Read more information on the Health and Human Services Council, including meeting agendas and council member biographies.

Overview

Administrative rules are published in the Texas Register to give the public notice of a state agency's proposed rulemaking action and to allow people to review and comment on the proposed rule.

The public comment period begins on the day after the notice of a proposed rule is published in the Texas Register and lasts usually for 30 days. The notice will tell you where to submit comments. Once effective, rules become part of the Texas Administrative Code.

To get email notification of HHSC's rulemaking actions contact the Texas Register at register@sos.state.tx.us.

The rules listed here have been presented to the Health and Human Services Council and approved for publication in the Texas Register by the executive commissioner of HHSC. The rules are listed in the order they appeared on the council meeting agenda. The links will take you to the table of contents in the Texas Register. Scroll down to find the rule notice you wish to view and click on the provided link. See the Health and Human Services Council agendas for more information on proposed rules.

November 17, 2016

Agenda Item 2a: Concerning the Health Insurance Premium Payment (HIPP) program.

The Health and Human Services Commission (HHSC) proposes new §354.2361, in Title 1 Texas Administrative Code (TAC), Part 15, Chapter 354, Medicaid Health Services, Subchapter J, Division 7, concerning the Health Insurance Premium Payment (HIPP) program

Agenda Item 2a published as proposed: 12/23/16

Agenda Item 2a published as adopted: 3/10/17

Effective date: 3/15/17

Agenda Item 2b:  Telemedicine and Telehealth Benefits and Limitations

HHSC proposes amendments to §354.1432, in Title 1 TAC, Part 15, Chapter 354, Medicaid Health Services, Subchapter A, Division 33, concerning Telemedicine and Telehealth Benefits and Limitations

Agenda Item 2b published as proposed: 12/23/16:  

Agenda Item 2b published as adopted: 3/17/17:

Effective date: 3/21/17

Agenda Item 2c: Concerning Terminology and Reference Updates.

HHSC proposes amendments to certain sections in Title 1 TAC, Part 15, Chapter 354, Medicaid Health Services, and Chapter 355, Reimbursement Rates, concerning Terminology and Reference Updates

Agenda Item 2c published as proposed: 12/23/16

Agenda Item 2c published as adopted: 3/10/17

Effective date: 3/15/17

Agenda Item 2d: Concerning Outpatient Hospital Reimbursement.

HHSC proposes amendments to §355.8061 in Title 1 TAC, Part 15, Chapter 355, Reimbursement Rates, Subchapter J, Division 4, concerning Outpatient Hospital Reimbursement.

Agenda Item 2d published as proposed: 11/4/16:

Agenda Item 2d published as adopted: 1/27/17:

Effective date: 1/31/17

Agenda Item 2e: Concerning Children's Advocacy Programs.

HHSC proposes new sections, in Title 1 TAC, Part 15, Chapter 377, concerning Children's Advocacy Programs

Agenda Item 2e published as proposed: 12/23/16:

Agenda Item 2e published as adopted:

Effective date:

Agenda Item 4b: Proposed Rules for the Ombudsman for Children and Youth in Foster Care

The Texas Health and Human Services Commission (HHSC) proposes to amend Texas Administrative Code Title 1, Part 15, Chapter 351, by adding a new Subchapter B, Ombudsman Services, Division 2, Ombudsman for Children and Youth in Foster Care.

Agenda Item 4b published as proposed: 8/26/16:

Agenda Item 4b published as adopted: 1/13/17:

Effective date: 1/16/17

Sept. 23, 2016

Agenda Item 3b: Reimbursement Methodology for Home and Community-Based Services and Texas Home Living Programs
HHSC proposes amendments to §355.723, in Title 1 TAC, Part 15, Chapter 355, Subchapter F, concerning Reimbursement Methodology for Home and Community-Based Services and Texas Home Living Programs.

Agenda Item 3b published as proposed: 11/4/16 Agenda Item 3b published as adopted Effective date:

Aug. 19, 2016

Agenda Item 4a: Proposed Rules for the HHS Executive Council
The Texas Health and Human Services Commission (HHSC) proposes new Title 1, Part 15, Chapter 351, Subchapter A, §351.4, concerning Health and Human Services Commission Executive Council.

Agenda Item 4a published as proposed: 07/29/16 Agenda Item 4a published as adopted: 10/14/2016 Effective date: 10/23/16

May 20, 2016

Agenda Item 6a: DSRIP Program Transition Year - September
HHSC proposes Title 1, Part 15, Chapter 354, Subchapter D, new Division 6, concerning DSRIP Program Transition Year, and new sections §§354.1661, 354.1663, 354.1665, 354.1667, 354.1669, 354.1671, 354.1673, and 354.1675 within the new division. HHSC also proposes to amend Chapter 354, Subchapter D, Division 3, section §354.1624, concerning Independent Assessment of DSRIP Projects.

Agenda Item 6a published as proposed: 7/29/16 Agenda Item 6a published as adopted:10/21/16 Effective date: 10/30/16

Agenda Item 6c: STAR Kids, STAR+PLUS, STAR Health, and Home and Community-Based Services
HHSC proposes amendments to Title 1, Part 15, Chapter 353 (relating to Medicaid Managed Care): Subchapter A (relating to General Provisions), §353.2, concerning Definitions; Subchapter G (relating to STAR+PLUS), §353.603; and Subchapter H (relating to STAR Health), concerning Member Participation; §353.701, concerning General Provisions; and §353.702, concerning Member Participation.

HHSC proposes new Subchapter M, concerning Home and Community Based Services in Managed Care, including new §§353.901, 903, and 905. HHSC also proposes new Subchapter N, concerning STAR Kids, including new §§353.1201 to 353.1209.

Agenda Item 6c published as proposed: 7/22/16 Agenda Item 6c published as adopted:10/21/16 Effective date: 11/1/16

Agenda Item 6d: Eligibility and Related Rules for Medicaid for the Elderly and People with Disabilities
HHSC proposes amendments to Title 1 Chapter 358, Subchapter C, Division 6, §358.431, concerning Definitions.

