The Texas Health and Human Services Commission (HHSC) announced its intent to submit an amendment to the Texas State Plan for Medical Assistance, in the December 13 Texas Register. The proposed amendment concerns the Hospital-Specific Limit (HSL) calculation. The amendment is proposed to be effective January 1, 2014.
HHSC proposes to amend the state plan to ensure that to the extent a third-party commercial payment exceeds the Medicaid allowable cost for a service provided to a recipient and for which reimbursement was not paid under the medical assistance program, the payment is not considered a medical assistance payment. This change is being made to ensure that the state plan language regarding this calculation is in compliance with §32.0284, Subchapter B, Chapter 32 of the Texas Human Resources Code.
The proposed amendment is estimated to result in no change in the amount of federal funds eligible to be received by the state. The source of non-federal funding for the DSH program is public funds from local and state governmental entities.
Interested parties may obtain copies of the proposed amendment by contacting Pam McDonald, Rate Analysis Department by mail at the Rate Analysis Department, Texas Health and Human Services Commission, P.O. Box 149030, H-400, Austin, Texas 78714-9030; by telephone at (512) 707-6079; by facsimile at (512) 730-7475; or by e-mail at pam.mcdonald@hhsc.state.tx.us. Copies of the proposal will also be made available for public review at the local offices of the Texas Department of Aging and Disability Services.