicaidSeptember 01, 2021Notice Of Proposed Prospective Reimbursement For Rural Hospitals Participating In Medicaid
09-01-2021-prospective-reimbursement-rural-hospitals-in-medicaid.pdfNotice Of Proposed Prospective Reimbursement For Rural Hospitals Participating In Medicaid Attachment
09-01-2021-prospective-reimbursement-rural-hospitals-in-medicaid-attch-rate-vis.pdf
Notice of Proposed Adjustments to Fees, Rates or Charges for Wound CareMarch 01, 2021Notice of Proposed Adjustments to Fees, Rates or Charges for Wound Care
03-2021-policy-woundcare.pdf
Notice of Proposed Adjustments to Fees, Rates or Charges for Telemonitoring UpdateMarch 01, 2021Notice of Proposed Adjustments to Fees, Rates or Charges for Telemonitoring Update
03-2021-policy-telemonitoring.pdf
Notice of Proposed Adjustments to Fees, Rates or Charges for Stereotactic RadiosurgeryMarch 01, 2021Notice of Proposed Adjustments to Fees, Rates or Charges for Stereotactic Radiosurgery
03-2021-policy-stereotactic-radiosurgery.pdf
Notice of Proposed Adjustments to Fees, Rates or Charges for Nutritional (Enteral) Products, Supplies, and Equipment – Home Health & CCP: Immobilized Lipase CartridgeMarch 01, 2021Notice of Proposed Adjustments to Fees, Rates or Charges for Nutritional (Enteral) Products, Supplies, and Equipment – Home Health & CCP: Immobilized Lipase Cartridge
03-2021-policy-nutrional-prod-sup-equip.pdf
Notice of Proposed Adjustments to Fees, Rates or Charges for Digital Breast TomosynthesisMarch 01, 2021Notice of Proposed Adjustments to Fees, Rates or Charges for Digital Breast Tomosynthesis
03-2021-policy-dbt.pdf
Notice of Proposed Adjustments to Fees, Rates or Charges for Colorectal Cancer Screening PolicyMarch 01, 2021Notice of Proposed Adjustments to Fees, Rates or Charges for Colorectal Cancer Screening Policy
03-2021-policy-colorectal-cancer-screen.pdf
Notice of Proposed Adjustments to Fees, Rates or Charges for Healthcare Common Procedure Coding System (HCPCS)March 01, 2021Notice of Proposed Adjustments to Fees, Rates or Charges for Healthcare Common Procedure Coding System (HCPCS)
03-2021-policy-hcpcs.pdfNotice of Proposed Adjustments to Fees, Rates or Charges for Healthcare Common Procedure Coding System (HCPCS) Attachments
03-2021-policy-hcpcs-att.zip
Biennial Calendar Fee ReviewMarch 01, 2021Biennial Calendar Fee Review
03-2021-biennialcalendarfeereview.pdfBiennial Calendar Fee Review Attachments
03-2021-biennialcalendarfeereview-att.zip
Notice of Adjustments to Fees, Rates or Charges for Quarterly Healthcare Common Procedure Coding System (HCPCS) Updates Related to Coronavirus Disease 2019 (COVID-19) High Throughput TestingJanuary 01, 2021Notice of Adjustments to Fees, Rates or Charges for Quarterly Healthcare Common Procedure Coding System (HCPCS) Updates Related to Coronavirus Disease 2019 (COVID-19) High Throughput Testing
01-01-2021-notice-adjfees-hcpcs-covid19-highthrouhput-testing.pdf
Notice of Adjustments to Fees, Rates or Charges for Quarterly Healthcare Common Procedure Coding System (HCPCS) Updates Related to Coronavirus Disease 2019 (COVID-19)January 01, 2021Notice of Adjustments to Fees, Rates or Charges for Quarterly Healthcare Common Procedure Coding System (HCPCS) Updates Related to Coronavirus Disease 2019 (COVID-19)
01-01-2021-notice-adjfeesratescharges-hcpcs-covid19.pdf

DATE CHANGE: 2022 Requests for Applications for the Value-Based Insurance Design (VBID) Model and its Hospice Benefit Component Webinar. The Value-Based Insurance Design (VBID) Model team will host a webinar on Thursday, January 28, 2021 from 4-5 PM ET. During this webinar, presenters will provide a brief review of the recently released Calendar Year (CY) 2022 Requests for Applications (RFAs) for the VBID Model and the Hospice Benefit Component. This session will also offer attendees an opportunity to ask follow-up questions. Please submit questions in advance by emailing the VBID Mailbox at VBID@cms.hhs.gov.