Agenda Item 6d published as proposed: 8/5/16: Agenda Item 6d published as adopted: 11/25/16: Effective date: 11/29/16

Agenda Item 6e: Financial Eligibility Exclusions for Medicaid for the Elderly and People with Disabilities
HHSC proposes new §358.357, concerning Achieving a Better Life Experience Program; §358.358, concerning School-Based Savings Program; §358.389, concerning Achieving a Better Life Experience Program; and §358.390, concerning School-Based Savings Program.

Agenda Item 6e published as proposed: 8/5/16: Agenda Item 6e published as adopted:11/11/16: Effective date: 11/20/16

Agenda Item 6f: Financial Eligibility Exclusions for Medicare Savings Programs
HHSC proposes to amend §359.103, concerning the Qualified Medicare Beneficiary Program and §359.109, concerning the Qualified Disabled and Working Individual Program.

Agenda Item 6f published as proposed: 8/5/16: Agenda Item 6f published as adopted: 11/11/16: Effective date: 11/20/16

Agenda Item 6g: Regarding Financial Eligibility Exclusions for Medicaid Buy-In Programs
HHSC proposes amendments to §360.113, concerning Resources.

Agenda Item 6g published as proposed: 8/5/16: Agenda Item 6g published as adopted: 11/11/16: Effective date: 11/20/16

Agenda Item 6h: Financial Eligibility Exclusions for the Medicaid Buy-In for Children Program
HHSC proposes amendments to §361.111, concerning Income.

Agenda Item 6h published as proposed:8/5/16: Agenda Item 6h published as adopted: 11/11/16: Effective date: 11/20/16

Agenda Item 6i: Eligibility Rules for Medicaid programs
HHSC proposes amendments to §366.319, concerning Child Support and Medical Support; §366.703 and §366.707, concerning Medicaid for Parents and Caretaker Relatives; §366.821 and §366.847, concerning Medically Needy Program; and §366.1107, concerning Determination of Household Composition.

Agenda Item 6i published as proposed: 8/5/16: Agenda Item 6i published as adopted: 11/11/16: Effective date: 11/20/16

Agenda Item 6j: Eligibility Rules for the Children's Health Insurance Program (CHIP)
HHSC proposes amendments to 1 Texas Administrative Code (TAC) Chapter 370 concerning the State Children's Health Insurance Program (CHIP) to align the rules with federal law and current HHSC policy and processes.

Agenda Item 6j published as proposed: 8/5/16: Agenda Item 6j published as adopted: 11/11/16: Effective date: 11/20/16

Agenda Item 6k: Eligibility and Related Rules for Temporary Assistance for Needy Families (TANF) and the Supplemental Nutrition Assistance Program (SNAP)
HHSC proposes amendments to 1 Texas Administrative Code (TAC) §372.354, concerning Treatment of Resources in TANF; §372.355, concerning Treatment of Resources in SNAP; §372.404, concerning Countable and Excluded Income in TANF; §372.406, concerning Countable and Excluded Income in SNAP; §372.802, concerning One-Time TANF Eligibility Requirements; §372.1153, concerning Personal Responsibility Agreement Requirements; and §372.1154, concerning Cooperating with Personal Responsibility Agreement Requirements.

Agenda Item 6k published as proposed: 8/5/16: Agenda Item 6k published as adopted: 11/11/16: Effective date: 11/20/16

Feb. 26, 2016

Agenda Item 5d: State Children's Health Insurance Program (CHIP) Enrollment
HHSC proposes amendments to Title 1, Part 15, Chapter 370, Subchapter C, Division 1, §370.303, concerning Completion of Enrollment.

Agenda Item 5d published as proposed: 5/13/16 Agenda Item 5d published as adopted: 9/30/16 Effective date: 10/9/16

Feb. 26, 2016

Agenda Item 4a: Provider Enrollment
The Texas Health and Human Services Commission (HHSC) proposes amendments to Texas Administrative Code Title 1 Part 15, Chapter 352, §352.3, concerning Definitions; §352.7, concerning Applying for Enrollment; §352.9, concerning Screening Levels; and §352.21, concerning Duty to Report Changes.

Agenda Item 4a published as proposed: 2/12/16: Agenda Item 4a published as adopted: 4/29/16: Effective date: 5/2/16

Agenda Item 4b:Potentially Preventable Readmissions and Potentially Preventable Complications:
HHSC proposes to amend Title 1, Part 15, Chapter 354, Subchapter A, Division 35, §354.1445, relating to Potentially Preventable Readmissions and §354.1446, relating to Potentially Preventable Complications.

Agenda Item 4b published as proposed: 2/5/16: Agenda Item 4b published as adopted: 5/6/16: Effective date: 5/15/16

Agenda Item 4d:Minimum Payment Amounts to Qualified Nursing Facilities
HHSC proposes amendments to Title 1, Part 15, Chapter 353, Subchapter G, §353.608, concerning Minimum Payment Amounts to Qualified Nursing Facilities.

Agenda Item 4d published as proposed: 3/4/16: Agenda Item 4d published as adopted: 5/13/16: Effective date: 5/22/16

Agenda Item 4e:Refugee Resettlement Program
HHSC proposes new §375.701 and new §376.1001 to Title 1, Part 15 of the Texas Administrative Code, both concerning Local Governmental and Community Input.

Agenda Item 4e published as proposed: 2/5/16: Agenda Item 4e published as adopted:4/22/16: Effective date: 5/1/16

Agenda Item 4f: Office of Inspector General (OIG) Statistical Sampling
HHSC proposes new §371.35 to Title 1, Part 15, Chapter 371, Subchapter B, concerning Sampling and Extrapolation.

