Texas Register


TITLE 26. HEALTH AND HUMAN SERVICES PART 1. HEALTH AND HUMAN SERVICES COMMISSION CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES SUBCHAPTER I. RESPONSE TO COVID-19 AND PANDEMIC-LEVEL COMMUNICABLE DISEASE 26 TAC §558.961–The Health and Human Services Commission is renewing the effectiveness of emergency new §558.961 for a 60-day period.   Original effective date: May 28, 2021.  Expiration date: November 23, 2021.

PART 9. TEXAS MEDICAL BOARD CHAPTER 174. TELEMEDICINE SUBCHAPTER A. TELEMEDICINE 22 TAC §174.5The Texas Medical Board (Board) adopts amendments to Subchapter A: Telemedicine, §174.5, concerning Issuance of Prescriptions. §174.5 relating to Issuance of Prescriptions, the amendments to §174.5(e) allow physicians to utilize telemedicine to continue issuing previous prescription(s) for scheduled medications to established chronic pain patients, if the physician has, within the past 90 days, seen a patient in-person or via a telemedicine visit using two-way audio and video communication. The amendments will consistently and conveniently provide patients access to schedule drugs needed to ensure on-going treatment of chronic pain and avoid potential adverse consequences associated with the abrupt cessation of pain medication.  To review comments and response, go to:  https://www.sos.state.tx.us/texreg/archive/October12021/Adopted%20Rules/22.EXAMINING%20BOARDS.html#87.


Federal News and Information


US Department of Justice Drug Enforcement Agency


DEA will hold our National Prescription Drug Take Back (NTBI 21) on Saturday, October 23, 2021 – 10AM to 2PM

The National Prescription Drug Take Back Day aims to provide a safe, convenient, and responsible means of disposing of prescription drugs, while also educating the general public about the potential for abuse of medications.

Please check back after October 1, 2021 to locate collection sites near you.  Go to:  https://www.deadiversion.usdoj.gov/drug_disposal/takeback/.


Centers for Medicare and Medicaid Services (CMS)


VBID Model Hospice Benefit Component Participating Plans

CMS released the list of those states that were selected to participate in the VBID Model.  Presbyterian Healthcare Services in Albuquerque, New Mexico and United HealthGroup with plans in Texas are participating.  Information for Texas is pending.


Presbyterian Shares Hospice VBID Fact Sheet and FAQs provides an overview of the Hospice VBID program, including information regarding:

  • Benefits
  • Copays and deductibles
  • Eligibility
  • Enrollment
  • Evidence of Coverage
  • Reimbursement rates
  • Requests for VBID transitional services

To review their FAQ, go to:  http://docs.phs.org/idc/groups/public/documents/communication/pel_00957289.pdf.


Medicaid Hospice Rates for Federal Fiscal Year 2022

The Annual Change in Medicaid Hospice Payment Rates was released on September 22, 2021.  The rates are effective October 1, 2021.  Remember, if a provider does not comply with the quality data submission requirements with respect to that FY, their minimum rates would be reduced due to non-reporting. The hospice cap runs from October 1st of each year through September 30th of the following year.  The hospice cap amount for Medicare for the cap year ending September 30, 2022, is $31,297.61.  To review the CMS letter, go to:

https://www.medicaid.gov/medicaid/benefits/downloads/medicaid_hospice_rate_letter_fy_2022_final.pdf .

Updated Current Measures and the new Quality Measure (QM) Specifications User’s Manual are now available

Version 1.00 of the HQRP QM Specifications User’s Manual and updated Current Measures document are now available. These documents detail the four HQRP measures that meet the HQRP requirements. They are the HIS Comprehensive Assessment at Admission (NQF# 3235); the claims-based Hospice Visits in the Last Days of Life; the claims-based Hospice Care Index; and the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Hospice Survey. The documents are available in the Downloads section of the Current Measures webpage:  https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting/Current-Measures.  These changes were finalized in the FY 2022 Hospice Final Rule, which published on August 4, 2021.


National Hospice and Palliative Care Organization (NHPCO)


NHPCO shared the following information

OCR Issues Guidance on HIPAA, COVID-19 Vaccinations, and the Workplace

The HHS Office for Civil Rights (OCR) issued guidance to help the public understand when the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule applies to disclosures and requests for information about whether a person has received a COVID-19 vaccine. The guidance reminds the public that the HIPAA Privacy Rule does not apply to employers or employment records. This is because the HIPAA Privacy Rule only applies to HIPAA covered entities (health plans, health care clearinghouses, and health care providers that conduct standard electronic transactions), and, in some cases, to their business associates. Read more in the HHS news release:  https://www.hhs.gov/about/news/2021/09/30/ocr-issues-guidance-on-hipaa-covid-19-vaccinations-workplace.html/.



Texas News and Information


Health and Human Services Commission



Monthly Provider Reporting Requirements Beginning September 1, 2021, in Compliance with SB 809 and Rider 143- Extension, Deadlines and Reporting Requirements

As required by Senate Bill (SB) 809 and Rider 143 (included below) of the 87th Legislature (regular session), HHSC will begin collecting information on the total value and uses of COVID-19 related federal funds through monthly reports. The first ongoing monthly report is due October 15, 2021.


