February 14, 2019 - 9:00am

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

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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. Opening comments
  2. Medicaid Director’s update; Medicaid and Children’s Health Insurance Program activities
  3. Approval of November 8, 2018, meeting minutes (Vote required)

    ACTION ITEMS

  4. Preadmission Screening and Resident Review Specialized Services Habilitation Coordination

    The Health and Human Services Commission (HHSC) proposes the repeal of Texas Administrative Code (TAC) Title 40, Part 1, Chapter 17, and new TAC Title 26, Chapter 303, concerning preadmission screening and resident review. The reason for repealing TAC, Title 40, Part 1, Chapter 17, and adopting new TAC, Title 26, Part 1, Chapter 303, is to consolidate HHSC rules in Title 26, Part 1. Many of the proposed new sections are similar to repealed sections.

     - Haley Turner, Associate Commissioner, Intellectual and Developmental Services, HHSC

  5. Managed Care Organization Recovery Rules

    HHSC proposes amendments to TAC Title 1, Part 15, Chapter 353, Subchapter F, §353.502, concerning Managed Care Organizations’ Plans and Responsibilities in Preventing and Reducing Waste, Abuse, and Fraud, and §353.505, concerning Recovery of Funds; and Chapter 371, Subchapter F, §371.1311, concerning the Role of the OIG and SIUs. The amendments will implement various provisions of House Bill 2379, 85th Legislature, Regular Session, 2017, and update procedures the managed care organizations must follow to refer cases to the HHSC Office of the Inspector General.

     - Anne Dvorak, Director of Program Integrity Development and Support, HHSC-OIG Medicaid Program Integrity and Medical Services Division

     - Patrick Myers, HHSC-OIG Senior Counsel

  6. Closing Investigations

    HHSC proposes amendments to TAC Title 1, Part 15, Chapter 371, Subchapter F, §371.1305, concerning Preliminary Investigation and §371.1307, concerning Full Investigation and to add new rule, §371.1312, concerning Recipient Investigations. As recommended by the Sunset Commission, the proposed amendments and the new rule formalize criteria for prioritizing and closing cases.

     - Anne Dvorak, Director of Program Integrity Development and Support, HHSC-OIG Medicaid Program Integrity and Medical Services Division

  7. Home and Community-Based Services – Adult Mental Health (HCBS-AMH) Program

    HHSC proposes the repeal of TAC Title 25, Part 1, Chapter 416, Subchapter B, §§416.51 to 416.58 and proposes new TAC, Title 26, Part 1, §§307.51 to 307.57, concerning HHSC Home and Community-based Services—Adult Mental Health Program

     - Sonja Gaines, Home and Community-Based Services – Adult Mental Health

     INFORMATIONAL ITEMS

  8. Direct Graduate Medical Education Reimbursement

    HHSC proposes an amendment to TAC Title 1, Part 15, Chapter 355, Subchapter J, Division 4, §355.8058, concerning Inpatient Direct Graduate Medical Education Reimbursement.

     - Rene Cantu, Director, Hospital Rate Analysis

  9. Public comment

  10. Proposed next meeting: June 13, 2019, at 9:00 a.m.

  11. Adjourn

Contact: Questions regarding agenda items, content, or meeting arrangements should be directed to Camille Weizenbaum, Medicaid and CHIP Services Department, 512-487-3446, Camille.Weizenbaum@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 Weizenbaum at 512-487-3446 at least 72 hours before the meeting so appropriate arrangements can be made.