Proposed Medicaid Payment Rates for Ambulance, Birth and Woman’s Health Services, Evaluation and Management, Private Duty Nursing, Personal Care Services, Rural Hospital Inpatient and Outpatient Services

Hearing. The Texas Health and Human Services Commission (HHSC) will conduct a public hearing to receive public comments on proposed Medicaid payment rates for Ambulance, Birth and Woman’s Health Services, Evaluation and Management, Private Duty Nursing, Personal Care Services, Rural Hospital Inpatient and Outpatient Services. The proposed rate actions are based on direction provided by the 2024-25 General Appropriations Act (GAA), House Bill 1, 88th Legislature, Regular Session, 2023 (Article II, Special Provisions Relating to all Health and Human Services Agencies).  

This hearing will be conducted both in-person and online. 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/4862721446890562654

After registering, you will receive a confirmation email containing information about joining the hearing. Instructions for dialing-in by phone will be provided after you register.

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

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 they may access a live stream of the meeting at https://www.hhs.texas.gov/about/live-archived-meetings. For the live stream, select the “Winters Live” tab. A recording of the hearing will be archived and can be accessed on demand at https://www.hhs.texas.gov/about/live-archived-meetings under the “Archived” tab. The hearing will be held in compliance with Texas Human Resources Code Section 32.0282, which requires public notice of and hearings on proposed Medicaid reimbursements.

Proposal.  The rate actions for the following services are proposed to be effective September 1, 2023:

A(1) Ambulance

A(2) Birth and Women’s Health Services

A(3) Evaluation and Management

A(4) Private Duty Nursing

A(5) Personal Care Services

B(1) Rural Hospital Inpatient Services

B(2) Rural Hospital Outpatient Services

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

Section 355.8021 – Reimbursement Methodology for Home Health Services;

Section 355.8085 – Reimbursement Methodology for Physicians and Other Practitioners;

Section 355.8441 – Reimbursement Methodologies for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Services (known in Texas as Texas Health Steps);

Section 355.8600 - Reimbursement Methodology for Ambulance Services; and

Section 355.8641 – Reimbursement Methodology for the Women's Health Program.

Section 355.8052 –Inpatient Hospital Reimbursement

Section 355.8061 –Outpatient Hospital Reimbursement

Rate Hearing Packet. A briefing packet describing the proposed payment rates will be made available at https://pfd.hhs.texas.gov/rate-packets no later than June 30, 2023. 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 or pfd_hospitals@hhsc.state.tx.us.

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, 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

or

pfd_hospitals@hhsc.state.tx.us

Preferred Communication.  For quickest response 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.