Texas Health and Human Services Digest: January 29, 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.

Please Note: This is a comprehensive list of upcoming meetings provided by HHSC. Not every meeting fits the parameters for coverage by Texas Insight. Refer to Texas Insight’s “Weekly Insight” newsletters for regular updates on planned coverage.

January 29, 2021

February 3, 2021

February 4, 2021

February 5, 2021

February 8, 2021

February 10, 2021

February 11, 2021

February 17, 2021

February 25, 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To let the public know about a rulemaking action – such as new, amended or repealed rules – HHS publishes a notice in the Texas Register, a publication of the Texas Secretary of State.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 26, Chapter 553, Licensing Standards for Assisted Living Facilities#19R066: Assisted Living Facilities ReorganizationHHS Rules Coordination Office3/1/21
Title 1, Chapter 353, Subchapter O, Sections 353.1320 and 353.1322, concerning Community Mental Health Center Directed Payment Program#21R038: Community Mental Health Center Directed Payment ProgramKimberly Tucker3/1/21
Title 1, Chapter 353, Subchapter O, Sections 353.1315 and 353.1317, concerning Rural Health Clinic Directed Payment Program#21R040: Rural Health Clinic Directed Payment ProgramKimberly Tucker3/1/21
Title 25, Chapter 131, concerning Freestanding Emergency Medical Care Facilities#20R009: Freestanding Emergency Medical Care FacilitiesHHS Policy, Rules and Training2/22/21
Title 26, Chapter 509, concerning Freestanding Emergency Medical Care Facilities#20R009: Freestanding Emergency Medical Care FacilitiesHHS Policy, Rules and Training2/22/21
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

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 25, Chapter 295, Subchapter I, Texas Environmental Lead Reduction#21R034DSHS Environmental Hazards Branch1/28/212/11/21

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, 2021 Notice Of Proposed Prospective Reimbursement For Rural Hospitals Participating In Medicaid
09-01-2021-prospective-reimbursement-rural-hospitals-in-medicaid.pdf

Notice Of Proposed Prospective Reimbursement For Rural Hospitals Participating In Medicaid Attachment
09-01-2021-prospective-reimbursement-rural-hospitals-in-medicaid-attch-rate-vis.pdf

Proposed Payment Rates for Home and Community-Based Services – Adult Mental Health (HCBS-AMH) Supported Home Living (SHL) and Youth Empowerment Services (YES) Waiver In-Home RespiteApril 01, 2021 Proposed Payment Rates for Home and Community-Based Services – Adult Mental Health (HCBS-AMH) Supported Home Living (SHL) and Youth Empowerment Services (YES) Waiver In-Home Respite
04-01-2021-proposed-rate-hcs-hcbs-mh-sbl-yes-waiver-ihresp.pdf
Notice of Proposed Adjustments to Fees, Rates, or Charges for Medicaid Biennial Calendar Fee Review of the following: Long Acting Reversible Contraceptives (LARCs)April 01, 2021 Notice of Proposed Adjustments to Fees, Rates, or Charges for Medicaid Biennial Calendar Fee Review of the following: Long Acting Reversible Contraceptives (LARCs)
04-01-2021-larcs-biennialcalendarfeereview.pdf
Notice of Proposed Adjustments to Fees, Rates or Charges for Wound CareMarch 01, 2021 Notice 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, 2021  Notice 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, 2021 Notice 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, 2021 Notice 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, 2021 Notice 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, 2021 Notice 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, 2021 Notice of Proposed Adjustments to Fees, Rates or Charges for Healthcare Common Procedure Coding System (HCPCS)
03-2021-policy-hcpcs.pdf

Notice 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, 2021 Biennial Calendar Fee Review
03-2021-biennialcalendarfeereview.pdf

Biennial Calendar Fee Review Attachments
03-2021-biennialcalendarfeereview-att.zip

