Texas Health and Human Services Digest: January 6, 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 6, 2021

January 8, 2021

January 11, 2021

January 12, 2021

January 13, 2021

January 15, 2021

January 21, 2021

January 22, 2021

January 26, 2021

January 27, 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To let the public know about a rulemaking action – such as new, amended or repealed rules – HHS publishes a notice in the Texas Register, a publication of the Texas Secretary of State.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 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 UpdatedDocuments
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

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 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

DEADLINE EXTENDED – CMS is extending the Request for Application (RFA) open period to January 7, 2021 for the Value in Opioid Use Disorder Treatment (ViT) Initiative. The Centers for Medicare & Medicaid Services (CMS), Center for Medicare and Medicaid Innovation (Innovation Center) is announcing the Request for Application (RFA) for a new initiative that aims to increase access to opioid use disorder (OUD) treatment services to eligible Medicare Fee-For-Service (FFS) beneficiaries, including those dually eligible for Medicare and Medicaid. This is one of a number of new initiatives required under The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (the SUPPORT Act). The statute makes available $10,000,000 each of fiscal years 2021-2024 for demonstration payments.

Value in Opioid Use Disorder Treatment (Value in Treatment) is a four-year demonstration that creates two new payments to participating providers: 1) a per beneficiary per month care management fee (CMF) and 2) a performance-based incentive payment. These new payments will be made in addition to the OUD treatment services Medicare currently covers.

Value in Treatment participants may use these payments to furnish certain patient-centered OUD treatment services and have a reasonable expectation of improving or maintaining the health or overall function of participating beneficiaries.

The demonstration is open to a wide range of eligible participants, including:

  • Individual physicians
  • Group practices comprised of at least one physician or Nurse Practitioner
  • Hospital outpatient departments
  • Federally qualified health centers
  • Rural health clinics
  • Community mental health centers
  • Certified community behavioral health clinics (CCBHCs)
  • Opioid treatment programs (OTPs)
  • Critical Access Hospitals (CAHs)

CMS encourages eligible participants to apply to the demonstration by January 7, 2021 at 11:59 EST. Selected participants are expected to implement the demonstration by April 1st, 2021, at which point demonstration payments will also start.

For more information, and to access the Request for Application (RFA), please visit: https://innovation.cms.gov/innovation-models/value-in-treatment-demonstration

CMS adds to ACO, ESCO resources with a care transformation toolkit, case studies, and a tip sheet. CMS is announcing the release of new resources highlighting strategies that Medicare Accountable Care Organizations (ACOs) and End-Stage Renal Disease Seamless Care Organizations (ESCOs) use to improve quality of care, lower health care costs, and enhance the beneficiary experience. These resources, posted on the ACO General Information web page, include:

  • care transformation toolkit that describes ACO approaches to developing and implementing programs that transform the delivery of care and relate to telehealth, home visits, and timely access to skilled nursing facilities.
  • Four case studies that feature specific ACO and ESCO initiatives to:
  • tip sheet that highlights strategies for enhancing education on home dialysis and for expanding the use of home dialysis.

The care transformation toolkit, case studies, and tip sheet join a collection of resources for organizations participating in value-based care models, including toolkits on provider engagementbeneficiary engagement and care coordination, and over a dozen case studies that describe ACO and ESCO strategies to improve care delivery. For more information please visit the ACO General Information web page.

2021 MIPS Resources Now Available
Now Available: 2021 MIPS Resources
The Centers for Medicare & Medicaid Services (CMS) has posted 2021 MIPS resources, including the 2021 MIPS Measure Specifications, to the QPP Resource Library.

2021 MIPS Measure Specifications
The following documents, which provide comprehensive descriptions and details on 2021 measures, are now available:

Please note that the 2021 MIPS Historical Quality Benchmark file will be updated after this posting, at minimum to provide scoring examples and to identify topped out measures as well as any measures that will be capped at 7 achievement points for the 2021 performance period. The 2021 Quality Measure Benchmarks zip file will also be updated to include a Quality Benchmark Fact Sheet, and the 2021 MIPS Multi-Performance Rate Measures file.

Additional materials will be posted to the QPP Resource Library soon to assist with 2021 participation.

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

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

The MIPS 2020 Data Submission Period is Now Open – MIPS Eligible Clinicians Can Start Submitting Data for 2020 through March 31CMS has opened the data submission period for Merit-based Incentive Payment System (MIPS) eligible clinicians who participated in the 2020 performance year of the Quality Payment Program (QPP). Data can be submitted and updated from 10:00 a.m. EST on January 4, 2021 until 8:00 p.m. EDT on March 31, 2021.

