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On May 17th, HHSC will conduct a public hearing to receive comments on the new proposed regional healthcare partnership (RHP) map. In early April 2012, HHSC issued a map dated March 30, 2012, outlining proposed RHP boundaries under the Texas Healthcare Transformation and Quality Improvement 1115 waiver. The new map incorporates feedback HHSC received from proposed anchor entities and counties on the proposed March 30, 2012 map. 

Please see the public notice and the agenda for the May 17, 2012 RHP public hearing for more information. Addtional details about the 1115 Wavier process can be found at http://www.hhsc.state.tx.us/1115-waiver.shtml.

There are a few important items not included in the attached notices that HHSC would like to share with stakeholders:

• The public hearing will start promptly at 1:30 p.m. HHSC will hear public testimony until each person who wishes to speak has an opportunity to present. If testimony ends before 4:30 p.m., the hearing will end early. Those interested in speaking at the public hearing should plan to arrive by 1:30.
• The purpose of the hearing is for Executive Commissioner Tom Suehs to hear from entities in RHPs that are still in contention (either counties disagreeing with RHP placement on the May 11, 2012 map or an RHP anchor still in question) in order to finalize RHP region development. HHSC requests those counties and anchors in question to please attend the public hearing to voice concerns to the Executive Commissioner. The Executive Commissioner will take these public hearing comments into consideration when developing the final RHP geography and anchors. HHSC will issue the final RHP map shortly following the public hearing based on the Executive Commissioner’s final recommendations and submit to CMS for federal approval.
• HHSC encourages RHP participants to work together prior to the public hearing to determine RHP geography and anchors.  Should participants have questions on RHP development, please contact HHSC at TXHealthcareTransformation@hhsc.state.tx.us.
• During the public hearing, HHSC intends to accept comments in response to the May 11, 2012 RHP map, not the March 30, 2012 RHP map.
• Depending on the amount of public comment during the hearing, the 3-minute presentation rule may be invoked.
• A conference call line is available for out-of-town stakeholders interested in listening to the hearing. Please note: stakeholders wishing to testify need to attend the hearing in person. Testimony will not be allowed over the conference call line.
  • Conference Call Number – 1-877-226-9790
  • Access Code – 8317345

In a press release today from HHS, Secretary Kathleen Sebelius announced that HHS will initiate a process to postpone the compliance date by which certain health entities have to comply with ICD-10. The press release can be found below.

Press Release: HHS Announces Intent to Delay ICD-10 Compliance Date
As part of President Obama’s commitment to reducing regulatory burden, Health and Human Services Secretary Kathleen G. Sebelius today announced that HHS will initiate a process to postpone the date by which certain health care entities have to comply with International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10).

The final rule adopting ICD-10 as a standard was published in January 2009 and set a compliance date of October 1, 2013 – a delay of two years from the compliance date initially specified in the 2008 proposed rule. HHS will announce a new compliance date moving forward.

“ICD-10 codes are important to many positive improvements in our health care system,” said HHS Secretary Kathleen Sebelius. “We have heard from many in the provider community who have concerns about the administrative burdens they face in the years ahead. We are committing to work with the provider community to reexamine the pace at which HHS and the nation implement these important improvements to our health care system.”
ICD-10 codes provide more robust and specific data that will help improve patient care and enable the exchange of our health care data with that of the rest of the world that has long been using ICD-10. Entities covered under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) will be required to use the ICD-10 diagnostic and procedure codes.

Please visit the ICD-10 website for the latest news and resources from CMS.
 

Thanks to a unified outcry from the physician community, CMS has announced that they will reverse their previous decision and will be publishing RVUs for CPT Code 96110 (developmental screening).

CMS has published  0.29 total RVUs and revised the code status indicator for 96110 from "X" (Statutory Exclusion) to "N" (Noncovered Service), which now allows non-Medicare payers that cover developmental screening, and base payment on Medicare RBRVS, to continue to do so. For additional details, please see the CMS Bulletin announcing this decision.

HHSC has announced tentative award contracts for Medicaid, CHIP, and dental managed care services effective March 1, 2012. Below you will find maps of the new service areas, as well as information on the managed care organizations that will be serving each area.

Service Area Maps:
STAR Service Areas and Medicaid Rural Service Area (MRSA)
Medicaid Rural Service Area Regions
STAR+PLUS Service Area
CHIP Service Areas

MCO Provider Representative Contact Information

The prescription drug benefit will also be included in CHIP and Medicaid managed care effective March 1, 2012. Prescription drug benefits will no longer be paid through HHSC's Vendor Drug Program, but managed care organizations will use the same state drug formulary as Medicaid fee-for-service.

HHSC will be hosting a series of provider trainings in the Managed Care Expansion service delivery areas. These meetings will allow HHSC to present information on managed care and providers will be given an opportunity to ask questions relevant to Medicaid and CHIP services.
There is no cost to attend these trainings. Trainings will be conducted in select cities across the state between September and November 2011 in half-day segments. 

Calendar of Trainings

Register for Training Online

For additional information please visit the HHSC Medicaid managed care initiatives webpage at: http://www.hhsc.state.tx.us/medicaid/MMC.shtml.
More info is also available through the TMHP webpage at: http://www.tmhp.com/Pages/PCCM/PCCM_Home.aspx.