What: Webinar: 2022 Requests for Applications for the Value-Based Insurance Design (VBID) Model and its Hospice Benefit Component
When:
Thursday, January 28, 2021 from 4-5 PM ET
How to Join: Registration for the webinar is now open. Register now using the link here.
Event number:  177 169 9247
Event password:  2022RFA

NOTE: If you have already registered for this event, you do not have to take any additional action.

Additional Resources:
For more information, visit the VBID overview page or contact VBID@cms.hhs.gov.

CMS Releases Final Snapshot for the 2021 Federal Exchange Open Enrollment PeriodThe Centers for Medicare & Medicaid Services (CMS) released the final weekly enrollment snapshot that shows approximately 8.3 million people selected individual market plans through the Marketplaces using the federal platform during the 2021 Open Enrollment Period. This total enrollment is nearly the same as enrollments during the 2020 Open Enrollment Period, despite the fact that New Jersey and Pennsylvania transitioned to State-based Exchange platforms starting with the 2021 Open Enrollment Period. As a result of their transition, selections in New Jersey and Pennylvania are not included in this snapshot. After removing these states from the total plan selection totals in the 2020 Open Enrollment Period and comparing year-over-year trends shows plan selections this year increased by 7.0% from 2020 despite a decline in new consumers. Also, for the fourth straight year in a row, the consumer satisfaction rate at the Call Center remained high – averaging over 90% – throughout the entire Open Enrollment Period.

The data indicates enrollment remained stable and, with the investments over recent years to improve the stability and experience on the HealthCare.gov platform, more consumers were able to actively enroll or re-enroll in coverage this year without the need for waiting rooms.

To view the final enrollment snapshot, visit: https://www.cms.gov/newsroom/fact-sheets/2021-federal-health-insurance-exchange-weekly-enrollment-snapshot-final-snapshot

Read the full release.

CMS Unleashes Innovation to Ensure our Nation’s Seniors Have Access to the Latest Advancements. The Centers for Medicare & Medicaid Services (CMS) issued a final rule that propels innovative technology so Medicare beneficiaries have access to the latest, most advanced devices. This action represents a step forward that will help smooth the Medicare coverage pathway for innovative products, resulting in faster access to new devices for America’s seniors. This action delivers on CMS’s Unleashing Innovation and Patients Over Paperwork Initiative.

For additional details, please read the full press release.

Reminder: Upcoming MIPS Important Dates and Deadlines. The Centers for Medicare & Medicaid Services (CMS) would like to remind clinicians of important upcoming Merit-based Incentive Payment System (MIPS) dates and deadlines:

  • January 4, 2021 – 2020 MIPS performance year data submission window opened.
  • February 1, 2021 – 2020 MIPS Extreme and Uncontrollable Circumstances Application period closes for COVID-19 related applications only. Clinicians, groups, and virtual groups who believe they are eligible for this exception may apply, and if approved, will qualify for a re-weighting of one or more MIPS performance categories. CMS will notify applicants via email whether their requests are approved or denied. If approved, the exception will be added to the QPP Participation Status Tool.
    • New: CMS has finalized that for the 2020 performance year, Alternative Payment Model (APM) Entities may submit Extreme and Uncontrollable Circumstances applications as a result of COVID-19. For more information about the impact of COVID-19 on Quality Payment Program participation, see the Quality Payment Program COVID-19 Response webpage.
  • March 1, 2021 – Deadline for CMS to receive 2020 claims for the Quality performance category. Claims must be received by CMS within 60 days of the end of the performance period. Deadline dates vary to submit claims to the MACs. Check with the MACs for more specific instructions.
  • March 31, 2021 – 2020 MIPS performance year data submission window closes.

For More Information
To learn more, visit the QPP website and access the following resources:

Questions?
Contact the Quality Payment Program at 1-866-288-8292 or by e-mail at: QPP@cms.hhs.gov
To receive assistance more quickly, please consider calling during non-peak hours—before 10 a.m. and after 2 p.m. Eastern Time.

  • Customers who are hearing impaired can dial 711 to be connected to a TRS Communications Assistant.

HHSC Requests Comments about Proposed Measures for TIPPS. The Health and Human Services Commission (HHSC) is accepting comments on measures and performance requirements for the Texas Incentives for Physicians and Professional Services (TIPPS). To provide feedback, stakeholders may access an on-line form to submit their comments. Comments about the measures and performance requirements are due by February 2, 2021 at 5:00 p.m. CST.

