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RULE §351.821Value-Based Payment and Quality Improvement Advisory Committee

(a) Statutory authority. The Value-Based Payment and Quality Improvement Advisory Committee (Quality Committee) is established in accordance with Texas Government Code §531.012.

(b) Purpose. The Quality Committee provides a forum to promote public-private, multi-stakeholder collaboration in support of quality improvement and value-based payment initiatives for Medicaid, other publicly funded health services, and the wider health care system.

(c) Tasks. The Quality Committee performs the following tasks:

  (1) studies and makes recommendations regarding:

    (A) value-based payment and quality improvement initiatives to promote better care, better outcomes, and lower costs for publicly funded health care services;

    (B) core metrics and a data analytics framework to support value-based purchasing and quality improvement in Medicaid/CHIP;

    (C) HHSC and managed care organization incentive and disincentive programs based on value; and

    (D) the strategic direction for Medicaid/CHIP value-based programs; and

  (2) pursues other deliverables consistent with its purpose to improve quality and efficiency in state health care services as requested by the Executive Commissioner or adopted into the work plan or bylaws of the committee.

(d) Reports.

  (1) By December 31st of each fiscal year, the Quality Committee files a written report with the Executive Commissioner that covers the meetings and activities in the immediately preceding fiscal year. The report:

    (A) lists the meeting dates;

    (B) provides the members' attendance records;

    (C) briefly describes actions taken by the committee;

    (D) describes how the committee has accomplished its tasks;

    (E) summarizes the status of any rules that the committee recommended to HHSC;

    (F) describes anticipated activities the committee will undertake in the next fiscal year;

    (G) recommends amendments to this section, as needed; and

    (H) identifies the costs related to the committee, including the cost of HHSC staff time spent supporting the committee's activities and the source of funds used to support the committee's activities.

  (2) By December 1st of each even-numbered year, the committee submits a written report to the Executive Commissioner and Texas Legislature that:

    (A) describes current trends and identifies best practices in health care for value-based payment and quality improvement; and

    (B) provides recommendations consistent with the purposes of the Quality Committee.

(e) Date of abolition. The Quality Committee is abolished, and this section expires, on December 31, 2023.

(f) Membership.

  (1) The Quality Committee is composed of 19 voting members appointed by the Executive Commissioner.

    (A) HHSC solicits voting members from the following categories:

      (i) Medicaid managed care organizations;

      (ii) Regional Healthcare Partnerships;

      (iii) hospitals;

      (iv) physicians;

      (v) nurses;

      (vi) pharmacies;

      (vii) providers of long-term services and supports;

      (viii) academic systems; and

      (ix) members from other disciplines or organizations with expertise in health care finance, delivery, or quality improvement.

    (B) The final composition of the committee is determined by the Executive Commissioner.

    (C) The committee may include nonvoting, ex officio agency representatives as determined by the Executive Commissioner.

  (2) In selecting voting members, the Executive Commissioner considers ethnic and minority representation and geographic representation.

  (3) Members are appointed to staggered terms so that the terms of approximately half the members expire on December 31st of each even-numbered year.

  (4) Except as necessary to stagger terms, the term of each voting member is four years.

(g) Officers. The Quality Committee selects from its members a presiding officer and an assistant presiding officer.

  (1) The presiding officer serves until December 31st of each odd-numbered year. The assistant presiding officer serves until December 31st of each even-numbered year.

  (2) The presiding officer and the assistant presiding officer remain in their positions until the committee selects a successor; however, the individual may not remain in office past the individual's membership term.

Source Note: The provisions of this §351.821 adopted to be effective July 1, 2016, 41 TexReg 4432; amended to be effective February 25, 2019, 44 TexReg 807; amended to be effective January 27, 2020, 45 TexReg 523

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