Adopted Rules Title 1

TITLE 1. ADMINISTRATION

PART 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION

CHAPTER 382. WOMEN'S HEALTH SERVICES

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §382.1, concerning Introduction; §382.5, concerning Definitions; §382.7, concerning Client Eligibility; §382.9, concerning Application and Renewal Procedures; §382.15, concerning Covered and Non-covered Services; §382.17, concerning Health-Care Providers; §382.101, concerning Introduction; §382.105, concerning Definitions; §382.107, concerning Client Eligibility; §382.109, concerning Financial Eligibility Requirements; §382.113, concerning Covered and Non-covered Services; §382.115, concerning Family Planning Program Providers; §382.119, concerning Reimbursement; §382.121, concerning Provider's Request for Review of Claim Denial; §382.123, concerning Record Retention; §382.125, concerning Confidentiality and Consent; and §382.127, concerning FPP Services for Minors; and adopts the repeal of §382.3, concerning Non-entitlement and Availability; and §382.11, concerning Financial Eligibility Requirements.

The amendments to §§382.1, 382.5, 382.7, 382.9, 382.15, 382.17, 382.101, 382.105, 382.107, 382.109, 382.113, 382.115, 382.119, 382.121, 382.123, 382.125, and 382.127; and the repeal of §382.3 and §382.11 are adopted without changes to the proposed text as published in the March 8, 2024, issue of the Texas Register (49 TexReg 1360). Therefore, the rules will not be republished.

BACKGROUND AND JUSTIFICATION

The primary purpose of the adopted rules is to update eligibility and other Medicaid requirements in the Healthy Texas Women (HTW) program to describe the agency's compliance with the HTW Section 1115 Demonstration that was approved by the Centers for Medicare and Medicaid Services on January 22, 2020, and transitioned the majority of the program into Medicaid. For eligible minors, the HTW program remains fully funded by state general revenue.

Another purpose of the adopted rules is to comply with Texas Health and Safety Code §32.102, added by Senate Bill (S.B.) 750, 86th Legislature, Regular Session, 2019, which requires HHSC to provide enhanced postpartum care services, called HTW Plus, to eligible clients. HHSC made HTW Plus available to eligible clients enrolled in the HTW program beginning September 1, 2020.

Another purpose of the adopted rules is to comply with Texas Health and Safety Code §31.018, also added by S.B. 750, to include a requirement for women in HTW to receive referrals to the Primary Health Care Services Program.

Another purpose of the adopted rules is to make conforming amendments to the Family Planning Program (FPP) rules where necessary and update covered and non-covered services for HTW and FPP.

Other non-substantive clarifying changes were made throughout the rules.

COMMENTS

The 31-day comment period ended April 8, 2024.

During this period, HHSC received comments regarding the proposed rules from five commenters, including Every Body Texas, Texas Association of Community Health Centers, Texans Care for Children, Teaching Hospitals of Texas, and Texas Women's Healthcare Coalition. A summary of comments relating to the rules and HHSC's responses follows.

Comment: Several commenters supported the inclusion of HTW Plus in these rules, specifically in §382.5 by adding a definition for and references to HTW Plus, §382.7 by including the requirements for HTW clients to qualify for HTW Plus services, and §382.15 by incorporating HTW Plus covered services.