On May 10 the Medical Care Advisory Committee (MCAC) took action on several proposed rules and discussed several informational items.
Several witnesses spoke in favor of a recent amendment concerning Medicare Equalization. HHSC is amending 1 Texas Administrative Code (TAC) §354.1143 concerning the coordination of Medicaid with Medicare Parts A, B, and C (Medicare Equalization). The amended rules authorize HHSC to make higher cost-sharing payments for dual eligibles for certain services if HHSC determines that a higher payment amount is necessary to ensure adequate access to care or would be more cost-effective to the state.
Of note, several witness offered concerns on multiple amendments proposed by the HHSC (they were not voted on during the MCAC hearing but presented as informational items). Those amendments drawing concerns included:
- Waiver Payments to Hospitals and for Physician Services
HHSC is adding new 1 TAC §355.8201 and §355.8202 implementing the provider eligibility requirements and payment methodologies approved by the Centers for Medicare and Medicaid Services under the Texas Healthcare Transformation and Quality Improvement Program Demonstration Waiver. - Hospital Specific Limit Methodology
HHSC is adding new 1 TAC §355.8066 related to the hospital specific limit calculation as it applies to the disproportionate share hospital (DSH) program and the Texas Healthcare Transformation and Quality Improvement Program Demonstration Waiver. - Disproportionate Share Hospital Reimbursement
HHSC is amending 1 TAC §355.8065 to update the Texas DSH payment methodology in response to a petition for the adoption of a rule.
More details on the comments made and all the proposed rules voted on during the MCAC meeting can be viewed by any HillCo client, with a user account, by visiting: http://login.hillcopartners.com/node/1764.