Agenda Item 4f published as proposed: 3/4/16: Agenda Item 4f published as adopted: 5/6/16: Effective date: 5/15/16

Agenda Item 5a:Medicaid and Other Health and Human Services Fraud and Abuse Program Integrity
HHSC proposes amendments to Title 1, Part 15, Chapter 371, Subchapter B, §371.1, concerning Definitions, and Subchapter E, §371.1001, concerning Applicability; §371.1005, concerning Disclosure Requirements; §371.1009, concerning Verifications Required for Each Screening Level; §371.1011, concerning Recommendation Criteria; and §371.1015, concerning Types of Provider Enrollment Recommendations.

Agenda Item 5a published as proposed: 1/29/16: Agenda Item 5a published as adopted:4/22/16: Effective date: 5/1/16

Agenda Item 5b:School Health and Related Services (SHARS) Program Conditions for Participation:
HHSC proposes amendments to Title 1, Part 15, Chapter 354, Subchapter A, Division 25,
§354.1342, Conditions for Participation.

Agenda Item 5b published as proposed: 4/1/16: Agenda Item 5b published as adopted: Effective date:

Agenda Item 5e:HHSC Advisory Committees
HHSC proposes new Title 1, Part 15, Chapter 351, Subchapter B, Advisory Committees, §§351.801-351.837; and proposes the repeal of Title 1, Part 15, Chapter 351, §351.3, Purpose, Task and Duration of Advisory Committees.

Agenda Item 5e published as proposed: 4/15/16: Agenda Item 5e published as adopted: : Effective date:

Agenda Item 5d: State Children's Health Insurance Program (CHIP) Enrollment
HHSC proposes amendments to Title 1, Part 15, Chapter 370, Subchapter C, Division 1, §370.303, concerning Completion of Enrollment.

Agenda Item 5d published as proposed: 5/13/2016: Agenda Item 5d published as adopted: : Effective date:

Agenda Item 5f:Unrelated Donor Umbilical Cord Blood Bank Program Funding
HHSC proposes to amend Title 1, Part 15, Chapter 351, §351.701, relating to the Unrelated Donor Umbilical Cord Blood Bank Program.

Agenda Item 5f published as proposed: 3/25/16: Agenda Item 5f published as adopted: Effective date:

Agenda Item 5g:Supplemental Nutrition Assistance Program (SNAP) Disqualifications Due to Criminal Activity
HHSC proposes to amend 1 TAC §372.501, concerning Disqualifications Due
to Criminal Activity.

Agenda Item 5g published as proposed: 4/29/16: Agenda Item 5g published as adopted: : Effective date:

Nov. 20, 2015

Agenda Item 4a: Personal Care Services Attendant Minimum Wages.
The Texas Health and Human Services Commission (HHSC) proposes to amend Title 1, Part 15, Chapter 363, Subchapter F, § 363.603, relating to Provider Participation Requirements in the Personal Care Services (PCS) program.

Agenda Item 4a published as proposed:11/6/2015 Agenda Item 4a published as adopted: 2/5/16 Effective date: 2/14/16

Agenda Item 4b: Education and Training Assistance.
HHSC proposes new Title 1, Part 15, Chapter 396, concerning Employee Training and Education. Within the proposed new chapter, HHSC proposes §§ 396.1, concerning Purpose and Applicability; and 396.2, concerning Education and Training Assistance.

Agenda Item 4b published as proposed: 11/27/15 Agenda Item 4b published as adopted: 2/19/16 Effective date: 2/25/16

Agenda Item 4d: Vendor Drug Program Medicaid Audit Appeals. HHSC proposes to amend Title 1, Part 15, Chapter 354, Subchapter F, Division 5, §354.1891, Vendor Drug Providers Subject to Audit.

Agenda Item 4d published as proposed: 11/6/15 Agenda Item 4d published as adopted: 2/19/16 Effective date: 2/25/16

Agenda Item 5a: Community First Choice
HHSC proposes amendments to Texas Administrative Code, Title 1, Part 15, Chapter 354, Subchapter A, Division 27, §§ 354.1361, concerning Definitions; 354.1363, concerning Assessment; 354.1364, concerning Services and Limitations; 354.1365, concerning Provider Qualifications; and 354.1366, concerning Consumer Directed Services and Service Responsibility Option.

Agenda Item 5a published as proposed: 3/25/16: Agenda Item 5a published as adopted: Effective date:

Agenda Item 5b: Telemedicine in School-Based Settings
HHSC proposes to amend Title 1, Part 15, Chapter 354, Subchapter A, Division 33, § 354.1432, Telemedicine and Telehealth Benefits and Limitations.

Agenda Item 5b published as proposed: 1/15/16: Agenda Item 5b published as adopted: 4/15/16: Effective date: 5/15/16

Aug. 28, 2015

Agenda Item 4a. Managed Care Organization Requirements Concerning Out-of-Network Providers.
HHSC proposes to amend Texas Administrative Code Title 1, Part 15, Chapter 353, Subchapter A, §353.4, Managed Care Organization Requirements Concerning Out-of-Network Providers.

Agenda Item 4a published as proposed:10/23/15: Agenda Item 4a published as adopted: 4/29/16: Effective date: 5/2/16

Agenda Item 4b: Medicaid Drug Utilization Review Board Title 1, Part 15, Chapter 354, Subchapter F.

  • HHSC proposes to amend Title 1, Part 15, Chapter 354, Subchapter F, §354.1832, Prior Authorization Procedures; and §354.1924, Preferred Drug List.
  • HHSC proposes to repeal Title 1, Part 15, Chapter 354, Subchapter F, §354.1928, Pharmaceutical and Therapeutics Committee; §354.1941, Conflict of Interest Policy.
  • HHSC proposes as new Title 1, Part 15, Chapter 354, Subchapter F, §354.1941, Drug Utilization Review Board; §354.1942, Conflict of Interest Policy.
Agenda Item 4b published as proposed: 11/6/15 Agenda Item 4b published as adopted: 2/5/16 Effective date: 2/9/16

Agenda Item 4c: Medicaid Drug Utilization Review Board; Drug Clinical Prior Authorization. HHSC proposes to amend Title 1, Part 15, Chapter 353, Subchapter J, §353.903, Definitions; §353.907, Prior Authorization Requirements.

