August 13, 2020 - 1:30pm

Add to My Calendar

Location: Due to the COVID-19 pandemic, this meeting will be conducted online virtually using Microsoft Teams only. There is not a physical location for this meeting.

Join the meeting here. Attendees who would like to provide public comment should see the Public Comment section below.

  1. Welcome, roll call, introductions, and opening remarks
  2. Approval of February 13, 2020 meeting minutes (vote required)
  3. Medicaid and Children’s Health Insurance Program activities


  4. Intellectual and Developmental Disability (IDD) habilitative specialized services

    - Anne McGonigle, Program Services Manager, HHSC IDD Services and Anthony Jalomo, IDD Director, HHSC Business Operations

    The purpose of the proposal is to describe the requirements applicable to a service provider agency providing preadmission screening and resident review IDD habilitative specialized services (IHSS) to Medicaid-eligible nursing facility residents aged 21 years and older found through PASRR to need such services.

  5. Long term care regulatory certification principle re-write

    - Kristin Priddy, Senior Policy Specialist, HHSC Long-term Care Regulatory Services

    HHSC proposes to draft new rules describing regulatory certification principles for the Home and Community-based Services (HCS) Medicaid waiver program providers. The new rules will describe certification principles regarding service delivery, individual rights, requirements related to abuse, neglect and exploitation, staff member and service provider requirements, and quality assurance.

  6. HCS/Texas Home Living (TxHmL) respite and day habilitation reimbursement

    - Samuel West, Manager, HHSC Research, Development and Methodology

    The proposed amendments ensure compliance with the 21st Century Cures Act, which added Section 1903(l) to the Social Security Act to require all states to implement the use of electronic visit verification (EVV) for all Medicaid personal care services requiring an in-home visit by a service provider. Currently, HCS and TxHmL providers bill day habilitation (DH) and respite using service codes that do not distinguish between in-home and out-of-home service provision. The proposed amendments establish separate service codes for in-home and out-of-home care to allow HHSC to compare service claims for in-home DH and respite with the information in the EVV aggregator regarding the provision of those services.

  7. EVV

    - Jordan Nichols, Director, HHSC EVV

    This proposal is to consolidate the EVV rules into one location, implement federal and state requirements for the Texas EVV system, and remove unnecessary or duplicative rules from the Texas Administrative Code. Texas EVV began as a state-mandated system and is in the process of changing to comply with current state law and newly enacted federal law. An EVV system electronically verifies information relating to the delivery of services, such as the type of service provided, names of the member and provider, and dates and times of services provided. The proposed new rules list the services subject to the use of EVV and to whom they apply.

  8. Claims payment deadlines exceptions

    - Caryl Chambliss, Director, HHSC Operations Management Claims Administration

    Under Texas Administrative Code Title 1 §354.1003, most Medicaid providers must submit claims to the claims administrator within 95 days of the date of service or they will be denied for late filing. Additionally, providers must adhere to claims filing and appeal deadlines, and all claims must be finalized within 24 months of the date of service. On occasion, circumstances beyond the providers’ control result in claims being finalized outside of this 24-month requirement. The purpose of this amendment is to add an exception to the rule that allows HHSC to consider such situations as exceptions to the provider 24-month time limit for filing claims if the provider shows good cause and to the extent permitted by state and federal law. Exceptions for this reason are currently made on a case-by-case basis, and adding this additional exception will bring the rule into alignment with current practice.

  9. HHSC 2020 advisory committee amendments and repeals

    - Kymberly Oltrogge, Attorney, HHSC Legal Services Division

    The purpose of the proposal is to amend certain rules to extend advisory committees that are set to be abolished, revise certain committees’ membership and tasks to incorporate duties related to persons on the autism spectrum, align the rules with statute and statutory interpretations, clarify terms, and repeal a rule for an advisory committee that no longer functions.

  10. Public comment.
  11. Proposed next meeting: November 12, 2020, at 9:00 a.m.
  12. Adjourn

Public Comment: The Texas Health and Human Services Commission (HHSC) welcomes public comments pertaining to topics related to eligibility, health and medical care services and policies that govern the administration of the Texas Medicaid program. Members of the public who would to provide public comment are asked to complete a Public Comment Form here. Members of the public are encouraged to participate in this process by providing written public comment to HHSC by emailing Caroline Sunshine no later than 5:00 p.m., Tuesday, August 11, 2020. Please include your name and the organization you are representing, or state if you are speaking as a private citizen. Written comments are limited to three minutes and will be read during the meeting for consideration by the Council.

If you would like to register to provide oral comments, please mark the correct box on the Public Comment form.  Instructions for providing oral comment will be emailed to you.  Registration should be completed no later than 5:00 p.m., Tuesday, August 11, 2020. Members of the public may also use the Microsoft Teams Live Event Q&A section to submit a request to provide public comment.  The request must contain your name and either the organization you are representing or that you are speaking as a private citizen, and your direct phone number.

Public comment is limited to three minutes.  Speakers must state their name and on whose behalf they are speaking. Public members who are using handouts are asked to provide an electronic copy in accessible pdf format that will be distributed by HHSC staff to members, state staff and for public distribution. Handouts are limited to two pages (paper size: 8.5” by 11”, one side only). Handouts must be emailed to HHSC staff immediately after registering and include the name of the person who will be commenting.

Contact: Questions regarding agenda items, content, or meeting arrangements should be directed to Caroline Sunshine, Advisory Committee Coordinator, Medicaid and CHIP Services Department, 512-428-1948,

This meeting is open to the public. No reservations are required, and there is no cost to attend this meeting.

People with disabilities who wish to attend the meeting and require assistive technology or services should contact Sunshine at 512-428-1948 or at least 72 hours before the meeting so appropriate arrangements can be made.