Proposed Medicaid Payment Rates for the Medicaid Biennial Calendar Fee Review

December 13, 2021 - 9:30 am

John H Winters Building, Public Hearing Room 125
701 W 51st Street
78751
United States

Hearing. The Texas Health and Human Services Commission (HHSC) will conduct a public hearing to receive public comments on proposed Medicaid payment rates for the Medicaid Biennial Calendar Fee Review.

Due to the declared state of disaster stemming from COVID-19, this hearing will be conducted both in-person and as an online event. To join the hearing from your computer, tablet, or smartphone, register for the hearing in advance using the following link:

Registration URL:
https://attendee.gotowebinar.com/register/7233576367066930448
Webinar ID: 487-075-035

After registering, you will receive a confirmation email containing information about joining the hearing. You can also dial in using your phone by calling:

Conference Number: (415) 655-0060
Phone Audio Passcode: 377-443-173

If you are new to GoToWebinar, please download the GoToMeeting app at https://global.gotomeeting.com/install/626873213 before the hearing starts.

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. A recording of the hearing will be archived and can be accessed on demand at https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings.                                

Members of the public may attend the rate hearing in person, which will be held in the Public Hearing Room 125 in the John H Winters Building located at 701 W 51st Street, Austin, Texas or may access a live stream of the meeting here. For the live stream, select the “Winters Live” tab.

Proposal. The payment rates for the Medicaid Biennial Calendar Fee Review are proposed to be effective March 1, 2022, for the following services:

Physician Administered Drugs - Vaccines and Toxoids
Q Codes NDCX

Methodology and Justification. The proposed payment rates were calculated in accordance with Title 1 of the Texas Administrative Code

§355.8085, which addresses the reimbursement methodology for physicians and other practitioners;

§355.8441, which addresses the reimbursement methodologies for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services (known in Texas as Texas Health Steps);

Rate Hearing Packet.  A briefing packet describing the proposed payment rates will be made available at https://pfd.hhs.texas.gov/rate-packets on or after December 3, 2021. Interested parties may obtain a copy of the briefing packet on or after that date by contacting Provider Finance by telephone at (512) 730-7401; by fax at (512) 730-7475; or by e-mail at PFDAcuteCare@hhs.texas.gov.

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: Provider Finance, Mail Code H-400
P.O. Box 149030
Austin, Texas 78714-9030

Overnight mail or special delivery mail
Texas Health and Human Services Commission
Attention: Provider Finance, Mail Code H-400
North Austin Complex
4601 W Guadalupe St.
Austin, Texas 78751

Phone number for package delivery: (512) 730-7401

Fax
Attention: Provider Finance at (512) 730-7475

E-mail
PFDAcuteCare@hhs.texas.gov

Preferred Communication.  During the current state of disaster due to COVID-19, physical forms of communication are checked with less frequency than during normal business operations.  For quickest response, and to help curb the possible transmission of infection, please use e-mail or phone if possible for communication with HHSC related to this rate hearing.

Persons with disabilities who wish to participate in the hearing and require auxiliary aids or services should call Provider Finance at (512) 730-7401 at least 72 hours before the hearing so appropriate arrangements can be made.