The ongoing SB 809 and Rider 143 report and further information—including a PDF version of the report questions—are available on the HHSC Provider Finance Department website, and may be accessed on the main webpages for Acute Care Services, Hospitals and Clinic Services, and Long Term Services and Supports. Please note that this Microsoft Form link is separate from the initial report that covered the period of January 31, 2020 – August 31, 2021.


Grace Period

HHSC is granting a “grace period” to allow providers time to come into compliance if they fail to meet any deadlines between October 1, 2021, and November 30, 2021. While the deadlines to report will not change, HHSC will take no action against a provider as long as the provider submits all required reports due between October 1, 2021, and November 30, 2021, prior to the end of the grace period. The grace period ends December 1, 2021.


Rider 143

Reporting Requirement: COVID-19 Funding to Nursing Facilities and Hospitals. Out of funds appropriated above in Strategy B.1.1, Medicaid Contracts and Administration, the Health and Human Services Commission (HHSC) shall develop a report detailing the total value and uses of COVID-19-related Federal Funds, including Provider Relief Funds, provided directly to nursing facilities and hospitals contracting with HHSC since the beginning of the public health emergency. The report should include any temporary rate increases provided to nursing facilities related to the COVID-19 pandemic. Any facilities that do not provide information requested by the commission necessary to complete the report shall be identified in the report. The first submission of the report shall also include a description of any requirements implemented for nursing facilities in response to the COVID-19 pandemic, the cost to nursing facilities to implement the requirements, and recommendations on whether or not the requirements should be continued after the end of the public health emergency. HHSC shall submit the report to the Governor, Legislative Budget Board, and any appropriate standing committee in the Legislature on December 1st and June 1st of each fiscal year. The format and content of the report shall be specified by the Legislative Budget Board and posted on the HHSC website. Appropriations in Strategy A.2.4, Nursing Facility Payments, for fiscal year 2023 are contingent on the submission of the reports due December 1, 2021 and June 1, 2022.




Physician Assistant as Attending

The HCSSA rules state in §558.801(f) that the term attending practitioner is synonymous with the “attending physician,” as defined in 42 CFR §418.3.  The first part of the definition for attending physician states in CFR 418.3(1)(iii) that an attending physician can be a physician’s assistant (PA) who meets the requirements of 42 CFR §410.74(c).  A PA can be the physician of record if they had a documented relationship with the client before they elected hospice, however, the PA can only provide direction and oversight within the limited scope of practice, as you listed below.


The Interdisciplinary Team must ensure certain care, orders and services are coordinated and supervised by a hospice physician or hospice medical director. This includes certification of terminal illness for hospice episodes, orders, and physician delegation of certain schedule prescription drugs and services.


Palliative Care

Advancing Palliative Care in Texas Continuing Education Event- 2021

The Palliative Care Information and Education Program will host a continuing education event on Friday, November 5, 2021 from 1:00 pm – 4:00 pm CT. The presentation is free, and will take place virtually via GoToWebinar.


Register Now:

Three continuing education contact hours/credits are available for the following:

  • AMA PRA Category 1 Credits™
  • Continuing Nursing Education
  • Social Workers

For more information on registration, CE hours, and a brief agenda, please see the attached document.  Should you have any questions, feel free to email [email protected].


Texas Medicaid Healthcare Partnership (TMHP)


If you contract with Medicaid this is for you!

Provider Enrollment and Management Systems (PEMS) Video Series Now Available Information

Provider enrollment functions will be available through PEMS, and providers must use the new system to enroll in Texas Medicaid.

The new system will be the single tool for provider enrollment, reenrollment, revalidation, and maintenance requests (maintaining and updating provider enrollment record information).

PEMS video series is now available. The PEMS instructional video series explains the following features:

  • TMHP Secure User Account is a step-by-step video demonstrating how to create a new secure user account.
  • TMHP Message Dashboard is a step-by-step video demonstrating how to access the message dashboard while highlighting user features such as using column headers to sort.
  • Dashboard Overview is a very high-level video that showcases the different buttons/user features on the PEMS dashboard.
  • Website Navigation is a high-level video that acts as a virtual tour guide for providers who are interacting with PEMS for the first time. It also explains in detail both the provider management and requests tabs.


The PEMS video series is available on the TMHP Learning Management System (LMS) at the following link:

PEMS Instructional Video Series Welcome to TMHP LMS.  Users must have a username and password to access videos in the LMS. To obtain a username and password, click the “Don’t have an account? Sign up here” link on the LMS homepage and complete the new user registration.

The video series can also be accessed on the TMHP YouTube channel at the following link:  “Provider Enrollment & Management System Playlist” Provider Enrollment & Management System – YouTube.

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413. For LMS issues, send an email to TMHP LMS support at [email protected]


CHAP is offering customers a virtual version of our Accreditation Intensive on October 26-28, 2021!

The three-day agenda makes it easy if you want to attend both Home Health and Hospice sessions:
Day one: Hospice

Day two: Home Health & Hospice

Day Three: Home Health

  1. This event will focus on:
  2. The accreditation process
  3. The CHAP accreditation Standards
  4. The most cited deficiencies
  5. Strategies to implement to attain improved compliance within your own organization