Agenda Item 4c published as proposed: 11/6/15 Agenda Item 4c published as adopted: 2/5/16 Effective date: 2/9/16

Agenda Item 4d: Vendor Drug Program Medicaid Audit Appeals. HHSC proposes to amend Title 1, Part 15, Chapter 354, Subchapter F, Division 5, §354.1891, Vendor Drug Providers Subject to Audit.

Agenda Item 4d published as proposed: 11/6/15 Agenda Item 4d published as adopted: Effective date:

Agenda item 4e: Reimbursement for Certain Drugs in Disasters; Medicaid Fee-For-Service Drug Reimbursement.
HHSC proposes to amend §354.1835, Prescriber Identification Numbers; §354.1863, Prescription Requirements; and §354.1901, Pharmacy Claims.

  • HHSC proposes new §354.1868, Exceptions in Disasters.
Agenda Item 4e published as proposed:10/30/15: Agenda Item 4e published as adopted: 5/6/16: Effective date: 5/15/16

Agenda Item 4f: Medicaid Fee-For-Service Drug Reimbursement.
HHSC proposes to amend Title 1, Part 15, Chapter 355, Subchapter J, Division 28, §355.8541, Legend and Non-legend Medications; §355.8546, Brand-Name Drugs; §355.8547, Reimbursement for Compound Prescriptions; §355.8548, 340B Covered Entities; and §355.8551, Dispensing Fee.

  • HHSC proposed to repeal Title 1, Part 15, Chapter 355, Subchapter J, Division 28, §355.8545, Texas Maximum Allowable Cost.
Agenda Item 4f published as proposed:10/30/15: Agenda Item 4f published as adopted: 5/6/16: Effective date: 5/15/16

June 12, 2015

Agenda Item 6a. Vision Services, Chapter 355 The Medicaid/CHIP Division proposes to amend Title 1, Part 15, Chapter 355, Subchapter J, Division 1, §355.8001 (relating to Reimbursement for Vision Care Services). The proposed amendments correct a cross reference and make other nonsubstantive language changes. The amendments to this rule are being proposed in order to coincide with other changes to rules in Chapters 354 and 363 also related to vision care.

Agenda Item 6a published as proposed: 9/4/2015 Agenda Item 6a published as adopted: 12/4/15 Effective date: 12/20/15

Agenda Item 6b. Vision Services, Chapter 354 The Medicaid/CHIP Division proposes to amend §354.1015, 354.1017, 354.1021, 354.1023, and 354.1025 to update and simplify rule requirements related to vision care. Simplifying these rules allows HHSC more flexibility in developing timely and evidence based medical policy.

Agenda Item 6b published as proposed: 09/04/15 Agenda Item 6b published as adopted: 12/4/15 Effective date: 12/20/15

Agenda Item 6c. Vision Services, Chapter 363 The Medicaid/CHIP Division proposes to amend §363.501, 363.502, 363.503, and 363.504 to update and simplify rule requirements related to the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Eyeglass Program. Simplifying these rules allows HHSC more flexibility in developing timely and evidence-based medical policy.

Agenda Item 6c published as proposed: 9/4/15 Agenda Item 6c published as adopted: 12/4/15 Effective date: 12/20/15

Agenda Item 5a. Methodology for Incentives for Safety Net Hospitals, Chapter 354 The Health and Human Services Commission proposes to amend Title 1, Part 15, Chapter 354, Subchapter A, Division 35, §354.1445 (relating to Potentially Preventable Readmissions) and §354.1446 (relating to Potentially Preventable Complications). The rules are being amended to identify a methodology for incentives for HHSC defined safety net hospitals.

Agenda Item 5a published as proposed: 6/26/15 Agenda Item 5a published as adopted: 2/5/16 Effective date: 2/9/16

Agenda Item 5c. Inpatient Hospital Reimbursement Information on rule amendments to Title 1, Part 15, Chapter 355, Subchapter J, Division4, Rule §355.8052, Inpatient Hospital Reimbursement.

Agenda Item 5c published as proposed: 6/26/15 Agenda Item 5c published as adopted: 8/21/15 Effective date: 9/1/15

Agenda Item 5d. Outpatient Hospital Reimbursement Information on rule amendments to Title 1, Part 15, Chapter 355, Subchapter J, Division 4, Rule §355.8061, Outpatient Hospital Reimbursement.

Agenda Item 5d published as proposed: 6/26/15 Agenda Item 5d published as adopted: 8/21/15 Effective date: 9/1/15

Agenda Item 5e. Reimbursement Methodology for Telemedicine, Telehealth, and HomeTelemonitoring Services Information on rule amendments to Title 1, Part 15, Chapter 355, Subchapter G, Rule §355.7001, Reimbursement Methodology for Telemedicine, Telehealth, and Home Telemonitoring Services.

Agenda Item 5e published as proposed: 6/26/15 Agenda Item 5e published as adopted: 8/21/15 Effective date: 9/1/15

Agenda Item 5f. Office of Inspector General Relating to subpoena authority, provider disclosure and screening, general provisions as well as administrative actions and sanctions, repealing Title 1, Part 15, §371.21 and amending §§371.1003, 371.1013, 371.1607, 371.1609, 371.1615, 371.1709 and 371.1711.

Agenda Item 5f published as proposed: 6/26/15 Agenda Item 5f published as adopted: 9/25/15 Effective date: 10/1/15

Agenda Item 5g. HHSC Enterprise Contracting and Procurement, Chapter 391 Information on new Chapter 391 to clarify the contracting and procurement requirements for all health and human services agencies. Chapter 391 provides a clear template for HHSC contracting requirements for vendors and the public at large.

