Texas Health and Human Services Digest: July 23, 2020

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Previous meetings have made alternative arrangements like phone-in capability or have been canceled. These meetings are on the calendar as of today.
July 24, 2020

July 27, 2020

July 28, 2020

July 29, 2020

July 30, 2020

July 31, 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To let the public know about a rulemaking action – such as new, amended or repealed rules – HHS publishes a notice in the Texas Register, a publication of the Texas Secretary of State.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.,
ContactComment End Date
Title 1, Chapter 354, Subchapter D, Division 8 DSRIP Program Demonstration Years 9-10#19R067: Delivery System Reform Incentive Payment (DSRIP) Program DY 9-10HHS Texas Healthcare Transformation and Quality Improvement Program8/17/20
Title 26, Chapter 567 Certificate of Public Advantage#20R041: Certificate of Public Advantage (COPA)HHS Health Care Regulation’s Policy, Rules, and Training8/10/20
Title 25, Chapter 98, Subchapter C, Division 2 Advisory Committee#20R052: Texas HIV Medication Advisory CommitteeDSHS HIV-STD Program8/10/20
Title 26, Chapter 746, Subchapter B, Division 2 Required Notification#20R025: Annual Reporting of Employees Leaving Child-Care CentersHHS Child Care Regulation8/10/20


Draft Rules Informal Comments

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

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

The following are draft rules on which HHS is accepting informal public or stakeholder input. All rules are posted in MS Word format unless otherwise noted.

TitleProject No.ContactComment Start DateComment End Date
Title 26, Chapter 745 Licensing, Subchapters A, C, D, and L, and Chapter 748 Minimum Standards for General Residential Operations#20R039HHS Child Care Regulation7/15/207/29/20
Title 25, Chapter 217, Subchapter A, Grade Specifications and Requirements for Milk, and Subchapter B, Grade A Raw Milk and Raw Milk Products#20R051DSHS Milk and Dairy Unit7/14/207/28/20
Repeal of Title 25, Chapter 289, Subchapter E, §289.233 Radiation Control Regulations for Radiation Machines Used in Veterinary Medicine and new §289.233#20R030DSHS Consumer Protection Division7/13/207/27/20
Figures for new Title 25, Chapter 289, Subchapter E, §289.233 Radiation Control Regulations for Radiation Machines Used in Veterinary Medicine#20R030DSHS Consumer Protection Division7/13/207/27/20


For decades, Senior Corps RSVP has engaged older Americans in volunteer service that meets national and community needs and delivers lasting, meaningful results. CNCS intends to fund successful applicants that increase the impact of volunteers age 55 and older who provide volunteer service in response to local community needs.

Application Deadline: Tuesday, Sept. 1, 2020, 5:00 PM ET

View complete competition information

The following entities, including those that are current CNCS grantees, are eligible to apply: public or private nonprofit organizations (including faith-based and other community organizations), institutions of higher education, government entities within states or territories (e.g. cities, counties), government-recognized veteran service organizations, labor organizations, partnerships and consortia, and Indian Tribes.

Funding Priorities
Senior Corps RSVP volunteers help organizations expand services, build capacity, develop partnerships, leverage resources, create sustainable projects, and recruit and manage other volunteers. Grant funding partially covers expenses to operate a Senior Corps RSVP project such as staffing, supplies, volunteer stations, and training of staff and members.

Senior Corps funding priorities include:

  • Evidence-Based Program Implementation
  • Access to Care – Opioid Abuse
  • Aging in Place – Elder Justice
  • Aging in Place – Independent Living
  • Economic Opportunity – Workforce Development
  • Education – Intergenerational Programming
  • Disaster Services
  • Veterans and Military Families

Technical Assistance
CNCS will host a series of technical assistance calls to answer questions about this funding opportunity, performance measures, and eGrants. Call dates and times can be found on the competition website. If you have questions at any time during the application period, please send an email to 2021RSVP@cns.gov.

