June 12, 2015 Health and Human Services Commission Council
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Item 1 - Call to Order
Item 1
Call to Order
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Item 2 - Approval of the November 21, 2014 Council Meeting minutes and February 27, 2015 notes
Item 2
Approval of the November 21, 2014 Council Meeting minutes and February 27, 2015 notes
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Item 3 - Executive Commissioner’s Status Report: Update from the 84th Legislative Session (budget, legislation, cost containment, contracting)
Item 3
Executive Commissioner’s Status Report: Update from the 84th Legislative Session (budget, legislation, cost containment, contracting)
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Item 4A - Information Presentations.
Sunset Update
Item 4A
Information Presentations.Sunset Update
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Item 4B - Information Presentations.
1115 Transformation Waiver Update
Item 4B
Information Presentations.1115 Transformation Waiver Update
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Item 5A - Methodology for Incentives for Safety Net Hospitals, Chapter 354: The Health and Human Services Commission (HHSC) proposes to amend Title 1, Part 15, Chapter 354, Subchapter A, Division 35, §354.1445 (relating to Potentially Preventable Readmissions) and §354.1446 (relating to Potentially Preventable Complications). The rules are being amended to identify a methodology for incentives for HHSC defined safety net hospitals
Item 5A
Methodology for Incentives for Safety Net Hospitals, Chapter 354: The Health and Human Services Commission (HHSC) proposes to amend Title 1, Part 15, Chapter 354, Subchapter A, Division 35, §354.1445 (relating to Potentially Preventable Readmissions) and §354.1446 (relating to Potentially Preventable Complications). The rules are being amended to identify a methodology for incentives for HHSC defined safety net hospitals
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Item 5B - Minimum Payment Amounts to Qualified Nursing Facilities: Information on rule amendments to §353.608 to add a third eligibility period, Eligibility Period Two-A
Item 5B
Minimum Payment Amounts to Qualified Nursing Facilities: Information on rule amendments to §353.608 to add a third eligibility period, Eligibility Period Two-A
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Item 5C - Inpatient Hospital Reimbursement: Information on rule amendments to Title 1, Part 15, Chapter 355, Subchapter J, Division 4, Rule §355.8052, Inpatient Hospital Reimbursement
Item 5C
Inpatient Hospital Reimbursement: Information on rule amendments to Title 1, Part 15, Chapter 355, Subchapter J, Division 4, Rule §355.8052, Inpatient Hospital Reimbursement
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Item 5D - Outpatient Hospital Reimbursement: Information on rule amendments to Title 1, Part 15, Chapter 355, Subchapter J, Division 4, Rule §355.8061, Outpatient Hospital Reimbursement
Item 5D
Outpatient Hospital Reimbursement: Information on rule amendments to Title 1, Part 15, Chapter 355, Subchapter J, Division 4, Rule §355.8061, Outpatient Hospital Reimbursement
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Item 5E - Outpatient Hospital Reimbursement: Information on rule amendments to Title 1, Part 15, Chapter 355, Subchapter J, Division 4, Rule §355.8061, Outpatient Hospital Reimbursement
Item 5E
Outpatient Hospital Reimbursement: Information on rule amendments to Title 1, Part 15, Chapter 355, Subchapter J, Division 4, Rule §355.8061, Outpatient Hospital Reimbursement
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Item 5G - HHSC Enterprise Contracting and Procurement, Chapter 391: Information on new Chapter 391 to clarify the contracting and procurement requirements for all health and human services agencies. Chapter 391 provides a clear template for HHSC contracting requirements for vendors and the public at large
Item 5G
HHSC Enterprise Contracting and Procurement, Chapter 391: Information on new Chapter 391 to clarify the contracting and procurement requirements for all health and human services agencies. Chapter 391 provides a clear template for HHSC contracting requirements for vendors and the public at large
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Item 5F - Office of Inspector General: relating to subpoena authority, provider disclosure and screening, general provisions as well as administrative actions and sanctions, repealing Title 1, Part 15, §371.21 and amending §§371.1003, 371.1013, 371.1607, 371.1609, 371.1615, 371.1709 and 371.1711
Item 5F
Office of Inspector General: relating to subpoena authority, provider disclosure and screening, general provisions as well as administrative actions and sanctions, repealing Title 1, Part 15, §371.21 and amending §§371.1003, 371.1013, 371.1607, 371.1609, 371.1615, 371.1709 and 371.1711
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Item 6 & Item 7 - Action Items Related to Rules.