Agenda Item 5g published as proposed: 4/10/15 Agenda Item 5g published as adopted: 6/12/15 Effective date: 6/17/15

Agenda Item 5h. HHSC Enterprise Contracting and Procurement, Chapter 392 Information on new Chapter 392 to clarify and streamline the contracting and procurement processes for HHS agencies.

Agenda Item 5h published as proposed:4/17/15 Agenda Item 5h published as adopted: 6/12/15 Effective date: 6/17/15

Feb. 27, 2015

Agenda Item 5a. Related to Account Balance and Transaction Errors. (Information on proposed amendment to 1 TAC §372.1521, concerning timeframes for households to dispute electronic benefit transfer (EBT) account balance and transaction errors, timeframes for the agency to investigate and restore benefits as applicable and clarify that adjustments must be as a result of a system error.)

Agenda Item 5a published as proposed: 7/3/15 Agenda Item 5a published as adopted: 9/18/15 Effective date: 10/1/15

Agenda Item 5b. Anesthesiologist Assistants. (Information on proposed amendment to 1 TAC §354.1062, concerning additional services provided by an anesthesiologist assistant to the rule regarding the conditions under which a physician may bill Texas Medicaid and aligns the rule with other program rules (§354.1064 and §354.1065) relating to anesthesiologist assistants' services.

Agenda Item 5b published as proposed: 5/1/15 Agenda Item 5b published as adopted:10/9/15 Effective date: 10/15/15

Agenda Item 5c. Private Duty Nursing Services. (Information on the Texas Health and Human Services Commission (HHSC) proposal to repeal Title 1, Part 15, Chapter 363, Subchapter C in its entirety and propose new rules for this subchapter.)

Agenda Item 5c published as proposed: 5/1/15 Agenda Item 5c published as adopted: 10/9/15 Effective date: 10/15/15

Agenda Item 4a. Minimum Payment Amounts to Qualified Nursing Facilities. (Consideration of rule amendments to §353.608, concerning Minimum Payment Amounts to Qualified nursing Facilities to revise eligibility criteria and reconciliation procedures and to add language relating to recoupments of payments in certain situations.)

Agenda Item 4a published as proposed:4/3/15 Agenda Item 4a published as adopted: 6/12/15 Effective date: 6/21/15

Agenda Item 4b. Disproportionate Share Hospital Reimbursement Methodology and Waiver Payments to Hospitals for Uncompensated Care. (Consideration of rule amendments to Title 1, Part 15, Chapter 355, §355.8065, related to Disproportionate Share Hospital Reimbursement Methodology, and §355.8201, related to Waiver Payments to Hospitals for Uncompensated Care.)

Agenda Item 4b published as proposed: 2/6/15 Agenda Item 4b published as adopted: 4/24/15 Effective date: 5/3/15

Nov. 21, 2014

Agenda Item 4a. Hospital Presumptive Eligibility (1 TAC, Part 15, Chapter 366, Subchapter B)

Agenda Item 4a published as proposed: 9/5/2014 Agenda Item 4a published as adopted: 01/02/15 Effective date: 01/18/15

Agenda Item 4b. Payment for Physician Assistants and Other Practitioners (1 TAC. Part 15, Chapter 354, §354.1001, §354.1062)

Agenda Item 4b published as proposed: 10/17/14 Agenda Item 4b published as adopted: 12/19/14 Effective date: 1/1/15

Agenda Item 4c. Reimbursement Methodology for Physician Assistants and Other Practitioners (1 TAC, Part 15, amends §355.8093, Physician Assistants, §355.8161, Reimbursement Methodology for Midwife Services, and §355.8281, Reimbursement Methodology, under Title 1, Part 15, Subchapter J)

Agenda Item 4c published as proposed:10/17/14 Agenda Item 4c published as adopted:12/19/14 Effective date: 12/28/14

Agenda Item 4d. Informal Dispute Resolution Program (1 TAC, Part 15, Chapter 393)

Agenda Item 4d published as proposed:10/17/14 Agenda Item 4d published as adopted:12/26/14 Effective date: 1/1/15

Agenda Item 5a. Family Violence Program (1 TAC, Part 15, Chapter 379)

Agenda Item 5a published as proposed: 7/3/15 Agenda Item 5a published as adopted:: Effective date:

Agenda Item 5b. Reimbursement Methodology of School Health and Related Services (1 TAC, Part 15, Chapter 355, Subchapter J, §355.8443)

Agenda Item 5b published as proposed: 2/13/15 Agenda Item 5b published as adopted: 5/8/15 Effective date: 5/17/15

Agenda Item 5c. Community First Choice Program (1 TAC, Part 15, Chapter 354, Subchapter A, Division 27)

Agenda Item 5c published as proposed: 12/5/15 Agenda Item 5c published as adopted: 5/22/15 Effective date: 6/1/15

Agenda Item 5d. Reimbursement Methodology for Community First Choice Program (1 TAC, Part 15, Chapter 355, Subchapter M, Division 7)

Agenda Item 5d published as proposed:12/5/14: Agenda Item 5d published as adopted: 5/22/15 Effective date: 6/1/15

Agenda Item 5e. Texas Dual Eligibles Integrated Care Demonstration (1 TAC, Part 15, Chapter 353, Subchapter L)

Agenda Item 5e published as proposed: 01/16/15 Agenda Item 5e published as adopted: 3/20/15 Effective date:04/1/15

Agenda Item 5g. Reimbursement Methodology for Preferred Pediatric Extended Care Centers (1 TAC, Part 15, Chapter 355, Subchapter C, §355.307)

Agenda Item 5g published as proposed: 11/7/14 Agenda Item 5g published as adopted: 01/16/15 Effective date: 01/25/15

Aug. 15, 2014

Agenda Item 4a. Related to Hospital Presumptive Eligibility (1 TAC. Part 15, Chapter 366, Subchapter B)

Agenda Item 4a published as proposed: 9/5/2014 Agenda Item 4a published as adopted: 01/02/15 Effective date: 01/18/15

