HHSC: Proposed Medicaid Payment Rates for the Residential Care Program, Assisted Living Services, and Personal Care 3 Services

Regulatory
January 9, 2018
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The Texas Health and Human Services Commission (HHSC) conducted a public hearing to receive comment on proposed Medicaid payment rates for the Residential Care (RC) program, Assisted Living (AL) services, and Personal Care 3 (PC3) services.  The proposed rates for the RC program will be utilized in the fee-for-service payment model and the proposed rates for AL and PC3 services will be utilized in the calculation of the STAR+PLUS managed care capitation rates for the Home and Community-Based Services risk group. Although the Community Based Alternatives (CBA) Waiver ceased to exist effective September 1, 2014, CBA rates continue to be used by actuaries, providers and managed care organizations for informational purposes for the STAR+PLUS managed care program. Accordingly, HHSC will continue to propose and adopt the CBA payment rates to be used as proxy rates, and will conduct the required rate hearings. Background. An assisted living facility is an option for those who can no longe

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