The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §355.105, concerning General Reporting and Documentation Requirements, Methods, and Procedures.

BACKGROUND AND PURPOSE

The purpose of the proposal is to update language in §355.105 to allow for preliminary rate setting prior to a public hearing for non-discretionary items (e.g., Health Care Common Procedure Coding System (HCPCS) Updates, Indian Health Services (HIS), and the Medical Transportation Program (MTP)). These non-discretionary rates are published in the Federal Register or by the Texas Comptroller either on January 1 of each year or as deemed appropriate by the regulating entity. This rule amendment also corrects references to the HHSC Rate Analysis Department, now known as the HHSC Provider Finance Department.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §355.105 deletes references to "Rate Analysis" throughout the rule and replaces it with the current department name "Provider Finance."

The proposed amendment to §355.105 removes references to Department of Aging and Disability Services (DADS).

The proposed amendment to §355.105(b)(2)(A)(i) updates a reference to a repealed rule with the current rule regarding record retention and disposition.

The proposed amendment to §355.105(g)(1) adds subpararaphs (A) and (B) which defines preliminary rates and describes services for which these rates apply and the duration of the time period the rates will be effective.

FISCAL NOTE

Trey Wood, Chief Financial Officer, has determined that for each year of the first five years that the rule amendment will be in effect, enforcing or administering the rule amendment does not have foreseeable implications relating to costs or revenues of state or local governments.

GOVERNMENT GROWTH IMPACT STATEMENT

HHSC has determined that during the first five years that the rule will be in effect:

(1) the proposed rule will not create or eliminate a government program;

(2) implementation of the proposed rule will not affect the number of HHSC employee positions;

(3) implementation of the proposed rule will result in no assumed change in future legislative appropriations;

(4) the proposed rule will not affect fees paid to HHSC;

(5) the proposed rule will not create a new rule;

(6) the proposed rule will not expand, limit, or repeal existing rule;

(7) the proposed rule will not change the number of individuals subject to the rule; and

(8) the proposed rule(s) will not affect the state's economy.

SMALL BUSINESS, MICRO-BUSINESS, AND RURAL COMMUNITY IMPACT ANALYSIS

Trey Wood has also determined that there will be no adverse economic effect on small businesses, micro-businesses, or rural communities.

HHSC is already required to reprocess claims on these services. This rule update will expedite the process of implementing rates on services that are non-discretionary, thereby reducing the number of claims that require reprocessing and allowing providers to receive accurate reimbursement more promptly. This rule update also does not impose any additional costs on small businesses, micro-businesses, or rural communities.

LOCAL EMPLOYMENT IMPACT

The proposed rules will not affect a local economy.

COSTS TO REGULATED PERSONS

Texas Government Code §2001.0045 does not apply to this rule because the rule does not impose a cost on regulated persons.

PUBLIC BENEFIT AND COSTS

Victoria Grady, Director of Provider Finance, has determined that for each year of the first five years the rule amendment is in effect, the public benefit will be more prompt payments to providers rather than having them wait for claims to reprocess.

Trey Wood has also determined that for the first five years the rule amendment is in effect, there are no anticipated economic costs to persons who are required to comply with the proposed rule because there is no cost associated with this rule update.

TAKINGS IMPACT ASSESSMENT

HHSC has determined that the proposal does not restrict or limit an owner's right to his or her property that would otherwise exist in the absence of government action and, therefore, does not constitute a taking under Texas Government Code §2007.043.

PUBLIC COMMENT

Questions about the content of this proposal may be directed to the HHSC Provider Finance for Hospitals department at PFDAcuteCare@hhs.texas.gov.

Written comments on the proposal may be submitted to HHSC Provider Finance Department, 4601 Guadalupe, Austin, TX 78751 (Mail Code H-400); P.O. Box 149030, Austin, TX 78714-9030 (Mail Code H-400); by fax to (512)-730-7475; or by email to PFDAcuteCare@hhs.texas.gov.

To be considered, comments must be submitted no later than 31 days after the date of this issue of the Texas Register. Comments must be (1) postmarked or shipped before the last day of the comment period; (2) hand-delivered before 5:00 p.m. on the last working day of the comment period; or (3) faxed or emailed before midnight on the last day of the comment period. If the last day to submit comments falls on a holiday, comments must be postmarked, shipped, or emailed before midnight on the following business day to be accepted. When faxing or emailing comments, please indicate "Comments on Proposed Rule 22R109" in the subject line.

STATUTORY AUTHORITY

The amendment is proposed under Texas Government Code §531.033, which authorizes the Executive Commissioner of HHSC to adopt rules necessary to carry out HHSC's duties; Texas Human Resources Code §32.021 and Texas Government Code §531.021(a), which provide HHSC with authority to administer the federal medical assistance (Medicaid) program in Texas; Texas Government Code §531.021(b-1), which establishes HHSC as the agency responsible for adopting reasonable rules governing the determination of fees, charges, and rates for medical assistance payments under the Texas Human Resources Code Chapter 32.

The amendment affects Texas Government Code Chapter 355.