November 19, 2020 - 1:00pm

Add to My Calendar

Due to the COVID-19 pandemic, this meeting will be conducted virtually using Microsoft Teams only.  Join the meeting here

Closed captioning for this meeting is available. Viewers are asked to highlight the closed captioning symbol "cc" on the bottom of their viewing screen to enable this function. 

There is not a physical location for this meeting.

Attendees who would like to provide public comment should see the Public Comment section below.

  1. Call to order, roll call, and opening remarks
  2. Adoption of August 26, 2020, minutes (vote required)
  3. Election of Vice Chair (vote required)
  4. Advisory Committee chair updates
    1. Hospital Payment Advisory Committee
    2. Intellectual and Developmental Disability System Redesign Advisory Committee
    3. Medical Care Advisory Committee
    4. Perinatal Advisory Committee
    5. Policy Council for Children and Families
    6. STAR Kids Managed Care Advisory Committee
    7. STAR+PLUS Pilot Program Workgroup
  5. State Medicaid Managed Care Advisory Committee subcommittee updates
    1. Administrative simplification
      1. Durable medical equipment administrative simplification pilot project for individuals enrolled in STAR Kids and the Medically Dependent Children’s Program
      2. Provider management and enrollment system
      3. Other administrative simplification topics
    2. Clinical oversight and benefits
      1. Medical benefits process
      2. Update on continuous glucose monitoring benefit
      3. Update on RELiZORB topic nomination
      4. Implementation of Texas Government Code § 533.005, as adopted by Senate Bill 1177, 86th Legislature, Regular Session (2019), concerning evidence-based behavioral health services in lieu of state plan services
      5. Other clinical oversight and benefits topics
    3. Complaints, appeals, and fair hearings
      1. External medical review implementation
      2. Update on open enrollment for external medical review services
      3. Other complaints, appeals, and fair hearings topics
    4. Network adequacy and access to care
      1. Network rosters
      2. Update on options for remote delivery for federal qualified health centers and rural health clinics
      3. Texas Government Code 541 and 2020-21 General Appropriations Act, 86th Legislature, Regular Session, article II, at II-74, Rider 94, at II-74 (Health and Human Services, Health and Human Services Commission) (2019), concerning pediatric tele-connectivity resource program for rural Texas
      4. Delivery System Reform Incentive Program M-9 Milestone: Assessment of telemedicine and telehealth services
      5. Other network adequacy and access to care topics
    5. Service and care coordination
      1. Overview of managed care organization service coordination processes and roles
      2. Coordination between managed care service coordinators and other case management entities
      3. Service coordination during the COVID-19 emergency
      4. Other service and care coordination topics
  6. Health and Human Services Commission (HHSC) updates
    1. Business plan
    2. Legislative implementation
  7. Decline in care for children in Medicaid and Children’s Health Insurance Program due to the COVID-19 pandemic
  8. Committee discussion: Restructuring State Medicaid Managed Care Advisory Committee subcommittees
  9. State Medicaid Managed Care Advisory Committee reports to the Executive Commissioner and Legislature (vote required)
  10. Draft amendments to the State Medicaid Managed Care Advisory Committee Texas Administrative Code rule (Title 1, Texas Administrative Code, §351.805)
  11. Committee discussion: Review of State Medicaid Managed Care Advisory Committee bylaws
  12. Public comment
  13. Review of action items and agenda items for future meeting
  14. Adjourn and thank you

The committee may take action on any agenda item.

Public Comment: HHSC welcomes public comments pertaining to topics related to State Medicaid Managed Care Advisory Committee. Members of the public who would like to provide public comment are asked to complete a Public Comment Form here.

Members of the public are encouraged to participate in this process by providing written public comment to HHSC by emailing no later than 5:00 p.m. on Tuesday, November 17, 2020. Please include your name and either the organization you are representing or that you are speaking as a private citizen. Written comments are limited to three minutes and will be read during the meeting for consideration by the Committee. 

If you would like to register to provide oral comments, please mark the correct box on the registration form. Instructions for providing oral comment and information about joining the meeting will be emailed to you. Registration must be completed no later than 5:00 p.m. on Tuesday, November 17, 2020. Members of the public may also use the Microsoft Teams Live Event Q&A section to submit a request to provide public comment. The request must contain your name, either the name of the organization you are representing or that you are speaking as a private citizen, and your direct phone number.

Public comment is limited to three minutes. Speakers must state their name, affiliation, and on whose behalf they are speaking. Public members who are using handouts are asked to provide an electronic copy in accessible PDF format that will be distributed by HHS staff to Council members, State staff, and the public. Handouts are limited to two pages (paper size: 8.5” by 11”, one side only). Handouts must be emailed to HHSC staff immediately after registering and include the name of the person who will be commenting.

Contact: Questions regarding agenda items, content, or meeting arrangements should be directed to Pramila Nepal, Advisory Committee Coordinator, Medicaid and CHIP Services Department at 512-647-8853 or

This meeting is open to the public. No reservations are required, and there is no cost to attend this meeting.

Persons who want to attend the meeting and require assistive technology or services should contact Nepal at 512-647-8853 or at least 72 hours before the meeting so appropriate arrangements can be made.