TITLE 1. ADMINISTRATION

PART 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION

CHAPTER 355. REIMBURSEMENT RATES

SUBCHAPTER C. REIMBURSEMENT METHODOLOGY FOR NURSING FACILITIES

1 TAC §355.307, §355.316

The Texas Health and Human Services Commission (HHSC) adopts an amendment to §355.307, concerning Reimbursement Setting Methodology, and new §355.316, concerning Reimbursement Methodology for Pediatric Care Facilities. Section 355.307 and §355.316 are adopted without changes to the proposed text as published in the August 6, 2021, issue of the Texas Register (46 TexReg 4765). The rules will not be republished.

BACKGROUND AND JUSTIFICATION

The amendment and new section are necessary to comply with the 2022-23 General Appropriations Act, Senate Bill (S.B.) 1, 87th Legislature, Regular Session, 2021 (Article II, HHSC, Rider 40). This legislation requires HHSC to revise the reimbursement methodology for pediatric long-term care facilities to mirror that of Medicare reimbursement.

The amendment removes language related to the pediatric nursing facility rate methodology currently in §355.307(c)(1) - (c)(4) and moves it to new §355.316. The creation of new §355.316 improves clarity as it separates the pediatric care facility reimbursement methodology from the reimbursement methodology used for nursing facilities in general. The language in new §355.316 is updated to meet the requirements of the new reimbursement methodology.

The reimbursement methodology revision will lead to reimbursement rates that are calculated at higher levels than under the current methodology, leading to higher quality and greater access to care for medically fragile children in Texas.

COMMENTS

The 21-day comment period ended on August 27, 2021.

During this period, HHSC did not receive any comments regarding the proposed rules.

STATUTORY AUTHORITY

The amendment and new section are adopted under Texas Government Code §531.033, which authorizes the Executive Commissioner of HHSC to adopt rules necessary to carry out HHSC's duties; Texas Human Resources Code §32.021 and Texas Government Code §531.021(a), which provide HHSC with the authority to administer the federal medical assistance (Medicaid) program in Texas; and Texas Government Code §531.021(b-1), which establishes HHSC as the agency responsible for adopting reasonable rules governing the determination of fees, charges, and rates for medical assistance payments under the Texas Human Resources Code Chapter 32.

The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on September 29, 2021.

TRD-202103864

Karen Ray

Chief Counsel

Texas Health and Human Services Commission

Effective date: October 19, 2021

Proposal publication date: August 6, 2021

For further information, please call: (512) 424-6637