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RULE §351.839Nursing Facility Payment Methodology Advisory Committee

(a) Statutory authority. The Nursing Facility Payment Methodology Advisory Committee (NF-PMAC) 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 NF-PMAC advises the Executive Commissioner and the Health and Human Services system on the establishment and implementation of recommended improvements to the nursing facility (NF) reimbursement methodology and other NF payment topics.

(c) Tasks. The NF-PMAC:

  (1) studies and makes recommendations on the development of an NF reimbursement methodology that incentivizes quality care for individuals served in an NF, and is cost-effective, streamlined and transparent; and

  (2) performs other tasks consistent with its purpose as requested by the Executive Commissioner.

(d) Reporting requirement. By August 31 of each fiscal year, the NF-PMAC files a written report with the Executive Commissioner covering the meetings and activities in the immediately preceding fiscal year. The report includes:

  (1) a list of the meeting dates;

  (2) the members' attendance records;

  (3) a brief description of actions taken by the committee;

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

  (5) a description of activities the committee anticipates undertaking in the next fiscal year;

  (6) recommended amendments to this section, as needed; and

  (7) 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.

(e) Open meetings. The NF-PMAC complies with the requirements for open meetings under Texas Government Code, Chapter 551.

(f) Membership. The NF-PMAC is composed of one non-voting ex-officio HHSC representative and an odd number of voting members, not to exceed 15, appointed by the Executive Commissioner.

  (1) The voting members of the NF-PMAC may consist of:

    (A) Medicaid managed care organization representatives;

    (B) an association or associations representing managed care organizations;

    (C) private NF owners or operators;

    (D) non-state government-owned NF owners or operators;

    (E) an association or associations representing NF providers;

    (F) an association or associations representing individuals receiving Medicaid services in an NF;

    (G) rural NF providers;

    (H) urban NF providers;

    (I) NF providers serving 50 or fewer residents;

    (J) NF providers serving 51 or more residents;

    (K) NF resident advocates; and

    (L) other disciplines with expertise in NF finance, delivery, or quality improvement.

  (2) Voting members are appointed for three year terms. The terms will be staggered so that the terms of an equal or almost equal number of members expire on August 31 of each year. Regardless of the term limit, a member serves until the member's replacement has been appointed. This ensures sufficient, appropriate representation.

  (3) If a vacancy occurs, a member is appointed by the Executive Commissioner to serve the unexpired portion of that term.

  (4) Paragraphs (2) and (3) of this subsection do not apply to the ex-officio member, who serves at the pleasure of the Executive Commissioner. The ex-officio member provides informational updates about the NF-PMAC to the Long-Term Care Facilities Council, if such updates are requested by the Long-Term Care Facilities Council.

(g) Officers. NF-PMAC selects a chair of the advisory committee from its members.

  (1) The chair serves until September 1 of each even-numbered year.

  (2) A member serves no more than two consecutive terms as chair. A chair may not serve beyond their membership term.

(h) Required training. Each member shall complete all training on relevant statutes and rules, including this section, §351.801 of this division, and Texas Government Code, Chapters 551 and 2110, and §531.012. Training will be provided by HHSC.

(i) Date of abolition. The NF-PMAC is abolished, and this section expires, on August 31, 2022.

Source Note: The provisions of this §351.839 adopted to be effective February 1, 2020, 45 TexReg 524

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