Vision Services, Chapter 355: The Medicaid and Children's Health Insurance Program (CHIP) Division proposes to amend Title 1, Part 15, Chapter 355, Subchapter J, Division 1, §355.8001 (relating to Reimbursement for Vision Care Services). The proposed amendments correct a cross reference and make other nonsubstantive language changes. The amendments to this rule are being proposed in order to coincide with other changes to rules in Chapters 354 and 363 also related to vision care.
Vision Services, Chapter 354: The Medicaid and CHIP Division proposes to amend §354.1015, 354.1017, 354.1021, 354.1023, and 354.1025 to update and simplify rule requirements related to vision care. Simplifying these rules allows HHSC more flexibility in developing timely and evidence-based medical policy.
Vision Services, Chapter 363: The Medicaid and CHIP Division proposes to amend §363.501, 363.502, 363.503, and 363.504 to update and simplify rule requirements related to the Early and Periodic Screening, Diagnosis and Treatment Eyeglass Program. Simplifying these rules allows HHSC more flexibility in developing timely and evidence-based medical policy.
Durable Medical Equipment Exceptional Circumstance: HHSC is clarifying the requirements for durable medical equipment to qualify for Medicaid reimbursement as part of home health services under "exceptional circumstances" as noted in subparagraph (a)(4)(D) of 1 TAC §354.1039.
Tuberculosis (TB) Institution Exclusion: The Social Security Act historically precluded participation in Medicaid by an institution for tuberculosis, but the exclusion was removed. The proposed amendments remove the prohibition against a TB institution receiving Texas Medicaid payment for inpatient services.
Adjourn
Item 6 & Item 7
Action Items Related to Rules.Vision Services, Chapter 355: The Medicaid and Children's Health Insurance Program (CHIP) Division proposes to amend Title 1, Part 15, Chapter 355, Subchapter J, Division 1, §355.8001 (relating to Reimbursement for Vision Care Services). The proposed amendments correct a cross reference and make other nonsubstantive language changes. The amendments to this rule are being proposed in order to coincide with other changes to rules in Chapters 354 and 363 also related to vision care.
Vision Services, Chapter 354: The Medicaid and CHIP Division proposes to amend §354.1015, 354.1017, 354.1021, 354.1023, and 354.1025 to update and simplify rule requirements related to vision care. Simplifying these rules allows HHSC more flexibility in developing timely and evidence-based medical policy.
Vision Services, Chapter 363: The Medicaid and CHIP Division proposes to amend §363.501, 363.502, 363.503, and 363.504 to update and simplify rule requirements related to the Early and Periodic Screening, Diagnosis and Treatment Eyeglass Program. Simplifying these rules allows HHSC more flexibility in developing timely and evidence-based medical policy.
Durable Medical Equipment Exceptional Circumstance: HHSC is clarifying the requirements for durable medical equipment to qualify for Medicaid reimbursement as part of home health services under "exceptional circumstances" as noted in subparagraph (a)(4)(D) of 1 TAC §354.1039.
Tuberculosis (TB) Institution Exclusion: The Social Security Act historically precluded participation in Medicaid by an institution for tuberculosis, but the exclusion was removed. The proposed amendments remove the prohibition against a TB institution receiving Texas Medicaid payment for inpatient services.
Adjourn
