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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 (VBPQIAC) is established under Texas Government Code §531.012 and is subject to §351.801 of this division (relating to Authority and General Provisions).

(b) Purpose. The VBPQIAC advises the Texas Health and Human Services (HHSC) Executive Commissioner and Health and Human Services system agencies (HHS agencies) on quality improvement and value-based payment initiatives for Medicaid, other publicly funded health services, and the wider health care system.

(c) Tasks. The VBPQIAC 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 and CHIP;

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

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

  (2) adopts bylaws to guide the operation of the committee; and

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

(d) Reporting Requirements.

  (1) No later than December 31st of each year, the VBPQIAC files an annual written report with the HHSC Executive Commissioner covering the meetings and activities in the immediately preceding year. The report includes:

    (A) a list of the meeting dates;

    (B) the members' attendance records;

    (C) a brief description of the actions taken by the VBPQIAC;

    (D) a description of how the committee accomplished its tasks;

    (E) a description of the activities the VBPQIAC anticipates undertaking in the next year;

    (F) recommended amendments to this section; and

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

  (2) No later than December 1st of each even-numbered year, the VBPQIAC submits a written report to the HHSC 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 VBPQIAC.

(e) Meetings.

  (1) Open meetings. The VBPQIAC complies with the requirements for open meetings under Texas Government Code Chapter 551, as if it were a governmental body.

  (2) Frequency. The VBPQIAC will meet at least twice each year.

  (3) Quorum. A majority of members constitutes a quorum for the purpose of transacting official business. (To calculate a majority for a committee with an even number of members, divide the membership by two and add one; for a committee with an odd number of members, divide the membership by two and round up to the next whole number.)

(f) Membership.

  (1) The VBPQIAC is composed of 19 voting members and up to four non-voting ex officio members appointed by the HHSC Executive Commissioner. In selecting members to serve on the VBPQIAC, HHSC considers the applicants' qualifications, background, and interest in serving.

    (A) The 19 voting members represent the following categories:

      (i) Medicaid managed care organizations;

      (ii) hospitals;

      (iii) physicians;

      (iv) nurses;

      (v) pharmacies;

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

      (vii) academic systems; and

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

    (B) Four non-voting, ex officio members may be appointed to the VBPQIAC as determined by the HHSC Executive Commissioner.

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

  (3) Members are appointed for staggered terms so that the terms of an equal or almost equal number of members expire on December 31 of each year. Regardless of the term limit, a member serves until his or her replacement has been appointed. This ensures sufficient, appropriate representation.

    (A) If a vacancy occurs, the HHSC Executive Commissioner will appoint a person to serve the unexpired portion of that term.

    (B) Except as necessary to stagger terms, the term of each member is four years. A member may apply to serve one additional term.

    (C) This subsection does not apply to ex officio members, who serve at the pleasure of the HHSC Executive Commissioner and do not have the authority to vote on items before the full committee.

(g) Officers. The VBPQIAC selects a chair and vice chair of the committee from among its members.

  (1) The chair serves until December 31 of each odd-numbered year. The vice chair serves until December 31 of each even-numbered year.

  (2) A member may serve up to two consecutive terms as chair or vice chair.

  (3) A member is not eligible to serve in the role of chair or vice chair once another person has been appointed to fill the member's position on the VBPQIAC.

(h) Required Training. Each member must complete training on relevant statutes and rules, including this section, §351.801 of this division, Texas Government Code §531.012, Texas Government Code Chapters 551, 552, and 2110, the HHS Ethics Policy, and other relevant HHS policies. Training will be provided by HHSC.

(i) Travel Reimbursement. Unless permitted by the current General Appropriations Act, members of the VBPQIAC are not paid to participate in the VBPQIAC nor reimbursed for travel to and from meetings.

(j) Date of abolition. The VBPQIAC is abolished and this section expires on December 31, 2027.

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; amended to be effective October 26, 2023, 48 TexReg 6205

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