Notice of Proposed Adjustments to Fees, Rates or Charges for Medical Transportation Program (MTP) Fee ReviewJanuary 01, 2021 Notice of Proposed Adjustments to Fees, Rates or Charges for Medical Transportation Program (MTP) Fee Review
01-2021-medical-transport.pdf
Notice of Proposed Adjustments to Fees, Rates or Charges for 2021 Annual Healthcare Common Procedure Coding System (HCPCS) UpdatesJanuary 01, 2021 Notice of Proposed Adjustments to Fees, Rates or Charges for 2021 Annual Healthcare Common Procedure Coding System (HCPCS) Updates
01-01-2021-policy-hcpcs-annual-2021.pdf

Notice of Proposed Adjustments to Fees, Rates or Charges for 2021 Annual Healthcare Common Procedure Coding System (HCPCS) Updates Attachments
01-01-2021-policy-hcpcs-annual-2021-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, 2021 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 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, 2021 Notice 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

Household Pulse Survey. Based on responses collected January 6 through January 18, the Household Pulse Survey estimates that:

  • 27.0% of American adults expect someone in their household to experience a loss in employment income in the next 4 weeks
  • 38.4% of adults live in households where at least one adult substituted some or all in-person work for telework because of the coronavirus pandemic
  • 11.3% of American adults lived in households where there was either sometimes or often not enough to eat in the previous 7 days
  • 8.9% of adults are either not current on their rent or mortgage payment, or have slight or no confidence in making their next payment on time
  • Of adults living in households not current on rent or mortgage, 34.2% report eviction or foreclosure in the next two months is somewhat or very likely
  • 35.1% of adults live in households where it has been somewhat or very difficult to pay usual household expenses during the coronavirus pandemic
  • 80.7% of adults in households with post-secondary educational plans had those plans cancelled or changed significantly this fall
  • 7.7% of adults have received a COVID-19 vaccine
  • Among adults who have yet to receive a COVID-19 vaccine, 50.9% definitely will get one when available

Submit Comments on Wave 4 Candidate Episode Groups Now through February 5, 2021. As a reminder, the Centers for Medicare & Medicaid Services (CMS) and its contractor, Acumen, LLC, are gathering input on episode groups to consider for Wave 4 of the Merit-based Incentive Payment System (MIPS) cost measure development through a Call for Public Comment. Stakeholders are invited to submit their feedback in response to the information and questions included in the document between now and February 5, 2021, at 11:59 p.m. Eastern Time.

Where can stakeholders learn more about the public comment period? A recording of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Wave 4 Cost Measure Development Presentation is available on the Quality Payment Program Webinar Library. This recording provides detailed information about the Wave 4 public comment approach.
The rest of this email contains more details about the public comment posting and participation. Please share this message with anyone who may be interested in providing input on the public comment posting.

Why use a public comment approach? CMS and Acumen are using a public comment approach to solicit input on which measures to prioritize for Wave 4 development instead of the traditional Clinical Subcommittee (CS) approach. We understand that this past year has presented new challenges, and clinicians and specialty societies have expressed concern about their limited bandwidth during this time. The public comment approach allows for broader and more flexible stakeholder participation.

Where can stakeholders access the public comment materials and provide feedback? Stakeholders may access the public comment materials on CMS’s Currently Accepting Comments Page. The following documents are available for stakeholders to download and review:

To submit feedback, stakeholders may either: (i) email a comment letter to macra-episode-based-cost-measures-info@acumenllc.com, or (ii) submit a response to the Wave 4 Measure Development Survey: https://www.surveymonkey.com/r/wave_4_development.

How will the public comment process work? CMS and Acumen are soliciting input similar to what has been gathered in the past via the CS. Stakeholders may respond to targeted questions about the clinical areas and candidate episode groups. Stakeholders may also provide input on:

  • Important considerations for measure development in Wave 4
  • Preliminary measure specifications for the Wave 4 candidate episode groups
  • Clinical areas and concepts to explore for future Waves of development

Should you have any further questions, please contact the Acumen MACRA Cost Measures Support Team via email at macra-episode-based-cost-measures-info@acumenllc.com.

Now Available: Updated 2021 CMS QRDA III Implementation Guide, Schematron, and Sample Files to Support MIPS APM Entity Reporting. The Centers for Medicare & Medicaid Services (CMS) has published an update of the 2021 Quality Reporting Document Architecture (QRDA) Category III Implementation Guide (IG)Schematron, and Sample Files for Eligible Clinicians and Eligible Professionals Programs. The updated 2021 CMS QRDA III IG includes the addition of Merit-Based Incentive Payment System (MIPS) Alternative Payment Model (APM) Entity reporting for QRDA III submissions.

