TITLE 1. ADMINISTRATION
PART 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 371. MEDICAID AND OTHER HEALTH AND HUMAN SERVICES FRAUD AND ABUSE PROGRAM INTEGRITY
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Office of Inspector General (OIG), adopts in the Texas Administrative Code, Title 1, Part 15, Chapter 371 amendments to §371.1, concerning Definitions; §371.3, concerning Purpose and Authority; §371.31, concerning Federal Felony Match; §371.1011, concerning Recommendation Criteria; §371.1305, concerning Preliminary Investigation; §371.1613, concerning Informal Resolution Process; §371.1663, concerning Managed Care; §371.1669, concerning Self-Dealing; and §371.1709, concerning Payment Hold.
The amendments to §§371.1, 371.3, 371.31, 371.1011, 371.1305, 371.1613, 371.1663, 371.1669, and 371.1709 are adopted without changes to the proposed text as published in the November 8, 2024, issue of the Texas Register (49 TexReg 8797). These rules will not be republished.
BACKGROUND AND JUSTIFICATION
House Bill 4611, 88th Legislature, Regular Session, 2023, made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature's ongoing statutory revision program. The amendments are necessary to update citations in the rules to reflect changes in the organization of the Texas Government Code sections that become effective on April 1, 2025. The proposed amendments update the affected citations to the Texas Government Code and revise Texas Administrative Code references.
COMMENTS
The 31-day comment period ended December 9, 2024.
During this period, OIG did not receive comments regarding the proposed amendments to the rules.
SUBCHAPTER
B.
STATUTORY AUTHORITY
The amendments are 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 Government Code §531.033, which requires the Executive Commissioner of HHSC to adopt rules necessary to carry out the commission's duties under Chapter 531; 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, to administer Medicaid funds, and to adopt rules necessary for the proper and efficient regulations of the Medicaid program; and Texas Government Code §531.102, which provides that the Executive Commissioner of HHSC shall work in consultation with the HHSC OIG whenever the executive commissioner is required by law to adopt a rule.
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 February 19, 2025.
TRD-202500632
Karen Ray
Chief Counsel
Texas Health and Human Services Commission
Effective date: April 1, 2025
Proposal publication date: November 8, 2024
For further information, please call: (512) 221-7320
SUBCHAPTER
E.
STATUTORY AUTHORITY
The amendment 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 Government Code §531.033, which requires the Executive Commissioner of HHSC to adopt rules necessary to carry out the commission's duties under Chapter 531; 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, to administer Medicaid funds, and to adopt rules necessary for the proper and efficient regulations of the Medicaid program; and Texas Government Code §531.102, which provides that the Executive Commissioner of HHSC shall work in consultation with the HHSC OIG whenever the executive commissioner is required by law to adopt a rule.
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 February 19, 2025.
TRD-202500633
Karen Ray
Chief Counsel
Texas Health and Human Services Commission
Effective date: April 1, 2025
Proposal publication date: November 8, 2024
For further information, please call: (512) 221-7320
SUBCHAPTER
F.
STATUTORY AUTHORITY
The amendment 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 Government Code §531.033, which requires the Executive Commissioner of HHSC to adopt rules necessary to carry out the commission's duties under Chapter 531; 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, to administer Medicaid funds, and to adopt rules necessary for the proper and efficient regulations of the Medicaid program; and Texas Government Code §531.102, which provides that the Executive Commissioner of HHSC shall work in consultation with the HHSC OIG whenever the executive commissioner is required by law to adopt a rule.
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 February 19, 2025.
TRD-202500634
Karen Ray
Chief Counsel
Texas Health and Human Services Commission
Effective date: April 1, 2025
Proposal publication date: November 8, 2024
For further information, please call: (512) 221-7320
SUBCHAPTER
G.
DIVISION 1. GENERAL PROVISIONS
1 TAC §371.1613STATUTORY AUTHORITY
The amendment 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 Government Code §531.033, which requires the Executive Commissioner of HHSC to adopt rules necessary to carry out the commission's duties under Chapter 531; 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, to administer Medicaid funds, and to adopt rules necessary for the proper and efficient regulations of the Medicaid program; and Texas Government Code §531.102, which provides that the Executive Commissioner of HHSC shall work in consultation with the HHSC OIG whenever the executive commissioner is required by law to adopt a rule.