Agenda Item 4b. Regarding the Delivery System Reform Incentive Payment Rule Amendments (1 TAC, Part 15, Chapter 354, §354.1602, §354.1633, and §354.1634; and, new §354.1637; §354.1635)

Agenda Item 4b published as proposed: 7/11/14 Agenda Item 4b published as adopted: 9/19/14 Effective date: 9/30/2014

Agenda Item 4c. Related to Waiver Payments to Hospitals, for Physician Services, and other Providers (1 TAC, Part 15, Chapter 355, §355.8065, §355.8201, §355.8202, §355.8441)

Agenda Item 5c published as proposed: 6/27/14 Agenda Item 5c published as proposed: 8/22/14 Effective date: 9/1/14

Agenda Item 5a. Payment for Physician Assistants and Other Practitioners (1 TAC. Part 15, Chapter 354, §354.1001, §354.1062)

Agenda Item 5a published as proposed: 10/17/14 Agenda Item 5a published as adopted:12/19/14 Effective date: 1/1/15

Agenda Item 5b. Related to Reimbursement Methodology for Physician Assistants and Other Practitioners (1 TAC, Part 15, Amends §355.8093, §355.8161; and §355.8281)

Agenda Item 5b published as proposed: 10/17/14 Agenda Item 5b published as adopted:12/19/14 Effective date: 12/28/14

Agenda Item 5c. Regarding Medical Record Fees (1 TAC, Part 15, Chapter 354, §354.1005, Subchapter A, Division 1.)

Agenda Item 5c published as proposed: 10/24/14 Agenda Item 5c published as adopted: 02/27/15 Effective date: 03/08/2015

Agenda Item 5d. Related to Payments to Qualified Nursing Facilities under Managed Care (1 TAC, Part 15, Chapter 353, §353.608)

Agenda Item 5d published as proposed: 8/22/14 Agenda Item 5d published as adopted: 10/24/14 Effective date: 11/01/14

May 23, 2014

Agenda Item 5a. Regarding Transitioning Foster Care Youth Medical Eligibility** (1 TAC. Part 15, Chapter 366, §366.611) **The Texas Health and Human Services Commission is renewing the effectiveness of the emergency adoption of the amendment to §366.611, for a 60-day period. The emergency amendment was published in the January 17, 2014, issue of the Texas Register (39 TexReg 247).

Agenda Item 5a published as proposed: 4/25/14 Agenda Item 5a published as adopted: 6/27/14 Effective date: 6/30/2014

Agenda Item 5b. Regarding Adding Anesthesiologist Assistants to the Fee Schedule as a Medicaid Provider (Title 1, Part 15, Chapter 354, §354.1064, and §354.1065)

Agenda Item 5b published as proposed: 5/2/14 Agenda Item 5b published as adopted: 7/18/14 Effective date: 7/26/14

Agenda Item 5d. Regarding Medical Transportation Program Non-Emergency Transportation Services (1 TAC, Part 15, Chapter 380, §380.101, §380.201, §380.203, §380.205, §380.207, §380.209, §380.301, §380.401, §380.501, and §380.502)

Agenda Item 5d published as proposed: 5/2/14 Agenda Item 5d published as proposed: 7/25/14 Effective date: 9/1/14

Agenda Item 6a. Related to Out-of-State Provider Eligibility (Title 1, TAC, Part 15, Chapter 352, §352.17)

Agenda Item 6a published as proposed: 7/18/14 Agenda Item 6a published as adopted: 9/12/14 Effective date: 9/17/14

Agenda Item 6b. Related to Three-Day Payment Window to Providers (Title 1, TAC, Part 15, Chapter 354, §354.1072)

Agenda Item 6b published as proposed: 7/18/14 Agenda Item 6b published as adopted: Effective date:

Agenda Item 6c. Regarding Potentially Preventable Complications and Potentially Preventable Readmissions (Title 1, TAC, Part 15, Chapter 354, §354.1445 and §354.1446)

Agenda Item 6c published as proposed: 7/4/14 Agenda Item 6c published as adopted: 8/22/14 Effective date: 9/1/14

Agenda Item 6d. Regarding CHIP Out-of-Network Billing (Title 1, TAC, Part 15, Chapter 354, §354.1445 and §354.1446)

Agenda Item 6d published as proposed: 8/15/14 Agenda Item 6d published as adopted: 12/19/14 Effective date: 1/22/15

Agenda Item 6e. Related to CHIP Balance Billing (Title 1, TAC, Part 15, Chapter 370, §370.4 and §370.453)

Agenda Item 6e published as proposed: 7/18/14 Agenda Item 6e published as adopted: 12/19/14 Effective date: 1/22/15

Feb. 28, 2014

Agenda Item 5a. Emergency amendment to the Medicaid for Transitioning Foster Care Youth (1 TAC §366.611)

Agenda Item 5a published as proposed: NA Agenda Item 5a published as adopted: 1/17/2014 Effective date: 1/1/2014

Agenda Item 5b. Medicaid and Children's Health Insurance Program Eligibility (1 TAC, Chapters 366, 370, and 375)

Agenda Item 5b published as proposed: 2/14/2014 Agenda Item 5b published as adopted: 5/23/14 Effective date: 6/1/14

Agenda Item 5c. Hospital Specific Limit (1 TAC §355.8066)

Agenda Item 5c published as proposed: 2/14/2014 Agenda Item 5c published as proposed: 4/18/14 Effective date: 4/23/14

Agenda Item 6a. Inpatient Hospital Reimbursement (1 TAC §355.8052)

Agenda Item 6a published as proposed: 4/25/2014 Agenda Item 6a published as adopted: 8/22/2014 Effective date: 9/1/14

Agenda Item 6b. Managed Care Expansion (1 TAC, Chapter 353)

Agenda Item 6b published as proposed: 4/25/14 Agenda Item 6b published as adopted: 8/1/14 Effective date: 9/1/14

