May 27, 2020 - 1:30pm

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Due to the declared state of disaster stemming from COVID-19, this hearing will now be conducted online only.  No physical entry to the hearing will be permitted.

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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.  The hearing will be conducted online, recorded, and the recording will be made available on the HHSC website.

Proposal.  The payment rates for the Medicaid Biennial Calendar Fee Review are proposed to be effective September 1, 2020, for the following services:

Cardiovascular System Surgery
Digestive System Surgery
Eye and Ocular Adnexa Surgery
G Codes
Physician Administered Drugs – Non-Oncology
Physician Administered Drugs - Vaccines
Proton Therapy
T Codes
Urinary System Surgery
Vision Devices
End Date Procedure Code List

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

§355.8001, which addresses the reimbursement methodology for vision care services;

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

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

§355.8121, which addresses the reimbursement for ambulatory surgical centers; 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 Packet.  A briefing packet describing the proposed payment rates was made available at https://rad.hhs.texas.gov/rate-packets on May 12, 2020.  Interested parties may obtain a copy of the briefing packet 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

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, 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 or special delivery mail
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 packet delivery: (512) 730-7401

Fax
Attention:  Rate Analysis at (512) 730-7475

E-mail
RADAcuteCare@hhsc.state.tx.us

Preferred Communication.  During the current state of disaster due to COVID-19, physical forms of communication are checked with less frequency than during normal business operations.  For quickest response, and to help curb the possible transmission of infection, please turn to e-mail or phone if possible for communication with HHSC related to this rate hearing.

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.