The proposed new rules: §353.1309, concerning Texas Incentives for Physicians and Professional Services, and proposed new §353.1311, concerning Quality Metrics for the Texas Incentives for Physician and Professional Services Program were published in the December 25, 2020 issue of the Texas Register.

HHSC is proposing these new rules to align with its ongoing efforts to transition away from the Delivery System Reform Incentive Payment (DSRIP) program and the Network Access Improvement Program (NAIP).

Proposed New Rules Describe Enhanced Medicaid Physician Reimbursement
Currently, Texas’ Medicaid physician payments made through either the fee-for-service or managed care models, may not cover all Medicaid allowable costs for physician and professional services. Proposed new §353.1309 establishes the Texas Incentives for Physician and Professional Services (TIPPS) program and describes the circumstances under which HHSC will direct a Medicaid managed care organization (MCO) to provide enhanced reimbursement to physician practice groups in the MCO’s network in a participating service delivery area for the provision of physician and professional services. Proposed new §353.1311 describes the quality metrics and performance requirements associated with TIPPS.

Hearing for Proposed Measures and Performance Requirements
HHSC will conduct a public hearing on January 20, 2021, at 9:00 a.m. CST, to review the proposed measures and performance requirements for TIPPS. You may register for the hearing at: https://register.gotowebinar.com/register/1347491493651111952.

HHSC Requests Comments about Measures for CHIRP. The Health and Human Services Commission (HHSC) is accepting comments on measures and performance requirements for the Comprehensive Hospital Increase Reimbursement Program (CHIRP). To provide feedback, stakeholders may access an on-line form to submit their comments. Comments about the measures and performance requirements are due by February 2, 2021 at 5:00 p.m. CST.

UHRIP Becomes CHIRP
HHSC is proposing new rules: §353.1306, Comprehensive Hospital Increase Reimbursement Program (CHIRP) for program periods on or after September 1, 2021 and new §353.1307, concerning Quality Metrics and Required Reporting Used to Evaluate the Success of the Comprehensive Hospital Increase Reimbursement Program. These proposed rules were published in the January 1, 2021 issue of the Texas Register.

The proposed rules will apply to program periods on or after September 1, 2021, and the Uniform Hospital Rate Increase Program (UHRIP) will be re-named the Comprehensive Hospital Increase Reimbursement Program (CHIRP).

CHIRP will be comprised of the Uniform Hospital Rate Increase Payment (UHRIP) and the Average Commercial Incentive Award (ACIA). Proposed new §353.1306 describes the methodology HHSC will use to calculate and administer reimbursement increases and the eligibility requirements for the program. Proposed new §353.1307 describes the quality metrics and the required reporting HHSC will use to evaluate the success of the program.

Hearing for Proposed Measures and Performance Requirements
HHSC will conduct a public hearing on January 20, 2021, at 9:00 a.m. CST, to review the proposed measures and performance requirements for CHIRP. You may register for the hearing at: https://register.gotowebinar.com/register/1347491493651111952.

An MEPD and Texas Works Bulletin Has Been Released. An MEPD and Texas Works Bulletin has been released with new policy or policy clarification.

Click here to see the bulletin.

HHSC Encourages Cancer Screenings During Cervical Health Awareness Month. In observance of January as National Cervical Health Awareness Month, the Texas Health and Human Services Commission is encouraging women to get screened for cervical cancer.

The Breast and Cervical Cancer Services (BCCS) program provides low-cost and free women’s health services for uninsured and underinsured Texas women who meet eligibility requirements. Some of those services include cervical and cancer screenings, clinical breast examinations, mammograms and breast biopsies. BCCS helps fund clinics across the state to provide these life-saving screening and diagnostic services.

Between Sept. 2019 and Sept. 2020, BCCS helped more than 24,800 women including 9,466 women who received cervical cancer screenings and 1,043 women who received treatment for precancerous cervical conditions.

In 2017, which is the most recent year of available data, there were more than 12,000 new cases of cervical cancer for women in Texas. The disease is the third-most common cancer diagnosed among Texas women ages 20-39, and fifth among women ages 40-49.

To find BCCS providers or learn more about women’s health services, visit www.healthytexaswomen.org or call 2-1-1.

March 2021 Virtual Conference About Disability Prevention in Children. In honor of National Developmental Disabilities Awareness Month in March, the Office of Disability Prevention for Children will offer a FREE conference to discuss and learn strategies for implementing change and preventing developmental disabilities in children.