How to Submit Your 2020 MIPS Data
Clinicians will follow the steps outlined below to submit their data:

  1. Go to the Quality Payment Program webpage.
  2. Sign in using your QPP access credentials (see below for directions).
  3. Submit your MIPS data for the 2020 performance year or review the data reported on your behalf by a third party.

How to Sign In to the Quality Payment Program Data Submission System
To sign in and submit data, clinicians will need to register in the HCQIS Authorization Roles and Profile (HARP) system. For clinicians who need help enrolling with HARP, please refer to the QPP Access User Guide.

Note: Clinicians who are not sure if they are eligible to participate in the Quality Payment Program can check their final eligibility status using the QPP Participation Status Tool. Clinicians and groups that are opt-in eligible will need to make an election before they can submit data. (No election is required for those who don’t want to participate in MIPS.)

Small, Underserved, and Rural Practice Support
Clinicians in small practices (including those in rural locations), health professional shortage areas, and medically underserved areas may request technical assistance from organizations that can provide no-cost support. To learn more about this support, or to connect with your local technical assistance organization, we encourage you to visit our Small, Underserved, and Rural Practices page on the Quality Payment Program website.

Extreme and Uncontrollable Circumstances Application
As a reminder, to further support clinicians during the COVID-19 public health emergency (PHE), CMS extended the 2020 MIPS Extreme and Uncontrollable Circumstances Exception application deadline to February 1, 2021. For the 2020 performance year, MIPS eligible clinicians, groups, and virtual groups are allowed to submit an application requesting reweighting of one or more MIPS performance categories to 0% due to the current COVID-19 PHE. Please note that any data submitted before or after an application has been approved will be scored.

For More Information

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, consider calling during non-peak hours—before 10 a.m. and after 2 p.m. ET. We also encourage you to contact us earlier in the year, as response times often increase with heavier demand as the March 31 data submission deadline approaches.

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

MIPS 2021 Payment Adjustments in Effect Based on 2019 Performance. In August 2020, each Merit-based Incentive Payment System (MIPS) eligible clinician received a 2019 MIPS Final Score and associated payment adjustment factor(s) as part of their 2019 MIPS performance feedback, available on the Quality Payment Program website.

2021 MIPS payment adjustments, based on each MIPS eligible clinician’s 2019 MIPS Final Score, will now be applied to payments made for Part B covered professional services payable under the Physician Fee Schedule. Payment adjustments are determined by the final score associated with your Taxpayer Identification Number (TIN)/National Provider Identifier (NPI) combination.

MIPS eligible clinicians, identified by TIN/NPI combination for the 2019 performance period, will receive a positive, neutral, or negative MIPS payment adjustment in 2021 if they:

  • Were a clinician type that was included in MIPS;
  • Enrolled in Medicare prior to January 1, 2019;
  • Were not a Qualifying Alternative Payment Model (APM) Participant (QP);
  • Were a Partial Qualifying APM Participant (Partial QP) that elected to participate in MIPS as a MIPS eligible clinician; and
  • Met one of the following criteria:
    • Individually exceeded the low-volume threshold;
    • Were in a practice that exceeded the low-volume threshold at the group level and submitted group data or were part of an approved virtual group; or
    • Were in a MIPS APM and the APM Entity group exceeded the low volume threshold (This also includes Partial QPs who elected to participate in MIPS).

For More Information

  • Review the 2021 MIPS Payment Adjustment Fact Sheet for more details and answers to frequently asked questions.
  • Visit the Quality Payment Program Resource Library for more Quality Payment Program resources.
  • For questions, contact the Quality Payment Program at 1-866-288-8292, Monday through Friday, 8:00 AM-8:00 PM ET or by e-mail at: QPP@cms.hhs.gov. To receive assistance more quickly, consider calling during non-peak hours—before 10:00 AM and after 2:00 PM ET. We also encourage you to contact us earlier in the year, as response times often increase with heavier demand as the March 31 data submission deadline approaches.
    • Customers who are hearing impaired can dial 711 to be connected to a TRS Communications Assistant.

QPP Service Center Hold Times Expected to Increase. The Quality Payment Program (QPP) Service Center is projecting an increase in volume of calls and emails between January and March 2021 due to the opening of 2020 MIPS data submission period. The increase in call volume and emails will result in longer wait times.

