Texas Health and Human Services Digest: October 28, 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.

October 28, 2020

October 29, 2020

October 30, 2020

November 2, 2020

November 3, 2020

November 4, 2020

November 5, 2020

November 6, 2020

November 10, 2020

November 13, 2020

November 18, 2020

November 19, 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To let the public know about a rulemaking action – such as new, amended or repealed rules – HHS publishes a notice in the Texas Register, a publication of the Texas Secretary of State.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
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 354, Subchapter F, Division 8, Drug Utilization Review Board#21R007John Pepin10/30/2011/13/20
Title 26, Chapter 561, Employee Misconduct Registry (EMR)#19R045HHS Policy, Rules and Training10/30/2011/13/20
Title 26, Chapter 749, Minimum Standards for Child-Placing Agencies, concerning Legislative changes#20R101HHS Child Care Regulation10/19/2011/2/20

The monthly CMS Preclusion List has been published. Feel free to contact PreclusionList@cms.hhs.gov if you have any questions or concerns.

SNF QRP October Refresh 2020.  The October 2020 refresh of SNF QRP data is now available on Nursing Home Compare (NHC), as well as the Nursing homes including rehab services web pages within Care Compare (CCXP) and Provider Data Catalog (PDC).

The data are based on quality assessment data submitted by SNFs to CMS from Quarter 1 2019 through Quarter 4 2019 (01/01/2019 –12/31/2019); and the annual update of the claims-based measures data from Quarter 4 2017 – Quarter 3 2019 (10/01/2017 – 9/30/2019).

Starting in October 2020, six additional SNF QRP measures will be publicly reported on NHC, CCXP and PDC:

  • Changes in Skin Integrity Post-Acute Care: Pressure Ulcer/Injury,
  • Drug Regimen Review Conducted with Follow-Up for Identified Issues – PAC SNF QRP,
  • Application of IRF Functional Outcome Measure: Change in Self-Care (NQF #2633),
  • Application of IRF Functional Outcome Measure: Change in Mobility (NQF #2634),
  • Application of IRF Functional Outcome Measure: Discharge Self-Care Score (NQF #2635), and
  • Application of IRF Functional Outcome Measure: Discharge Mobility Score (NQF #2636).

Please visit the Nursing Home Compare, as well as the Nursing homes including rehab services web pages within Care Compare (CCXP) and Provider Data Catalog (PDC) websites, to view the updated quality data.

Please note that the October 2020 refresh of the SNF QRP data on Nursing Home Compare/Care Compare Sites is the last scheduled refresh of this data until the January 2022 refresh. For additional information, please review the available SNF QRP Public Reporting Tip Sheet.

For questions about SNF QRP Public Reporting please email SNFQRPPRQuestions@cms.hhs.gov.

New CMS Proposals Streamline Medicare Coverage, Payment, and Coding for Innovative New Technologies and Provide Beneficiaries with Diabetes Access to More Therapy Choices. On October 27, under the leadership of President Trump, CMS proposed new changes to Medicare Durable Medical Equipment, Prosthetics, Orthotic Devices, and Supplies (DMEPOS) coverage and payment policies. This rule would provide more choices for beneficiaries with diabetes, while streamlining the process for innovators in getting their technologies approved for coverage, payment, and coding by Medicare.

The proposed rule would expand the interpretation regarding when external infusion pumps are appropriate for use in the home and can be covered as DME under Medicare Part B, increasing access to drug infusion therapy services in the home. The proposed rule also drastically reduces administrative burdens – such as complicated government coverage, payment, and coding processes – that block innovators from getting their products to Medicare beneficiaries in a timely manner. This action aligns with President Trump’s Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors.

Read the full release.

For More Information:

Quality Payment Program – CORRECTED VERSION: CMS Releases Preliminary 2019 Performance Year Quality Payment Program Results. Today, the Centers for Medicare & Medicaid Services (CMS) released a blog post and infographic to share preliminary participation data for the Quality Payment Program (QPP) in 2019.

CMS is pleased to share that despite the challenges caused by the COVID-19 Public Health Emergency, clinicians still overwhelmingly engaged* in QPP and submitted 2019 data.
Key findings include the following (please note this message updates two of the data points from the previous listserv):

  • 97.44% of MIPS eligible clinicians engaged in QPP (correction).
  • Overall, MIPS engagement rose from 871,838 clinicians in 2018 to 930,219 clinicians in 2019.
  • MIPS APM participation rose from 356,546 clinicians in 2018 to 416,281 clinicians in 2019.
  • 6.83% of MIPS eligible clinicians received reweighting of one or more MIPS performance categories (correction).
  • The number of Qualifying Advanced Payment Model Participants (QPs) rose from 183,306 clinicians in 2018 to 195,564 in 2019.

