Current through Reg. 49, No. 38; September 20, 2024
(a) Statutory authority. The Nursing Facility
Payment Methodology Advisory Committee (NF-PMAC) is established under Texas
Government Code, §
RSA 531.012 and is
subject to §351.801 of this division (relating to Authority and General
Provisions).
(b) Purpose. The
NF-PMAC advises the Executive Commissioner and the Health and Human Services
system on the establishment and implementation of recommended improvements to
the nursing facility (NF) reimbursement methodology and other NF payment
topics.
(c) Tasks. The NF-PMAC:
(1) studies and makes recommendations on the
development of an NF reimbursement methodology that incentivizes quality care
for individuals served in an NF, and is cost-effective, streamlined and
transparent; and
(2) performs other
tasks consistent with its purpose as requested by the Executive
Commissioner.
(d)
Reporting requirement. By August 31 of each fiscal year, the NF-PMAC files a
written report with the Executive Commissioner covering the meetings and
activities in the immediately preceding fiscal year. The report includes:
(1) a list of the meeting dates;
(2) the members' attendance
records;
(3) a brief description of
actions taken by the committee;
(4)
a description of how the committee accomplished its tasks;
(5) a description of activities the committee
anticipates undertaking in the next fiscal year;
(6) recommended amendments to this section,
as needed; and
(7) the costs
related to the committee, including the cost of HHSC staff time spent
supporting the committee's activities and the source of funds used to support
the committee's activities.
(e) Open meetings. The NF-PMAC complies with
the requirements for open meetings under Texas Government Code, Chapter
551.
(f) Membership. The NF-PMAC is
composed of one non-voting ex-officio HHSC representative and an odd number of
voting members, not to exceed 15, appointed by the Executive Commissioner.
(1) The voting members of the NF-PMAC may
consist of:
(A) Medicaid managed care
organization representatives;
(B)
an association or associations representing managed care
organizations;
(C) private NF
owners or operators;
(D) non-state
government-owned NF owners or operators;
(E) an association or associations
representing NF providers;
(F) an
association or associations representing individuals receiving Medicaid
services in an NF;
(G) rural NF
providers;
(H) urban NF
providers;
(I) NF providers serving
50 or fewer residents;
(J) NF
providers serving 51 or more residents;
(K) NF resident advocates; and
(L) other disciplines with expertise in NF
finance, delivery, or quality improvement.
(2) Voting members are appointed for three
year terms. The terms will be staggered so that the terms of an equal or almost
equal number of members expire on August 31 of each year. Regardless of the
term limit, a member serves until the member's replacement has been appointed.
This ensures sufficient, appropriate representation.
(3) If a vacancy occurs, a member is
appointed by the Executive Commissioner to serve the unexpired portion of that
term.
(4) Paragraphs (2) and (3) of
this subsection do not apply to the ex-officio member, who serves at the
pleasure of the Executive Commissioner. The ex-officio member provides
informational updates about the NF-PMAC to the Long-Term Care Facilities
Council, if such updates are requested by the Long-Term Care Facilities
Council.
(g) Officers.
NF-PMAC selects a chair of the advisory committee from its members.
(1) The chair serves until September 1 of
each even-numbered year.
(2) A
member serves no more than two consecutive terms as chair. A chair may not
serve beyond their membership term.
(h) Required training. Each member shall
complete all training on relevant statutes and rules, including this section,
§351.801 of this division, and Texas Government Code, Chapters 551 and
2110, and §531.012. Training will be provided by HHSC.
(i) Date of abolition. The NF-PMAC is
abolished, and this section expires, on August 31, 2022.