Agenda Item 6c. Waiver Payments to Other Performers (1 TAC §§355.8201, 355.8202, and 355.8203)

Agenda Item 6c published as proposed: 04/11/2014 Agenda Item 6c published as proposed: 6/6/14 Effective date: 6/12/14

Agenda Item 6d. Reimbursement Methodology for Physicians and Other Practitioners (1 TAC §§355.8085, 355.7001, and 355.8081)

Agenda Item 6d published as proposed: 04/11/2014 Agenda Item 6d published as adopted: 6/20/2014 Effective date: 6/29/2014

Agenda Item 6e. Substitute Physicians (1 TAC §§354.1060 and 354.1062)

Agenda Item 6e published as proposed: 04/11/2014 Agenda Item 6e published as adopted: 7/11/14 Effective date: 7/14/14

Nov. 22, 2013

Agenda Item 4a. Federally-required income eligibility changes to Medicaid and Children's Health Insurance Program (1 TAC, Chapters 366, 370, and 375)

Agenda Item 4a published as proposed: 10/18/2013 Agenda Item 4a published as adopted: 12/27/2013 Effective date: 1/1/2014

Agenda Item 4b. Quality Improvement Process for Clinical Initiatives (1 TAC §354.2501, §354.2503, §354.2505, and §354.250)

Agenda Item 4b published as proposed: 10/18/2013 Agenda Item 4b published as adopted: 12/27/2013 Effective date: 1/1/2014

Agenda Item 5a. Fee for Service Pharmacy Prior Authorization (1 TAC §354.1832)

Agenda Item 5a published as proposed: 2/14/2014 Agenda Item 5a published as adopted: 4/25/14 Effective date: 5/1/14

Agenda Item 5b. Funding for Waiver Monitoring Program (1 TAC §355.8204)

Agenda Item 5b published as proposed: 1/3/2014 Agenda Item 5b published as adopted: 3/28/2014 Effective date: 4/15/2014

Agenda Item 5c. Reimbursement methodology for Early and Periodic Screening, Diagnosis, and Treatment (1 TAC §355.8441)

Agenda Item 5c published as proposed: 1/24/14 Agenda Item 5c published as adopted: 3/28/2014 Effective date: 4/6/2014

Agenda Item 5d. Medicaid Provider Marketing (1 TAC §353.405, §354.1452, and §354.1452)

Agenda Item 5d published as proposed: 2/7/14 Agenda Item 5d published as adopted: 6/27/14 Effective date: 7/6/2014

Agenda Item 5e. Personal Care Services (1 TAC §363.601-603, §363.605, and §363.607)

Agenda Item 5e published as proposed: 2/7/14 Agenda Item 5e published as adopted: 8/1/14 Effective date: 9/1/14

Agenda Item 5f. Electronic Visit Verifications (1 TAC §354.1177)

Agenda Item 5f published as proposed: 1/24/14 Agenda Item 5f published as adopted: 4/4/14 Effective date: 4/13/14

Agenda Item 5g. Electronic Health Record Incentive Program Notification and Appeals Process (1 TAC §356.202)

Agenda Item 5g published as proposed:4/11/14 Agenda Item 5g published as adopted: Effective date:

Agenda Item 5h. Advisory Committees (1 TAC §351.3)

Agenda Item 5h published as proposed: 1/24/14 Agenda Item 5h published as adopted: 4/4/14 Effective date: 4/13/14

Agenda Item 5i. Sanctions Investigations (1 TAC §371.1301, §371.1303, §371.1305, §371.1307, and §371.1309)

Agenda Item 5i published as proposed: 1/24/14 Agenda Item 5i published as adopted: 4/11/14 Effective date: 4/15/14

Agenda Item 5j. Acquisition Costs: Pharmacy Reimbursement (1 TAC §355.8548)

Agenda Item 5j published as proposed: 1/3/2014 Agenda Item 5j published as adopted: 3/21/2014 Effective date: 4/1/2014

Agenda Item 5k. Medicaid Inpatient Hospitalization Utilization Review (1 TAC §371.200-206, and §371.210)

Agenda Item 5k published as proposed: 10/04/2013 Agenda Item 5k published as adopted: 12/27/2013 Effective date: 1/1/2014

Aug. 28, 2013

Agenda Item 5a. Medicaid inpatient hospital utilization review (1 TAC §371.200 – §371.206, and §371.210)

Agenda Item 5a published as proposed: 10/4/2013 Agenda Item 5a published as adopted: 12/27/2013 Effective date: 1/1/2014

Agenda Item 5b. Texas Medicaid Wellness Program (1 TAC §354.1416)

Agenda Item 5b published as proposed: 11/1/2013 Agenda Item 5b published as proposed: 1/24/2014 Effective date: 2/2/2014

June 14, 2013

Agenda Item 5a.Inpatient hospital reimbursement (1 TAC §§355.8052, 355.8054, 355.8055, 355.8060)

Agenda Item 5a published as proposed: 6/28/2013 Agenda Item 5a published as adopted: 8/23/2013 Effective date: 9/1/2013

Agenda Item 5b.Payment for hospital services (1 TAC §355.8061)

Agenda Item 5b published as proposed: 6/28/2013 Agenda Item 5b published as adopted: 8/23/2013 Effective date: 9/1/2013

Agenda Item 5c.Out-of-state Medicaid provider eligibility (1 TAC §352.17)

Agenda Item 5c published as proposed: 6/28/2013 Agenda Item 5c published as adopted: 8/23/2013 Effective date: 9/1/2013

Agenda Item 5d.Medicaid managed care outpatient pharmacy services (1 TAC §§353.903, 353.905, 353.907, 353.913)

Agenda Item 5d published as proposed: 6/28/2013 Agenda Item 5d published as adopted: 8/23/2013 Effective date: 9/1/2013

Agenda Item 5e.Waiver reimbursements to other performers (1 TAC §355.8203)

