February 11, 2019 - 1:30pm

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

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Entry is through security at the main entrance of the building facing Lamar Blvd.

Hearing. The Texas Health and Human Services Commission (HHSC) will conduct a public hearing to receive public comment on proposed Medicaid payment rates for the Medicaid Biennial Calendar Fee Review. The hearing will be held in compliance with Texas Human Resources Code §32.0282, which requires public notice of and hearings on proposed Medicaid reimbursements. HHSC will broadcast the public hearing; the broadcast can be accessed at https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings. The broadcast will be archived and can be accessed on demand at the same website.

Proposal. The payment rates for the Medicaid Biennial Calendar Fee Review are proposed to be effective April 1, 2019, for the following services:

Durable Medical Equipment, Prosthetics, Orthotics, and Supplies – “E” Codes
Unusual TOS 1/2/I/T Combinations
Magnetoencephalography Hospital Diagnostic Radiology (TOS 4)
Magnetoencephalography Rural Hospital Diagnostic Radiology (TOS 4)
Nonclinical Laboratory Services (TOS 5,I,T)
“S” Codes (TOS 1,2,8)
“S” Codes (TOS 9,E,J)
Physician Administered Non Oncology
Physician Administered Vaccines
Physician Administered Drugs Oncology
Medical and Surgical Supplies

Methodology and Justification. The proposed payment rates were calculated in accordance with Title 1 of the Texas Administrative Code:

§355.8021, which addresses the reimbursement methodology for home health services;

§355.8023, which addresses the reimbursement methodology for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS);

§355.8061, which addresses outpatient hospital reimbursement;

§355.8085, which addresses the reimbursement methodology for physicians and other practitioners; and

§355.8441, which addresses the reimbursement methodologies for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services (known in Texas as Texas Health Steps).

Briefing Package. A briefing package describing the proposed payment rates will be available at https://rad.hhs.texas.gov/rate-packets on or after January 28, 2019. Interested parties may obtain a copy of the briefing package before the hearing by contacting Rate Analysis by telephone at (512) 730-7401; by fax at (512) 730-7475; or by e-mail at RADAcuteCare@hhsc.state.tx.us. The briefing package will also be available at the public hearing.

Written Comments. Written comments regarding the proposed payment rates may be submitted instead of, or in addition to, oral testimony until 5 p.m. the day of the hearing. Written comments may be sent by U.S. mail, overnight mail, special delivery mail, hand delivery, fax, or e-mail:

U.S. Mail
Texas Health and Human Services Commission
Attention: Rate Analysis, Mail Code H-400
P.O. Box 149030
Austin, Texas 78714-9030

Overnight mail, special delivery mail, or hand delivery
Texas Health and Human Services Commission
Attention: Rate Analysis, Mail Code H-400
Brown-Heatly Building
4900 North Lamar Blvd
Austin, Texas 78751

Phone number for package delivery: (512) 730-7401

Attention: Rate Analysis at (512) 730-7475


Persons with disabilities who wish to attend the hearing and require auxiliary aids or services should call Rate Analysis at (512) 730-7401 at least 72 hours before the hearing so appropriate arrangements can be made.