Hearing.  The Texas Health and Human Services Commission (HHSC) will conduct a public hearing on Aug. 15, 2012, at 1:30 p.m., to receive comment on proposed payment rates for the Medicaid Biennial Calendar Fee Review.  The hearing will be held in compliance with Human Resources Code §32.0282 and the Texas Administrative Code, Title 1 (1 TAC), §355.201, which require public notice of and hearings on proposed Medicaid reimbursements.    

Proposal.  The payment rates for Medicaid Biennial Calendar Fee Review are proposed to be effective Oct. 1, 2012, for the following services:

(1) Family Planning
(2) General and Integumentary System Surgery
(3) Orthotics and Prosthetics
(4) Physician-Administered Drugs, Vaccines and Toxoids
(5) Respiratory Therapists

Methodology and Justification.  The proposed payment rates were calculated in accordance with 1 TAC:

§355.8021, which addresses the reimbursement methodology for Home Health Services and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies;

§355.8081, which addresses payments for laboratory and x-ray services, radiation therapy, physical therapists' services, physician services, podiatry services, chiropractic services, optometric services, ambulance services, dentists' services, psychologists' services, licensed psychological associates' services, maternity clinic services, and tuberculosis clinic services;

§355.8085, which addresses the reimbursement methodology for physicians and other medical professionals, including medical services, surgery, assistant surgery, and physician-administered drugs/biologicals; medical services, surgery, assistant surgery, radiology, laboratory, and radiation therapy;

§355.8441, which addresses the reimbursement methodology for Early and Periodic Screening, Diagnosis, and Treatment services; and

§355.8582, which addresses payments for purchased counseling, educational, medical, and sterilization family planning services.

The reimbursement rates proposed reflect applicable reductions directed by the 2012-2013 General Appropriations Act, House Bill 1, 82nd Legislature, Regular Session, 2011 (Article II, All Health and Human Services Agencies, Section 16).  Detailed information related to specifics of the reductions can be found on the Medicaid fee schedules at http://public.tmhp.com/FeeSchedules/Default.aspx.

Briefing Package.  A briefing package describing the proposed payment rates will be available at http://www.hhsc.state.tx.us/rad/rate-packets.shtml on or after Aug. 1, 2012.  Those interested may obtain a copy of the briefing package before the hearing by contacting Rate Analysis by telephone at 512-491-1445; by fax at 512-491-1998; or by email at esther.brown@hhsc.state.tx.us.  The briefing package also will be available at the public hearing. 

Written Comments.  Written comments regarding the proposed payment rates may be submitted instead of, or in addition to, oral testimony until 5 p.m. the day of the hearing. Written comments may be sent by U.S. mail, overnight mail, special delivery mail, hand delivery, fax, or email:

U.S. Mail
Attention:  Rate Analysis
HHSC Rate Analysis, Mail Code H-400
P.O. Box 85200
Austin, Texas 78708-5200

Overnight mail, special delivery mail, or hand delivery
Attention:  Rate Analysis
HHSC Rate Analysis, Mail Code H-400
Braker Center, Building H
11209 Metric Boulevard
Austin, Texas 78758-4021

Phone number for package delivery:  512-491-1445
Fax
Attention:  Rate Analysis at 512-491-1998

E-mail
esther.brown@hhsc.state.tx.us