Agenda Item 5e published as proposed: 5/24/2013 Agenda Item 5e published as adopted: 8/2/2013 Effective date: 8/16/2013

Agenda Item 5f.Funding for waiver monitoring program (1 TAC §355.8203)

Agenda Item 5f published as proposed: 6/28/2013 Agenda Item 5f published for withdrawal: 10/18/2013 Effective date: 10/7/2013

Agenda Item 5g.Amendments and clarifications for the Texas Healthcare Transformation and Quality Improvement Program (1 TAC §§354.1601, 354.1602, 354.1611, 354.1612, 354.1613, 354.1621, 354.1622, 354.1631, 354.1632, 354.1633, 354.1634, 354.1635)

Agenda Item 5g published as proposed: 6/28/2013 Agenda Item 5g published as adopted: 8/23/2013 Effective date: 9/1/2013

Agenda Item 6a.Medicaid hospital services (1 TAC §§354.1149 and 354.1175 )

Agenda Item 6a published as proposed: 8/2/2013 Agenda Item 6a published as adopted: 10/18/2013 Effective date: 10/27/2013

Agenda Item 6b.Federally Qualified Health Centers affiliation agreements (1 TAC §354.1322)

Agenda Item 6b published as proposed: 8/2/2013 Agenda Item 6b published as adopted: 10/11/2013 Effective date: 10/17/2013

Agenda Item 6c.Reimbursement methodologies for advanced telecommunication (1 TAC §355.7001)

Agenda Item 6c published as proposed: 7/19/2013 Agenda Item 6c published as adopted: 9/27/2013 Effective date: 10/1/2013

Agenda Item 6d.Repeal of the Women's Health Program rules (1 TAC Division 27)

Agenda Item 6d published as proposed: 8/2/2013 Agenda Item 6d published as adopted: 11/1/2013 Effective date: 11/10/2013

Agenda Item 6e.Unauthorized charges and concerning payments to eligible providers (1 TAC §§354.1005 and 354.1131)

Agenda Item 6e published as proposed: 8/2/2013 Agenda Item 6e published as adopted: 11/15/2013 Effective date: 11/24/2013

Feb. 28, 2013

Agenda Item 5a. Waiver payments to hospitals and for physician services (1 TAC §355.8201, §355.8202)

Agenda Item 5a published as proposed: 2/8/2013 Agenda Item 5g published as adopted: 6/7/2013 Effective date: 6/13/2013

Agenda Item 5b. Disproportionate Share Hospital reimbursement methodology (1 TAC §355.8065)

Agenda Item 5b published as proposed: 3/1/2013 Agenda Item 5b published as adopted: 9/6/2013 Effective date: 9/11/2013

Agenda Item 5c. Hospital-Specific Limit methodology (1 TAC §355.8066)

Agenda Item 5c published as proposed: 3/15/2013 Agenda Item 5c published as adopted: 9/27/2013 Effective date: 10/6/2013

Agenda Item 5d. Payments to Regional Healthcare Partnership anchors (1 TAC §354.1634)

Agenda Item 5d published as proposed: 1/25/2013 Agenda Item 5d published as adopted: 3/22/2013 Effective date: 4/1/2013

Agenda Item 5e. Authorized inpatient hospital services and potentially preventable readmissions and complications (1 TAC §§354.1070, 354.1072, 354.1445, 354.1446)

Agenda Item 5e published as proposed: 2/8/2013 Agenda Item 5e published as adopted: 4/12/13 Effective date: 4/21/13

Agenda Item 5f. Reimbursement methodology for Preadmission Screening and Resident Review (PASRR) Level II evaluations and customized adaptive aids. (1 TAC §355.310, §355.748)

Agenda Item 5f published as proposed: 2/22/2013 Agenda Item 5f published as adopted: 5/17/13 Effective date: 5/24/13

Agenda Item 6a.Supplemental payments to governmental ambulance providers for unreimbursed costs of providing ambulance services to uninsured patients (1 TAC §355.8600 )

Agenda Item 6a published as proposed: 8/2/2013 Agenda Item 6a published as adopted: 10/18/2013 Effective date: 10/27/2013

Agenda Item 6b. Behavioral health services provided by Provisionally Licensed Psychologists (1 TAC §354.1281)

Agenda Item 6b published as proposed: 4/12/2013 Agenda Item 6b published as adopted: 8/2/2013 Effective date: 9/1/2013

Agenda Item 6c. Reimbursement methodology for behavioral health services provided by Provisionally Licensed Psychologists (1 TAC §355.8081)

Agenda Item 6c published as proposed: 4/12/2013 Agenda Item 6c published as adopted: 8/2/2013 Effective date: 9/1/2013

Agenda Item 6d. Medicaid claim filing for the Blind Children's Vocational Discovery and Development Program (1 TAC §355.1003)

Agenda Item 6d published as proposed: 4/26/2013 Agenda Item 6d published as adopted: 7/19/2013 Effective date: 7/22/2013

Agenda Item 6e. Updates to Medicaid claim filing requirements for physician and physician assistant services, hospital services, and podiatry services (1 TAC §§354.1061, 354.1071, and 354.1101)

Agenda Item 6e published as proposed: 4/19/2013 Agenda Item 6e published as adopted: 8/2/2013 Effective date: 8/5/2013

Agenda Item 6f. Medical Transportation Program (1 TAC §§380.101, 380.201, 380.203, 380.205, 380.209, 380.301, 380.401, 380.501, 380.502)

Agenda Item 6f published as proposed: 4/26/2013 Agenda Item 6f published as adopted: 8/2/2013 Effective date: 8/6/2013

Agenda Item 6g. Family Violence Program requirements for shelter centers, special nonresidential projects, and nonresidential centers (1 TAC Chapter 379)

Agenda Item 6g published as proposed: 4/19/2013 Agenda Item 6g published as adopted: 7/5/2013 Effective date: 9/1/2013