In order to reduce wait times and ensure successful 2020 submission, CMS recommends taking the following actions:

  • Use One Method to Report Issues—Due to the increase in volume at the QPP Service Center and to minimize backlog, we request that you use only one method of reporting for the same issue (email or phone). Note: Cases are processed in the order in which they are received regardless of the manner in which the Service Center was contacted. Please allow time for processing.
  • Submit Your Data Early—It is encouraged that you submit your 2020 MIPS performance year data early during the submission period as this allows you plenty of time for any necessary Service Center assistance.
  • Call the Service Center at Off-Peak Hours—We strongly recommend calling the Service Center during off-peak hours (8:00 AM-10:00 a.m. ET OR 2:00 p.m.-8:00 p.m. ET).

For More Information

  • Visit the QPP Resource Library to review new and existing QPP resources.
  • Contact the Quality Payment Program at 1-866-288-8292 or by e-mail at: QPP@cms.hhs.gov.
    • Customers who are hearing impaired can dial 711 to be connected to a TRS Communications Assistant.

Electronic Visit Verification Notification Requirement for HCS and TxHmL Program Providers (IL 2021-01). HHSC has published IL 2021-01 Electronic Visit Verification Notification Requirement (PDF).

The letter informs HCS and TxHmL program providers they are now required to use the EVV system for CFC PAS/HAB, in-home respite and day habilitation provided in the home of an individual who has a residential location of “own/family home.”

Texas Government Code, §531.024172(c), requires that HHSC inform an individual who receives a service requiring the use of EVV that the individual is required to comply with the EVV system. HHSC has developed a form for providers to comply with this statute.

The Electronic Visit Verification Responsibilities and Additional Information form is included with the IL 2021-01 (PDF).

REMINDER: Perinatal Advisory Council Applications Due January 15. If you’re interested in the hospital designation program for levels of care for neonatal and maternal services, you may want to apply to be a member of the Perinatal Advisory Council. But act quickly as applications are due Jan. 15!

Click here to learn more and apply.

HHSC Stakeholder Engagement Meetings (January 2021). The Texas Health and Human Services Commission (HHSC) will conduct stakeholder engagement meetings on January 21, 2021, beginning at 9:00 a.m. CST, to receive comments on Medicaid payment rates that may be addressed at the May 2021 rate hearings. More information can be found here.

DEADLINE EXTENDED: Texas Respite Advisory Committee Applications Due January 22. If you’re interested in issues surrounding respite and informal caregiving, you may want to apply to be a member of the Texas Respite Advisory Committee. But act quickly as applications are due January 22!

Click here to learn more and apply.

ALFs – We Need Your Input for Life Safety Code TM Topics. HHSC Long-term Care Regulatory issues guidance on LSC topics at least twice a year. We need assisted living facility providers input on topics to address.

Please provide your recommend topics for future life safety code technical memoranda by close of business on Jan. 15, 2021, to Kevin Knippa.

The Epilepsy Program Policy Manual has been revised. In Section 4100, Eligibility and Assessment of Co-pay/Fees, adds a child must be under 18 years of age to be counted as part of a larger family. Eligibility will end on the last day of the month the child becomes 18 years of age unless the child is a full-time high school student as defined by the school, attends an accredited GED class, or regularly attends vocational or technical training in place of high school and expected to graduate from one of the above before or during the month of his/her 19th birthday.

Click here to see the changes.

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

Effective January 1, 2021: Fee Schedule Changes for Austin and South Texas Laboratories. Effective January 1, 2021, the DSHS Austin and South Texas Laboratory Fee Schedules have been updated to reflect test additions, deletions, and fee changes. To view the revised fee schedules, visit the DSHS Laboratory’s website.

DSHS Laboratory – Microbiological Sciences Branch Notice. The following microbiological testing areas that were affected by the DSHS Laboratory COVID-19 response efforts have now resumed regular operations:

  • Fungal isolate identification
  • Parasitology identification
  • Influenza surveillance testing
  • Mosquito surveillance testing
  • Gonorrhea/Chlamydia/Hepatitis C specimen testing

Foodborne outbreak investigations (Listeria, SalmonellaEscherichia coli., etc.)

We do not expect any further delays in testing or laboratory results reporting due to the ongoing DSHS COVID-19 response efforts. A notification will be issued if any new delays are expected.

Please contact the DSHS Microbiology laboratory with any questions at
Lab.Microbiology@dshs.texas.gov.