PART 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER L. LOCAL FUNDS MONITORING
The Texas Health and Human Services Commission (HHSC) adopts new §355.8707, concerning Notification Requirements for the Creation of a Local Provider Participation Fund (LPPF).
HHSC adopts new §355.8707 with changes to the proposed text as published in the March 31, 2023, issue of the Texas Register (48 TexReg 1683). This rule will be republished.
BACKGROUND AND JUSTIFICATION
The new rule implements the requirements of House Bill 4289, 86th Legislature, Regular Session, 2019, by establishing a process that requires certain political subdivisions to notify HHSC of the creation of a new LPPF as authorized by Texas Health and Safety Code Chapter 300 or Texas Health and Safety Code Chapter 300A. This rule will ensure that HHSC receives appropriate and timely notice of newly created LPPFs, enabling the agency to maintain oversight and reduce the risk of federal recoupment.
This new rule is also necessary to comply with the requirements of 42 C.F.R. §433.51 (Public Funds as the State share of financial participation), 42 C.F.R. §433.68 (Permissible health care-related taxes), 42 C.F.R. §433.74 (Reporting requirements), and Sections 1903(w)(1)(A)(i)-(iii) of the Social Security Act.
COMMENTS
The 31-day comment period ended May 1, 2023.
During this period, HHSC received the following comments regarding the new rule from four commenters: UT Health Athens, Paris Regional Health, CHRISTUS Health, and the Texas Organization of Rural and Community Hospitals (TORCH). A summary of comments relating to the rule and HHSC's responses follows.
Comment: Two commenters requested clarification of the types of agreements that should be submitted to document relationships between the Local Governmental Entity (LGE) and private providers. The commenters thought a non-exhaustive list of types of agreements that HHSC has received from other local funds monitoring efforts would be helpful.
Response: HHSC understands the desire to have a list of potential types of agreements that must be submitted; however, HHSC does not have access to LGE records or insight into the full array of business relationships between LGEs and private entities. We will post a list of agreements we have encountered so far in our monitoring efforts. Still, it is the LGE's sole responsibility to provide each agreement between the LGE and private providers, regardless of type. Before annual reporting opens in October 2023, the non-exhaustive list of relationship and document types will be available on the Provider Finance Department's Local Funds Monitoring (LFM) website at: https://pfd.hhs.texas.gov/local-funds-monitoring. No changes to the rule text were made as a result of these comments.
Comment: Two commenters expressed support for the new rule.
Response: HHSC appreciates the commenters' support of the rule. No changes were necessary in response to these comments.
Minor editorial changes were made to §355.8707(a)(2)(G) and §355.8707(a)(4)(A) to correct punctuation and spelling.
STATUTORY AUTHORITY
The new rule is adopted under Texas Government Code §531.0055, which provides that the Executive Commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services agencies; Texas Human Resources Code §32.021 and Texas Government Code §531.021(a), which provide HHSC with the authority to administer the federal medical assistance (Medicaid) program in Texas; and Texas Health and Safety Code §300.0154 and §300A.0154, which require the Executive Commissioner of HHSC to adopt rules relating to LPPF reporting.
§355.8707.Notification Requirements for the Creation of a Local Provider Participation Fund (LPPF).
(a) A local government, as defined in Texas Health and Safety Code Chapter 300, or a district, as defined in Texas Health and Safety Code Chapter 300A, that creates a new local provider participation fund (LPPF) as authorized by those chapters must send HHSC notice of the creation of a new LPPF according to the following procedures.
(1) HHSC must receive notice of a newly created LPPF electronically to PFD_LFM@hhs.texas.gov no later than 10 business days from the date of the local government or district's creation of the LPPF.
(2) The notice must contain the following.
(A) Contact information for at least two employees, board members, or elected officials of the local government or district authorized to implement an LPPF, as well as any individuals the local government or district authorizes to receive informational updates related to LPPF formation and reporting. Contact information shall include:
(i) full names;
(ii) titles and description of involvement with the LPPF (if not an employee, board member, or elected official of the local government or district);
(iii) email addresses; and
(iv) phone numbers.
(B) Audio recordings of discussions or written minutes from public meetings, such as commissioner's court meetings or hospital district board meetings, that document the approval of LPPF formation and any associated rate setting.
(C) Resolution approving rules and procedures for LPPF mandatory assessment payments.
(D) Resolution authorizing the formation of the LPPF, collection of a mandatory assessment payment, and use of funds from the mandatory assessment payments.
(E) Public notices from a hardcopy or digital source, such as a newspaper article, notifying providers in the jurisdiction of the intent to create an LPPF and set associated rates.
(F) Copies of written notice provided to the chief operating officer of each provider that will be required to pay a mandatory assessment.
(G) Invoices or other records of LPPF mandatory assessments and payments received from providers, if any, have been made at the time notice is provided to HHSC.
(H) Any agreements between the local government or district implementing the LPPF (including a local government that created the district under Texas Health and Safety Code §300A.0021) and a health care provider or entity related to a health care provider that is required to pay a mandatory assessment, if applicable.
(3) On receipt of a notice for the creation of an LPPF, HHSC:
(A) acknowledges receipt of the notice to the local government or district; and
(B) reviews the information submitted by the local government or district.
(i) HHSC may request additional information from the local government or district. The additional information must be received by HHSC no later than 10 business days from the date of the written request for additional information.
(ii) HHSC will extend this deadline for an additional 10 business days if it receives a request for the extension prior to the initial 10 business day due date. A request for an extension that is not received by the stated deadline will not be accepted.
(4) No local government or district may transfer local funds generated by an LPPF to HHSC via IGT until it has completed the following steps.
(A) Notify HHSC of the creation of the LPPF in accordance with this section and receive acknowledgment of receipt from HHSC.
(B) Provide HHSC with any additional information requested by HHSC as provided in this section.
(C) Establish a unique TexNet Account through the Texas Comptroller.
(D) Establish a Texas Identifier Number (TIN) through the Provider Finance Department by emailing RAD_Payments@hhs.texas.gov.
(b) Any local government or district that creates an LPPF is subject to annual reporting requirements under 1 TAC Chapter 355, Subchapter L (relating to Local Funds Monitoring).
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on July 6, 2023.
TRD-202302434
Karen Ray
Chief Counsel
Texas Health and Human Services Commission
Effective date: July 26, 2023
Proposal publication date: March 31, 2023
For further information, please call: (737) 867-7877