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 February 19, 2025.
TRD-202500635
Karen Ray
Chief Counsel
Texas Health and Human Services Commission
Effective date: April 1, 2025
Proposal publication date: November 8, 2024
For further information, please call: (512) 221-7320
DIVISION 2. GROUNDS FOR ENFORCEMENT
1 TAC §371.1663, §371.1669STATUTORY AUTHORITY
The amendments are 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 Government Code §531.033, which requires the Executive Commissioner of HHSC to adopt rules necessary to carry out the commission's duties under Chapter 531; 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, to administer Medicaid funds, and to adopt rules necessary for the proper and efficient regulations of the Medicaid program; and Texas Government Code §531.102, which provides that the Executive Commissioner of HHSC shall work in consultation with the HHSC OIG whenever the executive commissioner is required by law to adopt a rule.
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 February 19, 2025.
TRD-202500636
Karen Ray
Chief Counsel
Texas Health and Human Services Commission
Effective date: April 1, 2025
Proposal publication date: November 8, 2024
For further information, please call: (512) 221-7320
DIVISION 3. ADMINISTRATIVE ACTIONS AND SANCTIONS
1 TAC §371.1709STATUTORY AUTHORITY
The amendment 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 Government Code §531.033, which requires the Executive Commissioner of HHSC to adopt rules necessary to carry out the commission's duties under Chapter 531; 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, to administer Medicaid funds, and to adopt rules necessary for the proper and efficient regulations of the Medicaid program; and Texas Government Code §531.102, which provides that the Executive Commissioner of HHSC shall work in consultation with the HHSC OIG whenever the executive commissioner is required by law to adopt a rule.
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 February 19, 2025.
TRD-202500637
Karen Ray
Chief Counsel
Texas Health and Human Services Commission
Effective date: April 1, 2025
Proposal publication date: November 8, 2024
For further information, please call: (512) 221-7320
CHAPTER 377. CHILDREN'S ADVOCACY PROGRAMS
SUBCHAPTER
B.
The Texas Health and Human Services Commission (HHSC) adopts amendments to §377.107, concerning Contract with Statewide Volunteer Advocate Organization, and §377.113, concerning Local Volunteer Advocate Program Administration.
The amendments are adopted without changes to the proposed text as published in the November 8, 2024, issue of the Texas Register (49 TexReg 8810). The rules will not be republished.
BACKGROUND AND JUSTIFICATION
The amendments are necessary to comply with House Bill (H.B.) 474, 88th Legislature, Regular Session, 2023, which amends Texas Family Code §264.603 and §264.604, which requires HHSC to include in the contract measurable goals and objectives for the number of active and inactive volunteers in the Court Appointed Volunteer Advocate Program, and to ensure the statewide volunteer advocate organization adopts a grievance process for complaints regarding negligence or misconduct by a volunteer advocate.
COMMENTS
The 31-day comment period ended December 9, 2024.
During this period, HHSC received a comment regarding the proposed rules from one commenter, Texas CASA, Inc. A summary of the comment relating to the rules and HHSC's responses follows.
Comment: The comment requests a change to the way inactive volunteers are counted and measured. The commenter wants to separate active and inactive volunteers and remove the requirement for measurable goals and objectives for inactive volunteers.
Response: HHSC disagrees and declines to revise the rule in response to this comment. H.B. 474, codified in Texas Family Code §264.603(a), requires measurable goals and objectives for both active and inactive volunteers. Goals and objectives for active volunteers may vary from the goals and objectives of inactive volunteers.
STATUTORY AUTHORITY
The amendments are 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, and Texas Family Code §264.609, which authorizes the Executive Commissioner of HHSC to adopt rules governing the Court Appointed Volunteer Advocate Program.
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 February 18, 2025.
TRD-202500588
Karen Ray
Chief Counsel
Texas Health and Human Services Commission
Effective date: March 10, 2025
Proposal publication date: November 8, 2024
For further information, please call: (512) 460-0992