November 12, 2020 - 9:00am

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Location: Due to the COVID-19 pandemic, this meeting is conducted virtually using the Microsoft Teams application. This meeting does not have a physical location.

Join the meeting here.

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

  1. Welcome, introductions, and opening remarks
  2. Approval of August 13, 2020, meeting minutes (vote required)
  3. Medicaid and Children’s Health Insurance Program (CHIP) activities
  4. Texas managed care quality strategy


  1. Intellectual and Developmental Disability (IDD) Habilitative Specialized Services

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

    - Anne McGonigle, Program Services Manager, Health and Human Services Commission (HHSC) IDD Services

  2. Medicaid Substance Use Disorder (SUD)

    HHSC is modifying Rule §354.1311, Benefits and Limitations, to allow SUD treatment services to exceed current limits when medically necessary in response to federal mental health and substance use disorder parity requirements and state Medicaid SUD medical policy updates. Rule §354.1312, Conditions for Participation, has been updated to remove obsolete references to the Department of State Health Services as the licensing entity for substance abuse treatment facilities, replacing them with references to HHSC. Furthermore, Rule §354.1312 proposes expanding the providers who may deliver medication assisted treatment, consistent with both federal and state legislation.

    - Meghan Young, Manager, HHSC Policy and Program Development

  3. Nurse Aide Training and Competency Evaluation Program (NATCEP)

    The purpose of the proposal is to allow a NATCEP provider to offer components of required training online in a virtual classroom location. Currently, all NATCEP training is provided in classroom and clinical settings. This initiative is a response to a critical shortage in trained nurse aides in nursing homes. This proposal aims to increase the number of nurse aides qualified for NF employment. Due to the challenges presented by COVID-19 and the need for greater awareness and emphasis on infection control, HHSC is also proposing NATCEP providers increase infection control training and continuing education requirements for nurse aides.

    - Catherine Anglin, Program Manager, HHSC Policy Rules and Training

  4. Nursing Facility Administrator Licensing

    This proposal will amend existing, add new, and repeal portions of the nursing facility administrators (NFA) licensure requirements to correspond with the Nursing Administrators Board (NAB) requirements, including reciprocity. NFAs will be able to take required training and to attain or maintain certification as a preceptor at their convenience and via computer-based training. Allowing reciprocity for individuals credentialed as a Health Services Executive will also streamline the process for obtaining credentialing as an NFA. Due to the challenges presented by COVID-19, HHSC is also proposing that NF providers increase infection control training and continuing education requirements for NFAs.

    - Catherine Anglin, Program Manager, HHSC Policy Rules and Training


  1. Behavioral Health Services Disaster Rules

    The purpose of this proposal is to allow HHSC flexibility to waive certain requirements for the delivery of services in response to a declared disaster. The proposed new rule is based on the existing emergency rule created in 26 Texas Administrative Code §306.1351, relating to COVID-19 Flexibilities. This proposal creates a standing rule, allowing providers subject to the rule to operate with the same flexibilities afforded by the emergency rule and it ensures continuity of services for individuals receiving community-based behavioral health services.

    - Lizet Alaniz, Rules Coordinator, HHSC Behavioral Health Services Operations

  2. Federally Qualified Health Care (FQHC) Services Reimbursement (SB 670)

    The proposed amendments specify that (1) a new FQHC included on the cost report of another FQHC should be assigned the rate of the other FQHC, and (2) telemedicine and telehealth services are to be included in the definition of “visit” and a “medical visit.” This change increases transparency and provides additional detail on the existing reimbursement structure for FQHCs.

    - Rene Cantu, Director, Director, HHSC Provider Finance

  3. Uncompensated care Secondary Reconciliation for Demonstration Years 6–8

     This proposal is to revise the secondary reconciliation process applied to hospitals that requested an adjustment to their interim hospital-specific limit for purposes of calculating uncompensated care payments in demonstration years 6 through 8 (October 1, 2016, to September 30, 2019), and to describe the methodology HHSC will use to redistribute recouped funds.

    - Victoria Grady, Director, HHSC Provider Finance

  4. Rate Increase Attestation Process COVID-19

    The proposed new rule outlines the process wherein HHSC will restrict eligible Medicaid providers from using temporarily increased reimbursement rates to increase hourly wages paid to direct care staff on an ongoing basis. In accordance with the contingencies placed upon use of the funds for staff compensation, they are limited to overtime payments, lump sum bonuses, bonuses for hazard pay, or other types of compensation that will not result in future reductions to hourly wages when the emergency temporary reimbursement rate increase is discontinued.

    - Victoria Grady, Director, HHSC Provider Finance

  5. Proposed next meeting: February 11, 2021, at 9:00 a.m.
  6. 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 like 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. Monday, November 9, 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. Monday, November 9, 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.  Each speaker must state their name and on whose behalf they are speaking (if anyone). Public members who are using handouts are asked to provide an electronic copy in accessible pdf format that will be distributed by HHS staff to Committee members, State staff, and the public. Handouts are limited to two pages (paper size: 8.5” by 11”, one side only). Handouts must be emailed to HHSC 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.