Each Tuesday beginning March 9, the 2021 HHS Office of Disability Prevention for Children Statewide Virtual Conference will host a series of webinars to highlight key topics on preventing intellectual and developmental disabilities in children. The four virtual sessions are described below; click on the respective link to register for that session.

We are excited to have state and national prevention professionals share information about current trends, exciting initiatives and practical information for attendees. A full ODPC Conference presenter list and schedule will be provided soon to those who register. Continuing education credit for multiple disciplines will be provided for this event.

If you need an accommodation, please email your request to the Office of Disability Prevention for Children at odpc@hhsc.state.tx.us by March 1, 2021.

SHARS and Vision Services Draft Policies Available for Comment. The Texas HHSC has opened the draft for the following policies for public comment.

The drafts are posted on the Medicaid Medical and Dental Policy webpage.
Comments will be accepted until Tuesday, Jan. 26 at 5 p.m.
Email MCD Medical Benefits Policy with questions.

HHSC Accepting Informal Comments on Diagnostic Assessment Draft Rules. Texas Health and Human Services Commission is accepting informal stakeholder input on the following draft rules. The informal comment period ends Jan. 22, 2021.

  • Title 26, Chapter 304, Diagnostic Assessment.

The purpose of this chapter is to describe the criteria to be used and the process to be followed by an authorized provider employed by or contracting with a local intellectual and developmental disability authority (LIDDA), or a state supported living center (SSLC) when conducting  a diagnostic assessment for intellectual disability (ID), autism spectrum disorder (ASD) and a related condition; and by a LIDDA or SSLC when reviewing a determination of ID or a diagnosis of ASD, or related condition for endorsement.  The chapter outlines  the qualifications and requirements for an authorized provider employed by or contracting with a LIDDA or an SSLC.

The draft rules can be found online at HHSC Comment on Proposed & Draft Rules website.

Email comments or questions to IDDServicesPolicyandRules@hhs.texas.gov .

Informal Comments on Draft Rules Due 1/25 on Research Involving Health and Human Services Commission Services. Texas Health and Human Services Commission is accepting informal comments from stakeholders on the following draft rules. The comment period ends January 25, 2021.

  • Texas Health and Human Services Commission Title 26, Part 1, Chapter 925, Research Involving Health and Human Services Commission Services. Comments can be emailed to HHSC Health and Specialty Care System.

Questions can be emailed to HHS Rules Coordination Office.

Read more.

Report on Medicaid Managed Care Provider Network Adequacy. Since the passage of S.B. 760, HHSC has made continuous efforts to enhance and improve MCO network adequacy requirements and processes for monitoring MCO compliance. HHSC adopted new travel time and distance standards for PCPs and specialty providers and updated processes for analyzing and monitoring MCO compliance with these standards. HHSC also enhanced requirements for provider directories and expedited credentialing. In 2018, HHSC adopted revised standards for LTSS and pharmacy providers; and in 2020 HHSC adopted revised network standards for outpatient chemical dependency treatment facilities, and outpatient opioid treatment programs. HHSC is currently working with stakeholders to develop additional options for monitoring network adequacy for community attendant care and anticipates adoption of new network adequacy standards in March 2021.

Additionally, HHSC is undertaking process improvement efforts to help streamline the Medicaid provider enrollment process. HHSC’s provider portal redesign initiative includes the design, development, and implementation of a new online provider portal, Provider Management and Enrollment System, which will allow HHSC to manage and maintain enrollments for all Medicaid providers through a single online application.

HHSC uses a variety of tools to monitor and assess member access to care, including review of appointment wait times, analysis of out-of-network utilization and member complaints, and member satisfaction surveys. While none of these tools alone can effectively ensure provider network adequacy, combined they help HHSC monitor member access to care and identify areas for improvement.

HHSC is continually evaluating network adequacy standards and monitoring processes for Medicaid managed care programs, as part of an ongoing effort to ensure that members have access to a choice of quality health care providers and services. HHSC is working on a range of initiatives related to network adequacy, including:

  • Streamlining the Medicaid provider enrollment process to reduce the enrollment cycle time for providers;
  • Identifying process changes to improve the accuracy of MCO provider directories, including simplifying the process for providers to update their information in the Provider Information Management System;
  • Developing and maintaining internal provider network adequacy-related dashboards to track:
    • MCO provider enrollment data and open panel status;
    • Provider terminations; o MCO compliance with network adequacy distance requirements; and

Read the report.

DSHS Respiratory Syncytial Virus Data Update. This information has recently been updated and is now available.