Item 1

Call to Order

Item 2

Approval of the Nov. 20, 2015 Council Meeting minutes

Item 3

Executive Commissioner’s Status Report: 1115 Waiver Update

Item 4

Information Presentation: Transformation

Item 5A

Regarding Managed Care Organization Audits: Health and Human Services Commission (HHSC) proposes new
Title 1, Part 15, Chapter 353, Subchapter A, §353.6, concerning Audit of Managed Care Organizations and new
Chapter 371, Subchapter B, §371.37, concerning Audit of Managed Care Organizations.

Item 5B

Regarding Supplemental Nutrition Assistance Program (SNAP) Disqualifications Due to Criminal Activity:
HHSC proposes to amend §372.501, concerning Disqualifications Due to Criminal Activity.

Items 5C & 6A

5C. Regarding Delivery System Reform Incentive Payment (DSRIP) Transition Year - June: HHSC proposes Title 1,
Part 15, Chapter 354, Subchapter D, new Division 5, concerning Actions in Preparation for Extension of the
DSRIP Program, and new sections §§354.1641 – 354.1649 within the new division.
6A. Regarding DSRIP Program Transition Year - September: HHSC proposes Title 1, Part 15, Chapter 354,
Subchapter D, new Division 6, concerning DSRIP Program Transition Year, and new sections §§354.1661,
354.1663, 354.1665, 354.1667, 354.1669, 354.1671, 354.1673, and 354.1675 within the new division. HHSC also proposes to amend Chapter 354, Subchapter D, Division 3, section §354.1624, concerning Independent
Assessment of DSRIP Projects.

Item 6B

Regarding Durable Medical Equipment Physician Signature: HHSC proposes amendments to Title 1, Part 15,
Chapter 354, Subchapter A, Division 25, §354.1342, Conditions for Participation.

Item 6C

Regarding STAR Kids, STAR+PLUS, STAR Health, and Home and Community-Based Services: HHSC
proposes amendments to Title 1, Part 15, Chapter 353 (relating to Medicaid Managed Care): Subchapter A
(relating to General Provisions), §353.2, concerning Definitions; Subchapter G (relating to STAR+PLUS),
§353.603; and Subchapter H (relating to STAR Health), concerning Member Participation; §353.701, concerning
General Provisions; and §353.702, concerning Member Participation.
HHSC proposes new Subchapter M, concerning Home and Community Based Services in Managed Care,
including new §§353.901, 903, and 905. HHSC also proposes new Subchapter N, concerning STAR Kids,
including new §§353.1201 to 353.1209.

Item 6D

Regarding Eligibility and Related Rules for Medicaid for the Elderly and People with Disabilities: HHSC
proposes amendments to Title 1 Chapter 358, Subchapter C, Division 6, §358.431, concerning Definitions.

Items 6E - 7

e. Regarding Financial Eligibility Exclusions for Medicaid for the Elderly and People with Disabilities: HHSC
proposes new §358.357, concerning Achieving a Better Life Experience Program; §358.358, concerning
School-Based Savings Program; §358.389, concerning Achieving a Better Life Experience Program; and
§358.390, concerning School-Based Savings Program.
f. Regarding Financial Eligibility Exclusions for Medicare Savings Programs: HHSC proposes to amend §359.103,
concerning the Qualified Medicare Beneficiary Program and §359.109, concerning the Qualified Disabled and
Working Individual Program.
g. Regarding Financial Eligibility Exclusions for Medicaid Buy-In Programs: HHSC proposes amendments to
§360.113, concerning Resources.
h. Regarding Financial Eligibility Exclusions for the Medicaid Buy-In for Children Program: HHSC proposes
amendments to §361.111, concerning Income.
i. Regarding Eligibility Rules for Medicaid programs: HHSC proposes amendments to §366.319, concerning Child
Support and Medical Support; §366.703 and §366.707, concerning Medicaid for Parents and Caretaker
Relatives; §366.821 and §366.847, concerning Medically Needy Program; and §366.1107, concerning
Determination of Household Composition.
j. Regarding Eligibility Rules for the Children's Health Insurance Program (CHIP): HHSC proposes amendments
to 1 Texas Administrative Code (TAC) Chapter 370 concerning the State Children's Health Insurance Program to
align the rules with federal law and current HHSC policy and processes.
k. Regarding Eligibility and Related Rules for Temporary Assistance for Needy Families (TANF) and SNAP:
HHSC proposes amendments to 1 TAC §372.354, concerning Treatment of Resources in TANF; §372.355,
concerning Treatment of Resources in SNAP; §372.404, concerning Countable and Excluded Income in TANF;
§372.406, concerning Countable and Excluded Income in SNAP; §372.802, concerning One-Time TANF
Eligibility Requirements; §372.1153, concerning Personal Responsibility Agreement Requirements; and
§372.1154, concerning Cooperating with Personal Responsibility Agreement Requirements.
7. Adjourn