The IG outlines requirements for eligible clinicians and eligible professionals to report electronic clinical quality measures, improvement activities, and promoting interoperability measures for the calendar year 2021 performance period for these programs:

  • Quality Payment Program: MIPS and APMs
  • Comprehensive Primary Care Plus
  • Primary Care First
  • Medicaid Promoting Interoperability Program

The updated 2021 CMS QRDA III IG includes these changes:

  • Added a new CMS Program Name code “MIPS_APMENTITY”, which is required for MIPS APM Entity reporting.
  • Updated Section 4.3 – MIPS QRDA III Submissions, and Section 4.4 – Identifiers with relevant language for MIPS APM Entity reporting.
  • New conformance statements for MIPS APM Entity reporting.

Changes to the 2021 CMS QRDA III Schematron:

  • The addition of Conformance rules to support MIPS APM Entity reporting.

Update to the 2021 CMS QRDA III Sample Files:

  • Addition of a new sample file showing the use of MIPS_APMENTITY.

Additional QRDA-Related Resources:
Find additional QRDA-related resources, as well as current and past IGs, on the Electronic Clinical Quality Improvement Resource Center QRDA page. For questions related to this guidance, the QRDA IGs, or Schematrons, visit the ONC Project Tracking System (Jira) QRDA project.

WIC Live Chat and Texting Available Statewide. Live chat and two-way texting are now available statewide for people receiving services in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

The live chat and texting platform also provides options to seamlessly transition the chat to voice and video calls without requiring users to download an app. This feature is crucial for virtual breastfeeding support or nutrition counseling needs during the COVID-19 pandemic.

The pilot program began Oct. 7 with the city of Dallas’s WIC program and their call center. While Texas WIC recently launched its Maya the chatbot feature, this new platform enables people to directly connect and chat or text with a client support representative.

Prior to the platform’s launch, people receiving WIC services and potential clients had to call or email for assistance. Especially during COVID-19, the live chat and texting service provides the state call center and local agency call centers with an additional option to serve Texans.

Since its launch, Texas WIC and its local partners have recorded:

  • 3,165 total chat sessions
  • 1,619 text message sessions
  • 1,546 online live chat sessions

To access the new features in English and Spanish, visit the Texas WIC Contact Us webpage. Staff are available to chat or text Monday through Friday, 8 a.m. – 5 p.m.

ALF Proposed Rules in the Texas Register are Open for Public Comment Jan 29. – Feb. 28. HHSC is accepting formal comments from stakeholders on the proposed rule, Texas Health and Human Services Title 26, Part 1, Chapter 553. The proposed rule is related to re-organization of the chapter and implementation of legislation passed by the 86th Texas Legislature for assisted living facilities. It is on page 704 of the Texas Register (PDF) in the issue posted on January 29.

The proposed rule relocates most content in Chapter 553 to new or different sections. HHSC has included two more reference documents for guidance:

  • An extra version of the proposed rule with all salient revisions to current Chapter 553 underscored.
  • A crosswalk or table of contents that lists each section in current Chapter 553 alongside its new location in proposed Chapter 553.

Email comments to HHS Policy, Rules and Training. Email questions to HHS Rules Coordination Office.
View the ALF crosswalk table with comments (PDF).
View the ALF proposed rules underscored (PDF).

Rule Comment Period Opens for New Community Mental Health Center Directed Payment Program. The Health and Human Services Commission (HHSC) is accepting comments on proposed new §353.1320, concerning Directed Payment Program for Behavioral Health Services; and new §353.1322, concerning Quality Metrics for the Directed Payment Program for Behavioral Health Services. The proposed rules were published in the January 29, 2021 issue of the Texas Register for public comment.

HHSC is encouraging community mental health centers (CMHCs) to earn certification as Certified Community Behavioral Health Clinics (CCBHCs) to implement processes and delivery of care that are consistent with the CCBHC model. Currently, Medicaid payments to CMHCs that are either CCBHC entities or in the process of getting certified, made through either the fee-for-service or managed care models, may not cover all costs of Medicaid allowable services provided by CMHCs. HHSC is proposing these rules to establish a new program developed under the Delivery System Reform Incentive Payment program (DSRIP) Transition Plan.

