Texas Health and Human Services Digest: November 16, 2020

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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.

November 16, 2020

November 17, 2020

November 18, 2020

November 19, 2020

November 20, 2020

November 30, 2020

December 11, 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To let the public know about a rulemaking action – such as new, amended or repealed rules – HHS publishes a notice in the Texas Register, a publication of the Texas Secretary of State.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., DescriptionContactComment End Date
Title 1, Chapter 355, Subchapter J, Division 14, Section 355.8261, Federally Qualified Health Center Services Reimbursement#21R008: Federally Qualified Health Center Services ReimbursementHHS Provider Finance Department12/14/20
Title 1, Chapter 355, Subchapter J, Division 11, Section 355.8201, Waiver Payments to Hospitals for Uncompensated Care#21R012: Uncompensated Care Secondary Reconciliation for DYs 6-8HHSC12/7/20
Repeal of Title 25, Chapter 415, Subchapter C, Use and Maintenance of Department of State Health Services/Department of Aging and Disability Services Drug Formulary#19R052: HHSC Psychiatric Drug FormularyHHS Health and Specialty Care11/23/20
Repeal of Title 40, Chapter 5, Subchapter C, Use and Maintenance of Drug Formulary#19R052: HHSC Psychiatric Drug FormularyHHS Health and Specialty Care11/23/20
New Title 26, Chapter 306, Subchapter G, Use and Maintenance of the Health and Human Services Commission Psychiatric Drug Formulary, Sections 306.351 – 306.360#19R052: HHSC Psychiatric Drug FormularyHHS Health and Specialty Care11/23/20
Title 1, Chapter 355, Subchapter B, Establishment and Adjustment of Reimbursement Rates for Medicaid, Section 355.205#21R015: Rate Increase Attestation Process COVID-19HHS Provider Finance Department11/23/20
Repeal of Title 1, Chapter 383, Interstate Compact on Mental Health and Mental Retardation#19R065: Interstate Compact CoordinationHHS Health and Specialty Care11/16/20
New Title 26, Chapter 903, Interstate Compact on Mental Health and Intellectual and Developmental Disabilities#19R065: Interstate Compact CoordinationHHS Health and Specialty Care11/16/20
Title 1, Chapter 354, Subchapter A, Division 1, Section 354.1003, Time Limits for Submitted Claims#20R006: Claims Payment Deadlines ExceptionsHHS Rules Coordination Office11/16/20
Title 25, Chapter 40, Subchapter D, concerning Maintenance and Administration of Asthma Medication#20R019: Asthma MedicationDSHS School Health Program11/16/20
Title 25, Chapter 40, Subchapters B and C, concerning Epinephrine Auto-Injector Policies in Certain Entities and Youth Facilities#20R018: Epinephrine Policies in Certain Entities and Youth FacilitiesDSHS School Health Program11/16/20

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 1, Chapter 351, Section 351.805, State Medicaid Managed Care Advisory Committee#20R108HHS Medicaid/CHIP Services11/5/2011/19/20

Reminder: CMS Proposes to Allow APM Entities to Submit Applications for the Extreme and Uncontrollable Circumstances Exception; Applications are Due December 31. In the 2021 Medicare Physician Fee Schedule (PFS) Notice of Proposed Rulemaking (NPRM), the Centers for Medicare & Medicaid Services (CMS) proposed to allow APM Entities to submit an application to reweight Merit-based Incentive Payment System (MIPS) performance categories as a result of extreme and uncontrollable circumstances. We intend to allow APM Entities to submit applications now, but CMS will not be able to make final determinations on applications until and unless the policy proposal is finalized.

If the policy is finalized and an APM Entity’s application is approved, that APM Entity would receive a final score equal to the performance threshold for the 2020 MIPS performance year, and the MIPS eligible clinicians in the APM Entity group would receive a neutral payment adjustment in 2022.

Who is Eligible to Submit an Application?
If the policy is finalized, then APM Entities affected by extreme and uncontrollable circumstances in the following models would be able to submit an application:

  • Medicare Shared Saving Program
  • Next Generation ACO Model
  • Vermont Medicare ACO Model
  • Comprehensive Primary Care Plus (CPC+)
  • Comprehensive ESRD Care (CEC)
  • Bundled Payments for Care Improvement (BPCI)
  • Oncology Care Model (OCM)
  • Maryland Primary Care Program
  • Independence at Home Demonstration

What are the Application Requirements?
Unlike those who choose to apply as individual clinicians, groups, or virtual groups, APM Entities must apply to reweight all MIPS performance categories to 0%. Additionally, 75% of the MIPS eligible clinicians in the APM Entity must qualify for reweighting in the MIPS Promoting Interoperability performance category. They may qualify automatically or through a MIPS Promoting Interoperability Hardship Exception Application.