The inflammatory molecule interleukin-17A (IL-17A) triggers immune cells that in turn reduce IL-17A’s pro-inflammatory activity, according to a study by National Eye Institute (NEI) researchers. In models of autoimmune diseases of the eye and brain, blocking IL-17A increased the presence of other inflammatory molecules produced by Th17 cells, immune cells that produce IL-17A and are involved in neuroinflammation. The finding could explain why IL-17-targeted treatments for conditions like the eye disease autoimmune uveitis and multiple sclerosis (MS) have failed. A report on the findings was published in Immunity. NEI is part of the National Institutes of Health…

Read the full release.

The Center for Medicare and Medicaid Innovation (Innovation Center) announced today that a new Frequently Asked Question, found below, has been released addressing stakeholder concerns about 2021 participation in the Next Generation ACO Model (NGACO), the Medicare Shared Savings Program, and Direct Contracting (Professional and Global Options).

Q. Our organization is currently an ACO in the Next Generation ACO Model (NGACO) or the Medicare Shared Savings Program for 2020. What is the deadline for deciding between NGACO, Shared Savings Program and the Direct Contracting Model for 2021 participation? Since PY1 for the Direct Contracting Model doesn’t start until April 1, 2021, can I participate in NGACO or the Shared Savings Program from January-March of 2021 before switching to the Direct Contracting Model for the rest of the year?

  • A. For ACOs participating in NGACO during 2020 that are deciding between NGACO and Direct Contracting for 2021 participation, the deadline to decide is 10/23/20 (when final DC participant provider lists are due for 2021). For ACOs participating in the Shared Savings Program during 2020 that are deciding between the Shared Savings Program and Direct Contracting for 2021 participation the deadline is 9/22/20 (when final ACO participant lists are due for ACOs participating in the Shared Savings Program in 2021). While we try to offer entities as much flexibility as possible to make participation decisions, there are operational limitations that require this decision deadline to be linked to the deadline for submission of final participant lists. Claims-based alignment, which functions similarly across these initiatives, aligns beneficiaries to the entity whose participating providers and suppliers have provided the plurality of the beneficiary’s primary care within a lookback period. By definition this is a competitive process since the amount of primary care provided to a given beneficiary is compared across health care providers both in and outside of each initiative. As a result, alignment within one initiative can affect alignment within other initiatives. Accordingly, alignment (specifically provider overlaps) for entities participating in Performance Year 1 of the Direct Contracting Model needs to be run prior to when NGACO and the Shared Savings Program begin their 2021 performance years (January), despite Performance Year 1 of the Direct Contracting Model not starting until April 1, 2021.

Given the above, entities are not able to participate in NGACO or Shared Savings Program in the first quarter of 2021 before switching to Direct Contracting. Entities that choose to participate in Direct Contracting in 2021 will therefore not be participating in the performance period of any initiative from January-March of 2021. However, we note that eligible clinicians in such entities may be able to become Qualifying APM Participants (QPs) under the Quality Payment Program based on performance measured on the June 30, 2021 and/or August 31, 2021 snapshot dates.

Stakeholders are encouraged to monitor the Direct Contracting webpage (https://innovation.cms.gov/innovation-models/direct-contracting-model-options) for future updates. Please email the Direct Contracting Model help desk with any questions or comments at  DPC@cms.hhs.gov.

This message is intended for users of both the PECOS Administrative Interface (AI) and Provider Interface (PI). The Production Release was deployed to the Production environment on Thursday, July 16th.

PECOS AI Enhancements for the Release:

  • Resolved a display issue for users when they select different pages of IDTF Supervising physicians and the associate flag is not properly displayed for the respective supervising physicians.
  • Incorporation date and state where incorporated will be displayed for 855A and MDPP forms in the ADR report.
  • All deleted A/R Codes will show the effective and end Date (if available) in Audit Log on the MCS Screen.
  • Updated pec_asct_updt_ts during finalizing for a locked associate so the records will be appear as expected in Data Mart and on extracts.
  • Resolved an error for users that was received when accessing Attachment 2 Section Supervising Physician after adding IDTF Supervising Physicians for APS Automated early screenings through the validation checklist or the L&T tab.