Proposed New Rules Describe Enhanced Medicaid Community Mental Health Center Reimbursement. The purpose of the proposed new rules is to describe the circumstances under which HHSC will direct a Medicaid managed care organization (MCO) to provide a uniform percentage rate increase and a uniform dollar increase in the form of prospective monthly payments to CMHCs in the MCO’s network in a participating service delivery area for the provision of services by CMHCs. The proposed rules also describe the methodology used by HHSC to determine the amounts of the rate and dollar increases.

HHSC Public Hearing on Proposed New Rules. HHSC is accepting public comments on the proposed rules until February 13, 2021. A public hearing is scheduled for February 5, 2021, at 11:00 a.m. (CST) to receive public comments on the proposal. Persons interested in attending may register for the public hearing here. Written comments may be submitted to TXHealthcareTransformation@hhsc.state.tx.us.

Rule Comment Period Opens for New Rural Health Clinic Directed Payment Program. The Health and Human Services Commission (HHSC) is accepting comments on proposed new §353.1315, concerning Rural Access to Primary and Preventive Services Program, and new §353.1317, concerning Quality Metrics for Rural Access to Primary and Preventive Services Program. The proposed rules were published in the January 29, 2021 issue of the Texas Register for public comment.

HHSC is proposing these new rules as part of the new programs developed to transition from the Delivery System Reform Incentive Payment (DSRIP) program. HHSC anticipates that the increased payments to rural health clinics (RHCs) will support access to services, promote better health outcomes, and increase focus on improving quality goals of the Texas Medicaid program.

Proposed New Rules Describe Enhanced Medicaid Rural Health Clinic Reimbursement. The purpose of the proposed new rules is to describe the circumstances under which HHSC will direct a Medicaid managed care organization (MCO) to provide a uniform dollar amount in the form of prospective monthly payments and rate increases for certain services tied to quality measurement to RHCs in the MCO’s network in a participating service delivery area for the provision of general medical services. The proposed rules also describe the methodology used by HHSC to determine the amounts of the payments and rate increases.

HHSC Public Hearing on Proposed New Rules. HHSC is accepting public comments on the proposed rules until February 13, 2021. A public hearing is scheduled for February 5, 2021, at 9:30 a.m. (CST) to receive public comments on the proposal. Persons interested in attending may register for the public hearing here. Written comments may be submitted to TXHealthcareTransformation@hhsc.state.tx.us.

New Submission Process for Forms and Claims for HCS, TxHmL and Local Authorities Providers Beginning Aug. 2, 2021.Home and Community-Based Services and Texas Home Living providers and Local Intellectual or Development Disability Authorities must submit forms online through the Texas Medicaid and Healthcare Partnership Long-Term Care Online Portal.

This will establish billing for claims processing and begins Aug. 2.

Visit the Texas Medicaid &Healthcare Partnership website for Medicaid and LTC training materials, navigational videos, published bulletins, training opportunities, and LTC news.

Read the notice, Coming Soon: New Processes for Submitting Forms and Claims for HCS and TxHml Providers announcing this change and the details involved.

REMINDER: Drug Utilization Review Board Applications Due Jan. 31. If you’re interested in the statewide Drug Utilization Review Program for Medicaid, you may want to apply to be a member of the Drug Utilization Review Board. But act quickly as applications are due Jan. 31!

Click here to learn more and apply.

The following new reports have been posted on the Reports and Presentations page:

January 2021

To see a list of all reports and presentations go to the Reports and Presentations page.

DSHS Flu Surveillance Activity Report Update. This information has recently been updated and is now available.

Published: Rider 24 Report for Utilization of Appropriate Levels of Care in Foster Care. As required in Rider 24, Article Il of The General Appropriations Act, 86th Texas Legislature, the Texas Department of Family and Protective Services (DFPS) shall submit quarterly reports within 60 days of the end of the fiscal quarter updated information regarding implementation of plans to ensure foster children are placed in the most appropriate service level.

Read the report.