TITLE 1. ADMINISTRATION

PART 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION

CHAPTER 353. MEDICAID MANAGED CARE

SUBCHAPTER O. DELIVERY SYSTEM AND PROVIDER PAYMENT INITIATIVES

1 TAC §353.1311

The Texas Health and Human Services Commission (HHSC) adopts an amendment to §353.1311, concerning Quality Metrics for the Texas Incentives for Physicians and Professional Services Program.

The amendment to §353.1311 is adopted without changes to the proposed text as published in the July 19, 2024, issue of the Texas Register (49 TexReg 5223) and, therefore, will not be republished.

BACKGROUND AND JUSTIFICATION

Each directed payment program (DPP) has a quality rule and financial rule. Effective January 28, 2024, HHSC amended the Texas Incentives for Physicians and Professional Services (TIPPS) financial rule, §353.1309, to add a pay-for-performance component to TIPPS beginning with state fiscal year 2026.

The adoption of amended §353.1311, the TIPPS quality rule, implements the quality reporting necessary for the pay-for-performance component of the TIPPS financial rule. The adopted amendment also makes non-substantive changes to the text of the rule to make the TIPPS quality rule mirror the quality rules for other DPPs.

COMMENTS

The 31-day comment period ended August 19, 2024.

During this period, HHSC did not receive any comments regarding the proposed rule.

STATUTORY AUTHORITY

The adoption of the amendment is authorized by Texas Government Code §531.033, which provides the Executive Commissioner with broad rulemaking authority; 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 Government Code §533.002, which authorizes HHSC to implement the Medicaid managed care 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 October 24, 2024.

TRD-202404970

Karen Ray

Chief Counsel

Texas Health and Human Services Commission

Effective date: November 13, 2024

Proposal publication date: July 19, 2024

For further information, please call: (512) 438-2910