March 12, 2020 - 1:00pm

Health and Human Services Commission, Brown-Heatly Building, Public Hearing Room
4900 North Lamar Blvd.
Austin Texas, 78751

Agenda

Webcasting Available

This meeting will be webcast. To access the webcast, go to https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings the day and time of the meeting.

1. Call to order
2. Roll call
3. Adoption of November 21, 2019, and December 12, 2019, minutes (vote required)
4. Advisory Committee chair updates
   1. Behavioral Health Advisory Committee
   2. Drug Utilization Review Board
   3. eHealth Advisory Committee
   4. Hospital Payment Advisory Committee
   5. Intellectual and Developmental Disability System Redesign Advisory Committee
   6. Medical Care Advisory Committee
   7. Palliative Care Interdisciplinary Advisory Committee
   8. Perinatal Advisory Committee
   9. Policy Council for Children and Families
   10. STAR Kids Managed Care Advisory Committee
   11. Texas Council on Consumer Direction
   12. Value Based Payment and Quality Improvement Advisory Committee
5. State Medicaid Managed Care Advisory Committee (SMMCAC) subcommittee updates
   1. Administrative Simplification
      1. Claims processing guidelines for managed care organizations
      2. Interaction between Texas Medicaid Healthcare Partnership provider enrollment and managed care organizations
      3. Provider abrasion and administrative burden involved in the prior authorization process
      4. Other administrative simplification topics
   2. Clinical Oversight and Benefits
      1. Texas Government Code §533.005, as adopted by Senate Bill 1177, 86th Texas Legislature, Regular Session, 2019
      2. Health and Human Services Commission’s prior authorization data collection effort
      3. Durable medical equipment
      4. Other clinical oversight and benefits topics
   3. Complaints, Appeals, and Fair Hearings
      1. Updates on appeals notices
      2. Changes to appeals data
      3. Appeals, Independent Review Organization, and fair hearings timeline from the client’s perspective
      4. Other complaints, appeals, and fair hearings topics
   4. Network Adequacy
      1. Texas Government Code, Chapter 531, as amended by Senate Bill 670, 86th Texas Legislature, Regular Session, 2019
         1. Expanded coverage of telemedicine and telehealth services
         2. New telemedicine and telehealth monitoring requirements
         3. New Federally Qualified Health Center (FQHC) facility fees
      2. Texas Government Code, Chapter 531, as amended by House Bill 1063, 86th Texas Legislature, Regular Session, 2019
         1. Cost effectiveness research
      3. Other network adequacy topics
   5. Service and Care Coordination
      1. Coordination activities between managed care service coordinators and fee for service programs
      2. Other service and care coordination topics
6. Health and Human Services Commission updates
   1. Medicaid/CHIP Services Advisory Committee appointment updates
   2. Legislative implementation update
   3. Business plan implementation update
7. Texas Government Code, Chapter 533, as amended by Senate Bill 1207, 86th Texas Legislature, Regular Session, 2019: Prior authorization timelines and reconsiderations
8. STAR+PLUS procurement update
9. Uniform Hospital Rate Increase Program
10. Behavioral Health Data Mart
11. Adoption assistance update
12. Recommendation to amend SMMCAC Texas Administrative Code rule
13. Public comment
14. Review of action items and agenda items for future meeting
15. Adjourn and thank you

Public comment may be taken on any agenda item.

Contact: Questions regarding agenda items, content, or meeting arrangements should be directed Maria Acuna, Advisory Committee Coordinator, Medicaid and CHIP Services Department at 512-424-6911 or OPP_SMMCAC@hhsc.state.tx.us.

This meeting is open to the public. No reservations are required, and there is no cost to attend this meeting.

People with disabilities who wish to attend the meeting and require auxiliary aids or services should contact Acuna at 512-424-6911 or OPP_SMMCAC@hhsc.state.tx.us at least 72 hours before the meeting so appropriate arrangements can be made.