(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.
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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 |