Hearing. Health and Human Services Commission (HHSC) will conduct a public hearing to receive comments on the proposed new rules §§353.1101, 353.1103, 353.1105, 353.1107, 353.1109, 353.1111, 353.1113, and 353.1115 under Part 15, Chapter 353, Subchapter L Texas Dual Eligibles Integrated Care Demonstration Project.  The proposed new rules were published in the January 16, 2015, issue of the Texas Register.

Federal law created the Federal Coordinated Health Care Office ("Medicare-Medicaid Coordination Office"). This office is charged with supporting the coordination of Medicare and Medicaid to allow the two programs to work together more effectively to improve care and lower costs. The Financial Alignment Demonstration, also referred to as the Dual Demonstration, was created by the Medicare-Medicaid Coordination Office.

In May 2014, HHSC received federal approval to implement the Dual Demonstration, a fully integrated, capitated model that involves a three-party agreement between a managed care organization with an existing STAR+PLUS contract, HHSC, and the Centers for Medicare and Medicaid Services for the provision of the full array of Medicare and Medicaid services. The initiative will test an innovative payment and service delivery model to alleviate fragmentation and improve coordination of services for dual eligibles, enhance quality of care, and reduce costs for both the state and federal government. The Dual Demonstration is scheduled to begin March 1, 2015, and will continue until December 31, 2018.

The proposed new rules outline the major differences and impacts the Dual Demonstration has on dual eligibles compared to the current STAR+PLUS rules. The proposed new rules describe member participation, member enrollment and disenrollment, participating providers, benefits, appeals and fair hearings, network adequacy standards, and accessibility of services.

Written Comments.  Written comments on the proposed amendments to the rule may be submitted to Rhyne Simon, Program Specialist, Medicaid and Children's Health Insurance Program Division, HHSC, at 4900 N Lamar Blvd, Austin, Texas 78751 or by email to rhyne.simon@hhsc.state.tx.us within 30 days of publication of this proposal in the Texas Register.