PECOS PI Enhancements for the Release:

  • Additional verbiage has been added to the Medicare Application Fee (MAF) payment pages in PECOS to alert Providers that MAF payments are waived due to COVID-19.

July 2020 NDC-to-HCPCS Crosswalk Now Available The quarterly NDC-to-HCPCS Crosswalk is now available for clinician-administered drug processing.

Change to Macrolide Preferred Drug List Prior Authorization Duration Set for Sept. 15. On Sept 15, 2020, HHSC will extend the non-preferred prior authorization duration for macrolides from 30 days to 90 days for people with diagnosis of Gastroparesis, Cerebral Palsy Gastroparesis, or GERD Gastrostomy complications. This will accommodate longer-term prescribing for such conditions.

MCOs are required to comply with this PDL prior authorization criteria, including duration. To learn more, refer to the Vendor Drug Program website.

Quantity Prescribed” Required for Schedule II Drugs Beginning Sept. 21. Beginning Sept. 21, 2020, HHSC will require the “Quantity Prescribed” field (460–ET) on all pharmacy claims for Schedule II drugs.

Pharmacies should refer to the payer sheet addendum for more information on how this change impacts claim processing.

We will revise the full B1 payer sheet upon implementation. To learn more, visit the Vendor Drug Program website.

With the first Texas case of West Nile virus disease this year, the Texas Department of State Health Services reminds people to take precautions to prevent mosquito bites and stop transmission of the potentially deadly disease. The first reported case was in an adult resident of Tarrant County who later died.

DSHS urges people not to give mosquitoes a biting chance by taking a few simple steps.

  • WEAR long sleeves and pants. Create a barrier to mosquito bites by covering up.
  • APPLY insect repellent. Use EPA-registered repellent such as those containing DEET, picaridin, IR3535 or oil of lemon eucalyptus/p-menthane-diol.
  • REMOVE standing water. Emptying out water that accumulates in toys, tires, trash cans, buckets, clogged rain gutters and plant pots will deny mosquitoes a place to lay their eggs and reproduce.

West Nile virus is transmitted through the bite of infected mosquitoes. Most people exposed to the virus don’t get sick, but about 20 percent develop symptoms like headache, fever, muscle and joint aches, nausea and fatigue. In a very small proportion, less than one percent, the virus affects the nervous system, leading to a more serious illness that can cause neck stiffness, disorientation, tremors, convulsions, paralysis and even death.

In the last 10 years, Texas has reported more than 3,300 cases of West Nile disease, including 172 deaths.

The Texas Department of State Health Services (CHW) is sharing a survey link for community health workers (CHWs) at the request of University of Texas at Arlington. DSHS will not collect or analyze any of the responses or data related to the study.

The University of Texas at Arlington is conducting a study entitled “Measuring perceived organizational performance of Community Health Worker organizations through member satisfaction.” This research seeks to understand CHW motivation to join a CHW organization. In addition, this research will describe how CHW organizations support their CHW members and whether CHW members are satisfied with the services provided by CHW organizations.

Research on the effectiveness of CHW organizations is currently lacking. The support provided by professional organizations such as CHW organizations can make a difference in the professional development of an individual.

Your input is vital! Please complete an online survey asking questions about your decision to join or not join a CHW organization and your satisfaction with the services provided by the organization. Your responses will remain anonymous. The survey should take approximately 10 minutes to complete.

Participation in this survey is voluntary, and your input is valuable to this research. Participants will be entered into a raffle for a $50 VISA gift card with four winners selected!

To take the survey, click ‘Take the survey’: Take the Survey.

If you have any questions about the survey or its contents, please contact Dr. Maria Martinez-Cosio at 817-272-3302 or Denise Hernandez at 979-402-5377 or denise.adame@mavs.uta.edu.

If you have any questions about your rights as a research subject, please contact the UTA Research Office at 817-272-3723 or regulatoryservices@uta.edu.