CMS does not require APM Entities to submit documentation with their applications. However, APM Entities should retain documentation of the circumstances supporting their application for their own records in the event they are selected by CMS for data validation or an audit.

When are Applications Due?
Applications are due to CMS by Thursday, December 31, 2020 at 8:00 p.m. ET.

How do I Apply?
New for 2020: You must have a HCQIS Access Roles and Profile (HARP) account to complete and submit an exception application. For more information on HARP accounts, please refer to the Register for a HARP Account document in the QPP Access User Guide.

Once you register for a HARP account, sign in to qpp.cms.gov, select ‘Exceptions Applications’ on the left-hand navigation, select ‘Add New Exception,’ and select ‘Extreme and Uncontrollable Circumstances Exception.’

How do I Know if I’m Approved?
If you submit an application and this policy is finalized to allow APM Entities to apply, then you will be notified by email if your request was approved or denied. If approved, this will also be added to your eligibility profile on the QPP Participation Status Tool, but it may not appear in the tool until the submission window is open in 2021.

Will Submitting Data Void the Exception?
Data submitted for an APM Entity will not override performance category reweighting from an approved application. This differs from the policy for individual, group, and virtual group applications.

Will an Approved Application Affect Model-Specific Reporting Requirements?
If the policy is finalized and an APM Entity’s application is approved, the approval would only affect MIPS reporting, and that APM Entity would still be required to meet its model-specific reporting requirements.

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, please consider calling during non-peak hours—before 10:00 a.m. and after 2:00 p.m. ET.

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

Envision color: Activity patterns in the brain are specific to the color you see. Researchers at the National Eye Institute (NEI) have decoded brain maps of human color perception. The findings, published today in Current Biology, open a window into how color processing is organized in the brain, and how the brain recognizes and groups colors in the environment. The study may have implications for the development of machine-brain interfaces for visual prosthetics. NEI is part of the National Institutes of Health.

The brain uses light signals detected by the retina’s cone photoreceptors as the building blocks for color perception. Three types of cone photoreceptors detect light over a range of wavelengths. The brain mixes and categorizes these signals to perceive color in a process that is not well understood.

To examine this process, Isabelle Rosenthal, Katherine Hermann, and Shridhar Singh, post-baccalaureate fellows in Conway’s lab and co-first authors on the study, used magnetoencephalography or “MEG,” a 50-year-old technology that noninvasively records the tiny magnetic fields that accompany brain activity. The technique provides a direct measurement of brain cell activity using an array of sensors around the head. It reveals the millisecond-by-millisecond changes that happen in the brain to enable vision. The researchers recorded patterns of activity as volunteers viewed specially designed color images and reported the colors they saw.

The researchers worked with pink, blue, green, and orange hues so that they could activate the different classes of photoreceptors in similar ways. These colors were presented at two luminance levels – light and dark. The researchers used a spiral stimulus shape, which produces a strong brain response.

The researchers found that study participants had unique patterns of brain activity for each color. With enough data, the researchers could predict from MEG recordings what color a volunteer was looking at – essentially decoding the brain map of color processing, or “mind-reading.”

Read the full release.

West Nile Virus – Nov. 10, 2020. DSHS has confirmed 54 cases and 10 deaths of West Nile illness in Texas this year.

People can be infected by West Nile virus through the bite of an infected mosquito. DSHS encourages everyone to protect themselves from bites by wearing long sleeves and pants, applying insect repellent and removing standing water.

Last year, Texas reported 32 cases of West Nile illness that resulted in four deaths.
Case counts will be updated each Tuesday through mosquito season.

News Release

Additional Surveillance Information

CountyWest Nile FeverWest Nile Neuroinvasive DiseaseTotal
Brazos 11
Collin134
Dallas51116
Denton 55
Ellis 11
Harris 11
Montgomery112
Orange 11
Red River 11
Tarrant11516
Travis 33
Williamson 33
Total84654