| (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.
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