The Texas Health and Human Services Commission (HHSC) determines payment rates for qualified contracted providers for the provision of services in the Medically Dependent Children Program (MDCP). HHSC applies the general principles of cost determination as specified in §355.101 of this title (relating to Introduction).

1. (1) Payment rates for MDCP services in effect on January 1, 1998, will remain in effect until HHSC obtains sufficient reliable cost data to determine new payment rates. These payment rates per hour of direct service are $24.00 for independent registered nurse (RN), $20.00 for independent licensed vocational nurse (LVN), $27.50 for home-and-community-support-service agency RN or LVN, $10.22 for personal assistance service (PAS) with delegation of the service by an RN, and $9.84 for PAS without delegation of the service by an RN.
2. (2) Payment rates may be determined in the future on a pro forma basis in accordance with §355.105(h) of this title (relating to General Reporting and Documentation Requirements, Methods, and Procedures). Payment rates if determined on a pro forma basis will include payment rates per hour of service for independent registered nurse (RN), independent licensed vocational nurse (LVN), home-and-community-support-service agency RN, home-and-community-support-service agency LVN, and personal assistance services.
3. (3) The following sections of this title will apply to cost reports or surveys required to obtain the necessary information to determine new payment rates: §355.102 of this title (relating to General Principles of Allowable and Unallowable Costs), §355.103 of this title (relating to Specifications for Allowable and Unallowable Costs), §355.104 of this title (relating to Revenues), §355.105 of this title (relating to General Reporting and Documentation Requirements, Methods, and Procedures), §355.106 of this title (relating to Basic Objectives and Criteria for Audit and Desk Review of Cost Reports), §355.107 of this title (relating to Notification of Exclusions and Adjustments), §355.108 of this title (relating to Determination of Inflation Indices), §355.109 of this title (relating to Adjusting Reimbursement When New Legislation, Regulations, or Economic Factors Affect Costs), §355.110 of this title (relating to Informal Reviews and Formal Appeals), and §355.111 of this title (relating to Administrative Contract Violations).

Source Note:The provisions of this §355.507 adopted to be effective December 10, 2002, 27 TexReg 11527.