UPDATE: After conferring with colleagues, this is not the major reimbursement changes that were discussed earlier this year but an annual update of codes with minor changes.
Hope you are having a nice Friday afternoon, the Friday before the Christmas weekend.
Notice on January 11 public hearing on rate changes taking effect January 1
Obviously this would be a good time for HHS to send out a notice that they are holding a public hearing in Austin on January 11, 2018, to get public comment on the Proposed Medicaid Payment Rates for the 2018 Annual Healthcare Common Procedure Coding System (HCPCS) Updates. Say what?
Yes, let us provide you below the text from the HHS webpage. Incredibly, HHS is holding a hearing on January 11 to get comment on fee changes that are taking place on January 1. What?
Worse, look, ” A briefing package describing the proposed payment rates will be available at http://rad.hhs.texas.gov/rate-packets on or after December 28, 2017. ”
Are these the earlier protested fee changes?
Are these the same fees that were put on hold due to provider outrage back in August? We don’t know and have started asking around.
Hopefully, we are wrong and it is not bad news. But you should know about this now regardless.
Merry Christmas to Medicaid providers from HHS.
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Hearing. The Texas Health and Human Services Commission (HHSC) will conduct a public hearing to receive public comment on proposed Medicaid payment rates for the 2018 Annual Healthcare Common Procedure Coding System (HCPCS) Updates. The hearing will be held in compliance with Texas Human Resources Code §32.0282, which requires public notice of and hearings on proposed Medicaid reimbursements. HHSC will broadcast the public hearing; the broadcast can be accessed at https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings. The broadcast will be archived and can be accessed on demand at the same website.
Location & Time:
January 11, 2018 – 3:00pm
Proposal. The payment rates for the 2018 Annual HCPCS Updates are proposed to be effective January 1, 2018, for the following services:
Physician Administered Drugs – Type of Service (TOS) 1 (Medical Services);
Medical Services – TOS 1 (Medical Services);
Surgery and Assistant Surgery Services – TOS 2 (Surgery Services) and 8 (Assistant Surgery);
Nonclinical Laboratory Services – TOS 5 (Laboratory), I (Interpretation Component), and T (Technical Component);
Clinical Laboratory Services – TOS 5 (Laboratory Services);
Anesthesia Services – TOS 7 (Anesthesia Services);
Durable Medical Equipment, Prosthetics, Orthotics, and Supplies – TOS 9 (Other Medical Items or Services) and J (DME Purchase – New);
Ambulatory Surgical Center – TOS F (Ambulatory Surgical Center); and
Dental Services – TOS W (Texas Health Steps Dental/Orthodontia).
Methodology and Justification. The proposed payment rates were calculated in accordance with Title 1 of the Texas Administrative Code:
§355.8021, which addresses the reimbursement methodology for home health services;
§355.8023, which addresses the reimbursement methodology for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS);
§355.8085, which addresses the reimbursement methodology for physicians and other practitioners;
§355.8097, which addresses the reimbursement methodology for physical, occupational, and speech therapy services;
§355.8121, which addresses the reimbursement methodology for ambulatory surgical centers;
§355.8221, which addresses the reimbursement methodology for certified registered nurse anesthetists and anesthesiologist assistants;
§355.8441, which addresses the reimbursement methodology for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Services (also known as Texas Health Steps); and
§355.8610, which addresses the reimbursement methodology for clinical laboratory services.
Briefing Package. A briefing package describing the proposed payment rates will be available at http://rad.hhs.texas.gov/rate-packets on or after December 28, 2017. Interested parties may obtain a copy of the briefing package before the hearing by contacting Rate Analysis by telephone at (512) 730-7401; by fax at (512) 730-7475; or by e-mail at RADAcuteCare@hhsc.state.tx.us. The briefing package will also 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 e-mail:
U.S. Mail
Texas Health and Human Services Commission
Attention: Rate Analysis, Mail Code H-400
P.O. Box 149030
Austin, Texas 78714-9030
Overnight mail, special delivery mail, or hand delivery
Texas Health and Human Services Commission
Attention: Rate Analysis, Mail Code H-400
Brown-Heatly Building
4900 North Lamar Blvd.
Austin, Texas 78751
Phone number for package delivery: (512) 730-7401
Fax
Attention: Rate Analysis at (512) 730-7475