As described in the briefing package posted on the HHSC Rate Analysis website at http://www.hhsc.state.tx.us/Medicaid/programs/rad/rate-packets.shtml, a public rate hearing is scheduled for Friday, January 7, 2011, at 1:00 p.m., in the Public Hearing Room, Brown-Heatly Building, 4900 N. Lamar, Austin, Texas, 78751 for the following:
Proposed Medicaid Payments for the following services:
Ambulance Services;
Case Management for Pregnant Women;
Early and Periodic Screening, Diagnosis and Treatment Services, including Medical Checkups, Private Duty Nursing, Therapies, and Therapies provided in a Comprehensive Outpatient Rehabilitation Facility / Outpatient Rehabilitation Facility, but not including Personal Care Services;
Family Planning Services;
Home Health Services, including Professional Services and Durable Medical Equipment and Expendable Supplies;
Mental Health Rehabilitation Services;
Mental Health Targeted Case Management;
Physicians and Certain Other Practitioners, including Dental Services, Anesthesia Services, Licensed Clinical Social Workers, Licensed Professional Counselors, Licensed Marriage and Family Therapists, and other Practitioners;
Tuberculosis Clinics;
and the Vendor Drug Dispensing Fee, to include both the fixed and variable component of the fee.
Payment reimbursements and the payment rate adjustment for the vendor drug dispensing fee are proposed to be effective February 1, 2011.
On Dec. 6, 2010, the Governor, Lieutenant Governor, and House Speaker sent a letter to all State Agencies asking them to identify savings of 2.5 percent of their original general revenue and general-dedicated-appropriations for fiscal year 2011. In response to this letter and in accordance with 1 TAC §355.201, reimbursements are proposed to be reduced. For the Vendor Drug Dispensing Fee, which was reduced by one percent effective Sept. 1, 2010, the fee effective Feb. 1, 2011, will be an amount equal to the fee in effect on Aug. 31, 2010, less two percent. For all the other listed services, for which the Sept. 1, 2010, one percent reduction was implemented by reducing reimbursements in effect on Aug. 31, 2010, by one percent, the proposed reimbursement for services provided on and after Feb. 1, 2011, will be equal to the reimbursement indicated on the agency’s current fee schedule in effect on Aug. 31, 2010, less two percent.
Other proposed rates
Proposed Medicaid Payments for the following:
Non-State Clinical Laboratory Services
Freestanding Psychiatric Facilities
Renal Dialysis Facilities
Ambulatory Surgical Center/Hospital Based Ambulatory Surgical Centers (ASC/HASC)
Hospital Outpatient Medicaid Services
Inpatient Hospital Services
In regards to the December 6, 2010 letter requesting agencies to identify savings of 2.5 percent, HHSC proposes to adjust payments for Clinical Laboratory Services (non-state entities), Freestanding Psychiatric Facilities (non-state entities), Renal Dialysis Facilities, ASC/HASC, Hospital Outpatient Medicaid Services and Inpatient Hospital Services. The payments for the Clinical Laboratory Services (non-state entities), Freestanding Psychiatric Facilities (non-state entities), Ambulatory Surgical Centers, Hospital Outpatient Medicaid Services, Renal Dialysis Facilities, and Inpatient Hospital Services will be reduced by an additional one percent effective February 1, 2011.
HHSC will conduct a public hearing to receive comments regarding the proposed Medicaid payments on January 7, 2011, at 8:00 a.m. in the Public hearing Room of HHSC, Brown –Heatly Building, located at 4900 N. Lamar Boulevard, Austin, Texas.
Rate packet: http://www.hhsc.state.tx.us/Medicaid/programs/rad/rate-packets/022011-hospitals-reimbursement-reduction.pdf
Proposed Medicaid Payment Rates for Home and Community-based Services (HCS) and Texas Home Living (TxHmL):
In regards to the December 6, 2010 letter requesting agencies to identify savings of 2.5 percent, HCS and TxHmL reimbursement rates are proposed to be reduced by two percent below the rates that are currently in effect. Reimbursement rates for HCS and TxHmL Attendant Compensation Rate Enhancement add-ons are not proposed to be reduced.
