October 11, 2018 - 2:00pm

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

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Hearing. The Texas Health and Human Services Commission (HHSC) will conduct a public hearing to receive comments on the proposed amendments to §355.8201, concerning Waiver Payments to Hospitals for Uncompensated Care. The proposed amendments to §355.8201 were published in the September 21, 2018 issue of the Texas Register (43 TexReg 6043).

The purpose of the amendment is to alter the final payment methodology for the Uncompensated Care (UC) program in demonstration years 7 and 8. HHSC previously proposed an amendment to 1 TAC §355.8201 on July 27, 2018 (43 TexReg 4911). HHSC withdrew the proposed amendment on September 10, 2018 but has included those changes in this proposed rule.

  • §355.8201(a) establishes effective dates and adds a reference to rule §355.8212 related to Waiver Payments to Hospitals for Uncompensated Charity Care. Updates to numbering and clarifying language is included throughout this proposed rule update in addition to the new items outlined below;
  • §355.8201(b)(20) replaces “Rider 38 hospital” with “Rural hospital” and limits the types of hospitals that qualify. New §355.8201(b)(26) defines “Urban Rural Referral Center.”;
  • §355.8201(c)(3)(A) adds another change that may affect eligibility for uncompensated-care payments. A portion of the last sentence is deleted regarding requiring uncompensated-care applications since applications are no longer used in the reconciliation process and replaced with the requirement for the hospital to cooperate in the reconciliation process. A change to §355.8201(c)(3)(B) adds “Department” to the end of “HHSC Rate Analysis.”;
  • §355.8201(e) updates the sentence to provide that the waiver payment schedule will be posted on HHSC’s website. Section 355.8201(e)(1) and (2) are deleted;
  • §355.8201(f) deletes §355.8201(f)(2)(B) and replaces it with new §355.8201(f)(2)(B) which allows for a set aside for urban RRCs for demonstration year 7 only. Changes to §355.8201(f)(2)(C)(i)(II) and (III) replaces “non-Rider 38” with “non-rural” and “non-rural and non-urban RRC.” Section 355.8201(f)(2)(C)(iii)(I)(-c-) and Section 355.8201(f)(2)(C)(iii)(III)(-d-) are deleted and edits are made for division organization;
  • §355.8201(g) joins §355.8201(g)(1)(A) and §355.8201(g)(1)(A)(i). Section 355.8201(g)(1)(A)(ii) and 355.8201(g)(1)(C) is deleted. A change to §355.8201(g)(5)(F) updates a reference and replaces “Rider 38” with “rural” and “non-Rider 38” with “non-rural and non-urban RRC.” New §355.8201(g)(5)(G) describes the method for determining the final payment for urban RRCs as well as a method to reduce those payments in the event that the aggregate pool limit is exceeded;
  • §355.8201(i) updates the sentence to provide generally that HHSC will reconcile actual costs for the demonstration year. Section 355.8201(i)(3) is deleted and the paragraphs are renumbered. A new 355.8201(i)(4) is added regarding the reporting requirements for the reconciliation process. 

The amendments are proposed to be adopted in November 2018 and will apply to services provided between October 1, 2017, and September 30, 2019. The hearing will be held in compliance with Texas Human Resources Code §32.0282, which requires public notice of and hearings on proposed Medicaid reimbursement rates.

Written Comments. Written comments regarding the proposed payment rates may be submitted in lieu of, or in addition to, oral testimony until 5:00 p.m. Monday, October 22, 2018. Written comments may be sent by U.S. mail, overnight mail, special delivery mail, hand delivery, fax, or email:

U.S. Mail:

Texas Health and Human Services Commission
Attn. Mariah Ramon, Project Manager
P.O. Box 149030
Mail Code H-100
Austin, Texas 78714-9030

Overnight mail, special delivery mail or hand delivery:

Texas Health and Human Services Commission
Attn. Mariah Ramon, Project Manager
4900 North Lamar
Austin, Texas 78751-2316

Phone number for package delivery: 512-730-7402.

E-mail: UCTools@hhsc.state.tx.us. When e-mailing comments, please indicate "Comments on Proposed Rule 18R076" in the subject line.

Persons with disabilities who wish to attend the hearing and require auxiliary aids or services should contact Rate Analysis at (512) 730-7402 at least 72 hours prior to the hearing so appropriate arrangements can be made.