*We define engaged clinicians as those who submitted some data to the program at the individual, group, virtual group, or APM Entity level (e.g., submitted one or more quality measures, attested to one or more improvement activities, etc.)

For More Information
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. Eastern Time (ET).

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

CMS Releases Additional 2018 Quality Payment Program Experience Report Data in New Public Use File. The 2018 Quality Payment Program (QPP) Experience Report Public Use File (PUF) is now available. This file will allow you to drill down into the details behind the data presented in the previously released 2018 Quality Payment Program (QPP) Experience Report.

As a reminder, the QPP Experience Report includes data regarding participation and performance in the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs) tracks of QPP during the 2018 performance year. It covers eligibility and participation, reporting options, performance categories, and final score and payment adjustments.

The new PUF provides more details on these data at the TIN/NPI level. You can sort PUF data by variables like clinician type, practice size, scores, and payment adjustments. Using these variables, you can create your own tables to get more details on certain data, such as:

  • MIPS performance category scores among small and rural practices
  • Number of participants reporting each measure and activity
  • Payment adjustments by group size

Please note: Since the PUF provides data at the TIN/NPI level, we have suppressed information on TIN/NPIs with fewer than 11 beneficiaries in 2018 per CMS rules. For that reason, the numbers in the PUF will not match those in the QPP Experience Report.

For More Information
Contact the Quality Payment Program at 1-866-288-8292 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. Eastern Time (ET).

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

Scientists use clues in the human genome to discover new inflammatory syndrome. Researchers from the National Institutes of Health (NIH) have discovered a new inflammatory disorder called vacuoles, E1 enzyme, X-linked, autoinflammatory and somatic syndrome (VEXAS), which is caused by mutations in the UBA1 gene. VEXAS causes symptoms that included blood clots in veins, recurrent fevers, pulmonary abnormalities and vacuoles (unusual cavity-like structures) in myeloid cells. The scientists reported their findings in the New England Journal of Medicine.

Nearly 125 million people in the U.S. live with some form of a chronic inflammatory disease. Many of these diseases have overlapping symptoms, which often make it difficult for researchers to diagnose the specific inflammatory disease in a given patient.

Researchers at the National Human Genome Research Institute (NHGRI), part of the NIH, and collaborators from other NIH Institutes took a unique approach to address this challenge. They studied the genome sequences from more than 2,500 individuals with undiagnosed inflammatory diseases, paying particular attention to a set of over 800 genes related to the process of ubiquitylation, which helps regulate both various protein functions inside a cell and the immune system overall. By doing so, they found a gene that is intricately linked to VEXAS, a disease which can be life-threatening. So far, 40% of VEXAS patients who the team studied have died, revealing the devastating consequences of the severe condition.

Read the full release.

Governor Abbott Appoints Distefano To Texas Medical Board.  Governor Greg Abbott has appointed James “JD” Distefano, D.O. to the Texas Medical Board for a term set to expire April 13, 2025. The board regulates the practice of medicine in Texas.

James “JD” Distefano, D.O. of College Station is a board certified physician at Cornerstone Sports Medicine. He also serves as a team physician for Texas A&M Athletics. Distefano honorably served in the United State Air Force. He is a member of the Texas Osteopathic Medical Association, American Osteopathic Association, American Osteopathic Board of Emergency Medicine, and the American Medical Society of Sports Medicine. In addition, he is a volunteer physician for the Special Olympics. Distefano received a Bachelor of Science in Radiologic Technology from Northeast Louisiana University, and a Doctor of Osteopathy from Oklahoma State University College of Osteopathic Medicine.

HCS and TxHmL Stakeholder Comments Requested for HCS, TxHmL and CFC Billing Guidelines Proposed EVV Revisions.  HCS and TxHmL Stakeholders can now comment on proposed EVV revisions to the HCS, TxHmL and CFC Billing Guidelines by Nov. 27, 2020.

The proposed billing guidelines revisions and a summary of changes are:




Email stakeholder comments to TxHmL Policy.

November 18 ICF/IID Annual Conference Topics Set. The annual Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions conference for providers and surveyors has been scheduled for November 18, 2020.

This year’s conference will be virtual and participants will be able to choose their topics.

Nov 18, 2020
Top 10 Citations
9:30 a.m. to 12:00 p.m.
1.5 hours of CEUs Available
Register for the Top 10 Citations Webinar

Infection Control
1:00 p.m. to 3:00 p.m.
1.5 hours of Nursing Continuing Professional Development Contact Available
1.5 hours of Continuing Education for Social Workers Available
Register for the Infection Control Webinar

Questions or requests can be sent to Kirsten.Notaro@hhs.texas.gov.