Rates professional services that are common across multiple Home and Community-Based Services Waivers are not proposed to be reduced. These services include: nursing services provided by a registered nurse, nursing services provided by a licensed vocational nurse, physical therapy, occupational therapy, speech/language therapy, behavioral support services, audiology services, and nutrition/dietary services.
HHSC will conduct a public hearing to receive comments regarding the proposed Medicaid rates on January 7, 2011, at 11:00 a.m. in the Brown-Heatly Building Public Hearing Room, 4900 North Lamar Boulevard, Austin, Texas.
Rate packet: http://www.hhsc.state.tx.us/Medicaid/programs/rad/rate-packets/022011-hcs-txhml-rate-packet.pdf and http://www.hhsc.state.tx.us/Medicaid/programs/rad/rate-packets/022011-hcs-txhml-rate-packet-att.pdf
Proposed Medicaid Payment Rates for Non-state Operated Intermediate Care Facilities for Persons with Mental Retardation:
In regards to the December 6, 2010 letter requesting agencies to identify savings of 2.5 percent, non-state operated ICF/MR reimbursement rates are proposed to be reduced by an additional two percent below the rates that were in effect August 31, 2010. This proposed reduction is in addition to the one percent reduction to the August 31, 2010 rates that became effective September 1, 2010. The combined impact of these two reductions will be that non-state operated ICF/MR rates proposed to be effective February 1, 2011 will be three percent less than non-state operated ICF/MR rates in effect on August 31, 2010. Reimbursement rates for ICF/MR Attendant Compensation Rate Enhancement add-ons are not proposed to be reduced.
HHSC will conduct a public hearing to receive comments regarding the proposed Medicaid rates on January 7, 2011, at 11:00 a.m. in the Brown-Heatly Building Public Hearing Room, 4900 North Lamar Boulevard, Austin, Texas.
Rate packet: http://www.hhsc.state.tx.us/Medicaid/programs/rad/rate-packets/022011-icfmr-rate-packet.pdf and http://www.hhsc.state.tx.us/Medicaid/programs/rad/rate-packets/022011-icfmr-rate-packet-att.pdf
Proposed Medicaid Nursing Facility and Hospice-Nursing Facility Payment Rates
In regards to the December 6, 2010 letter requesting agencies to identify savings of 2.5 percent, reimbursement rates for each NF Resource Utilization Group (RUG-III) and supplemental reimbursement group are proposed to be reduced by an additional two percent below the rates that were in effect August 31, 2010. This proposed reduction is in addition to the one percent reduction to the August 31, 2010 rates that was effective September 1, 2010. The combined impact of these two reductions will be that NF rates proposed to be effective February 1, 2011 will be three percent less than NF rates in effect on August 31, 2010. As well, reimbursement rates for purchased general and professional liability insurance and per diem add-on payments for enhanced staffing levels are proposed to be reduced by an additional two percent below the rates that were in effect August 31, 2010. Finally, minimum required Licensed Vocational Nurse (LVN) equivalent minutes are proposed to be reduced by an additional two percent. The proposed effective date for these reductions is February 1, 2011.
HHSC does not intend to reduce Medicaid Hospice-NF rates.
HHSC will conduct a public hearing to receive comments regarding the proposed Medicaid rates on January 7, 2011, at 10:00 a.m. in the Brown-Heatly Building Public Hearing Room, 4900 North Lamar Boulevard, Austin, Texas.
Rate packet: http://www.hhsc.state.tx.us/Medicaid/programs/rad/rate-packets/022011-nf-rate-packet.pdf and http://www.hhsc.state.tx.us/Medicaid/programs/rad/rate-packets/022011-nf-rate-packet-att.pdf