Status of HCS Rates as of January 17th, 2022

HCS and TxHmL Day Habilitation Rates, Respite Rates and Other Concerns
  • The Public Health Emergency (PHE) was renewed until April 16, 2022, and
  • Clarification:  The HCS & TxHmL rates posted on HHSC’s webpage listed as Effective March 1, 2022 to Current. are a bit confusing
HCS Day Habilitation (DH) & Respite Rates Some members have inquired about the HCS rates posted on HHSC’s website at:  https://pfd.hhs.texas.gov/sites/rad/files/documents/long-term-svcs/2022/03-01-2022-hcs-rates.pdf
This is a bit confusing according to those who have viewed it already, since the rates posted are the same as the 2020 rates.  Such is further confusing when only the DH and Respite rates note an effective date of March 1, 2022 and the statement at the bottom of the DH rate pages reads:  Effective March 1, 2022:  DH includes in-home and out-of-home. Some have questioned whether this statement means that the COVID add-on rate is ending March 1 – a date that contradicts the statement on the LTSS Rate home webpage:   https://pfd.hhs.texas.gov/long-term-services-supports .
The temporary COVID-19 rate increases were effective April 1, 2020, and are estimated to conclude at the end of the federally-declared public health emergency (PHE). The PHE is anticipated to end on March 16, 2022, unless the PHE is withdrawn before this date or extended. The official PHE notifications can be viewed here.
This action does not impact the current COVID add-on rate for the provision of in-home DH in HCS.  As noted in the above italicized paragraph, the PHE has been renewed.  Unfortunately, HHSC inadvertently erred in its statement that the PHE is now “anticipated to end on March 16th”.  PHEs are renewed on a 90-day basis, meaning that HHSC needs to correct this statement to read that the PHE is anticipated to end on April 16 unless withdrawn before that date or extended.

Status of HCS Rates as of Jan., 1st, 2020

HCS Rates 2020

https://pfd.hhs.texas.gov/sites/rad/files/documents/long-term-svcs/2020/2020-09-hcs-rates.pdf


Status of HCS Rates as of Oct. 11th, 2019:

 

As of October 11th, 2019, members of the HHSC Rate Workgroup were notified that the proposed rule amendments to implement the HCS rates that will be effective Jan. 1, 2020 thru August 31, 2021 have been sent to the Texas Register and will be published next Friday. 
. Any claims with DOS 11/10/19, and after will pay at the new rates. Claims billed prior to 11/10/19 will be reprocessed over the next three months and conclude by January 31.  Provider letter should go out next week.
These are the increases that will be applied to the LON 1, 5 & 8 residential rates and the additional rate increases that will be applied to the LON 6 & 9 residential rates. 
 Note:  A public hearing on the rule amendments and rates will be held at HHSC in its Public Hearing Room on November 4, 2019.
 HHSC Rate Analysis Director, has indicated that the rate increases for RSS LON 6 and 9, Day Habilitation and Supported Home Living/CFC will be posted Monday, October 14, 2019 (at the latest, Tuesday, October 15, 2019).
Remember:  These rates will be implemented as proposed in July, 2019 and will be retroactively effective to September 1, 2019.

SUMMARY OF PROPOSED PAYMENT RATES
Effective September 1, 2019

PROPOSED RATES:   HHSC proposes to increase the payment rates for the HCS Supervised Living / Residential Support Services, Day Habilitation, Supported Home Living Transportation, Community First Choice (CFC) Supported Home Living, and CFC Consumer Directed Services Supported Home Living in accordance with the 2020-21 General Appropriations Act, 86th Legislature, Regular Session, 2019 (Article II, HHSC, Rider 44).
METHODOLOGY AND JUSTIFICATION
The proposed payment rates were calculated in accordance with 1 TAC Section 355.723, which addresses the reimbursement methodology for the HCS program.  See HCS rates packet proposal below for Sept 1st, 2019.  Click on link to HCS rates document. 

09-01-19-hcs-rate-packet

Please contact the Rate Analysis Department’s Customer Information Center at (512) 424-6637 or by email at RAD-LTSS@hhsc.state.tx.us should you have any questions regarding the information in this document.