Texas Health and Human Services Digest: June 22, 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.
June 23, 2020

June 25, 2020

June 26, 2020

June 29, 2020

June 30, 2020

The Administrative Procedure Act (Texas Government Code, Chapter 2001(link is external)) 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.

The Administrative Procedure Act (Texas Government Code, Chapter 2001(link is external)) 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.

No rules are presently available for public comment.

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 558 Licensing Standards for Home and Community Support Services Agencies#19R069HHSC Policy, Rules, and Training6/23/207/7/20
Repeal of Title 40, Chapter 109, Subchapter C, Specialized Telecommunications Assistance Program, and new Title 26, Chapter 360, Subchapter C, Specialized Telecommunications Assistance Program#18R061Bryant Robinson6/18/207/2/20
Title 26, Chapter 744, 746, & 747 Minimum Standards for School Age and Before or After School Programs, Child-Care Centers, & Child-Care Homes#20R024HHSC Child Care Regulation6/17/207/1/20
Title 26, Chapter 742 Minimum Standards for Listed Family Homes#20R021HHSC Child Care Regulation6/15/206/29/20
Title 26, Chapter 303 Preadmission Screening and Resident Review (PASSR)#20R049Lisa Habbit6/12/206/26/20

VDP will implement the clinical prior authorization criteria for Oxbryta (voxelotor) for traditional Medicaid on Sept. 8.

The Texas Drug Utilization Review Board approved Oxbryta as part of the Sickle Cell Disease Agents criteria at its Jan. 2020 meeting.

This prior authorization is optional for Medicaid managed care.

The Pharmacy Clinical Prior Authorization Assistance Chart shows the prior authorization each MCO uses and how those authorizations relate to traditional Medicaid claim processing.

This chart is updated quarterly and available on the VDP website.

This report contains new recommendations or clarified recommendations from the previous report, recommendations from the last report where work is in progress and recommendations that are still important to the committee, but for which no work is in progress. Read the report here.

The Physician Compare 60-day Preview Period is officially open as of June 22, 2020 at 10 a.m. ET (7 a.m. PT). You can now preview your 2018 Quality Payment Program performance information before it will appear on Physician Compare profile pages and in the Downloadable Database. You can access the secured Preview through the Quality Payment Program website.

Access the resource below on how to preview your data:

For additional assistance with accessing the Quality Payment Program website, or obtaining your EIDM user role, contact the Quality Payment Program service center at QPP@cms.hhs.gov.
To learn more about the 2018 Quality Payment Program performance information that is available for preview as well as the 2017 clinician utilization data that will be added to the Downloadable Database, download these documents from the Physician Compare Initiative page:

The 60-day Preview Period will close on August 20, 2020 at 8 p.m. ET (5 p.m. PT).

Please note the 2018 performance information is targeted for public reporting in 2020 and will be added to Physician Compare and/or the Downloadable Database after all Targeted Reviews are completed. If you have an open Targeted Review request, you will still be able to preview your 2018 Quality Payment Program performance information through the Physician Compare Preview Period.

If you have any questions about Physician Compare, public reporting, or the 60-day Preview Period, please contact us at PhysicianCompare-Helpdesk@AcumenLLC.com.com.

Market Saturation and Utilization Data Tool was developed to allow the Centers for Medicare & Medicaid Services (CMS) to monitor market saturation as a means to help prevent potential fraud, waste, and abuse (FWA). Market saturation, in the present context, refers to the density of providers of a particular service within a defined geographic area relative to the number of beneficiaries receiving that service in the area. The data can be used to reveal the degree to which use of a service is related to the number of providers servicing a geographic region. There are also a number of secondary research uses for these data, but one objective of making these data public is to assist health care providers in making informed decisions about their service locations and the beneficiary population they serve.

The tool includes interactive maps and datasets that show national-, state-, county-, and Core-Based Statistical Area (CBSA)-level provider services and utilization data for selected health service areas. Provider services and utilization data by these geographic regions are easily compared using the interactive maps above. The tool is available through the CMS website at: https://data.cms.gov/market-saturation. Future releases may include comparable information on additional health service areas.

Release 11 includes  a total of fourteen, twelve-month reference periods, for State/County data, and nineteen health service areas: Home Health, Ambulance (Emergency, Non-Emergency, Emergency & Non-Emergency), Independent Diagnostic Testing Facilities (Part A and Part B), Skilled Nursing Facilities, Hospice, Physical and Occupational Therapy, Clinical Laboratory (Billing Independently), Long-Term Care Hospitals, Chiropractic Services, Cardiac Rehabilitation Programs, Psychotherapy, Federally Qualified Health Centers, Ophthalmology, Preventive Health Services, Dialysis, and Telemedicine.

Release 11 adds two reference periods, for a total of four reference periods for the Core-Based Statistical Area (CBSA). CBSAs are geographical delineations that encompass both metropolitan statistical areas and micropolitan statistical areas. A micropolitan statistical area is an urban cluster of at least 10,000 people but less than 50,000 people, while a metropolitan statistical area is an urban cluster of at least 50,000 people. CBSAs are Census Bureau-defined urban clusters of at least 10,000 people. In order to better provide appropriate data and services, CMS defines additional custom CBSAs beyond those defined by the US Census Bureau. At this time CBSA-level trend data is not calculated. CMS defined CBSAs are not currently included in the shapefile needed to create the CBSA interactive map. The CMS defined CBSAs are included in the interactive data set and contribute to the Nation + Territories level totals.

Read the full release here.