Health and Human Services Commission Public Hearing SB 1648

The Texas HHSC welcomes public comments pertaining to an amendment to chapter 353 of the Texas Administrative Code. The Texas Health and Human Services Commission (HHSC) conducted a public hearing on May 16, 2022, at 11:00 AM to solicit feedback and receive comment on the amendment of sections 353.4 and 353.7 of part 15 of title 1 of the Texas Administrative Code . This amended rule will direct managed care organizations (MCOs) to allow a Medicaid managed care recipient with complex medical needs to continue receiving care from a specialty provider with whom the recipient has an established relationship, regardless of whether the recipient has primary health benefit plan coverage in addition to Medicaid coverage; and to allow the provider to continue to be reimbursed at the fee-for-service rate until (1) an alternate reimbursement agreements, including a single-case agreement, has been reached; (2) the member or member’s legally authorized representative agree to select an in-network