TITLE 25. HEALTH SERVICES

PART 1. DEPARTMENT OF STATE HEALTH SERVICES

CHAPTER 61. CHRONIC DISEASES

SUBCHAPTER C. BREAST AND CERVICAL CANCER SERVICES

25 TAC §61.34, §61.41

The Executive Commissioner of the Health and Human Services Commission, on behalf of the Department of State Health Services (department), proposes amendments to §61.34 and §61.41, concerning breast and cervical cancer services.

BACKGROUND AND PURPOSE

The amendments and consideration by the department of the sections for re-adoption without change implement the federal Breast and Cervical Cancer Mortality Prevention Act of 1990, Public Law 101 - 534, and its reauthorization, the Women's Health Research and Prevention Amendments of 1998, Public Law 105 - 340, which establish a program of grants to states, territories, and tribal organizations for early detection and prevention of mortality from breast and cervical cancer. The department, through a cooperative agreement with the Centers for Disease Control and Prevention, provides statewide access to high-quality breast and cervical cancer screening and diagnostic services for financially eligible Texas women who are unable to access the same care through other funding sources or programs. The primary purpose of the Breast and Cervical Cancer Service is to reduce mortality from breast and cervical cancer. Amendments to the rules are necessary to reflect current program policy due to updates in clinical guidelines and to increase flexibility in allowable billing for administrative and support services according to program policy.

Government Code, §2001.039, requires that each state agency review and consider for re-adoption each rule adopted by that agency pursuant to the Government Code, Chapter 2001 (Administrative Procedure Act). Sections 61.31 - 61.34, 61.36, 61.37, 61.39, 61.41, and 61.42 have been reviewed, and the department has determined that reasons for adopting the sections continue to exist because rules on this subject are needed; however, §§61.31 - 61.33, 61.36, 61.37, 61.39, and 61.42 are being re-adopted without changes.

SECTION-BY-SECTION SUMMARY

Amendments to §61.34 revise language to clarify client age eligibility requirements for breast and cervical cancer screening and diagnostic services.

Amendments to §61.41 remove allowable billing for administrative and support services to reflect current program policy.

FISCAL NOTE

David Auzenne, Manager, Preventive Care Branch, has determined that for each year of the first five years the sections are in effect, there will be no fiscal implications to state or local governments as a result of administering the sections as proposed. The proposed rules do not change current program structure and implementation. These amendments are intended to clarify, update, and streamline the rules and are not anticipated to be controversial.

SMALL AND MICRO-BUSINESS IMPACT ANALYSIS

Mr. Auzenne has also determined that there will be no effect on small businesses or micro-businesses required to comply with the sections as proposed, because neither small businesses nor micro-businesses participate in, or are affected by, the Breast and Cervical Cancer Services.

ECONOMIC COSTS TO PERSONS AND IMPACT ON LOCAL EMPLOYMENT

There are no anticipated economic costs to persons who are required to comply with the sections as proposed. There is no anticipated negative impact on local employment.

PUBLIC BENEFIT

Mr. Auzenne has also determined that for each year of the first five years the sections are in effect, the public benefit anticipated as a result of administering the sections will be continued access to breast and cervical cancer screening and diagnostic services for eligible, low-income Texas women.

REGULATORY ANALYSIS

The department has determined that this proposal is not a "major environmental rule" as defined by Government Code, §2001.0225. "Major environmental rule" is defined to mean a rule the specific intent of which is to protect the environment or reduce risk to human health from environmental exposure and that may adversely affect, in a material way, the economy, a sector of the economy, productivity, competition, jobs, the environment or the public health and safety of a state or a sector of the state. This proposal is not specifically intended to protect the environment or reduce risks to human health from environmental exposure.

TAKINGS IMPACT ASSESSMENT

The department has determined that the proposed sections do not restrict or limit an owner's right to his or her property that would otherwise exist in the absence of government action and, therefore, do not constitute a taking under Government Code, §2007.043.

PUBLIC COMMENT

Comments on the proposal may be submitted to David Auzenne, Mail Code 1923, Community Health Services Section, Department of State Health Services, P.O. Box 149347, Austin, Texas 78714-9347 or by email to david.auzenne@dshs.state.tx.us. Comments will be accepted for 30 days following publication of the proposal in the Texas Register.

LEGAL CERTIFICATION

The Department of State Health Services General Counsel, Lisa Hernandez, certifies that the proposed rules have been reviewed by legal counsel and found to be within the state agencies' authority to adopt.

STATUTORY AUTHORITY

The amendments are authorized by Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001.

The amendments affect Government Code, Chapter 531, and Health and Safety Code, Chapter 1001. Review of the sections implements Government Code, §2001.039.

§61.34.Client Eligibility Requirements.

(a) In order for a woman to be [financially] eligible for Breast and Cervical Cancer Services, the woman must:

(1) - (2) (No change.)

(b) A woman age 40 or older that meets [financial] eligibility criteria is eligible for breast cancer screening and diagnostic services. A woman under age 40 that meets [financial] eligibility criteria is eligible for breast cancer diagnostic services only.

(c) A woman age 21 - 64 [18 or older] that meets [financial] eligibility criteria is eligible for cervical cancer screening [and/or diagnostic] services. A woman age 18 - 64 that meets eligibility criteria is eligible for cervical cancer diagnostic services only.

§61.41.Payment for Services.

(a) - (b) (No change.)

[(c) In accordance with department policy, providers may be allowed to bill for administrative and support services costs associated with the following activities:]

[(1) eligibility determination;]

[(2) public education and outreach;]

[(3) professional education;]

[(4) program management;]

[(5) coalition and partnership development;]

[(6) data collection and reporting; and]

[(7) other activities authorized in advance.]

[(d) In order to bill for administrative and support services costs, a provider must request such funding in its annual proposed budget. Administrative and support services costs shall not exceed 10% of a provider's actual expenditures for clinical services.]

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on December 7, 2012.

TRD-201206305

Lisa Hernandez

General Counsel

Department of State Health Services

Earliest possible date of adoption: January 20, 2013

For further information, please call: (512) 776-6972