1. (a) 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).
2. (b) Effective September 1, 2007, rates for home-and-community-support-service agency (HCSS) registered nurse (RN), HCSS agency licensed vocational nurse (LVN), and HCSS agency personal assistance services (PAS) (with delegation of the service by an RN and without delegation of the service by an RN)), will be based upon the Community-Based Alternatives (CBA) HCSS-approved rates for RN and LVN services in accordance with §355.503 of this title (relating to Reimbursement Methodology for the Community-Based Alternatives Waiver Program) and non-participant PAS in accordance with §355.112(l) of this title (relating to Attendant Compensation Rate Enhancement). However, if the rates in effect for these MDCP services on August 31, 2007, are greater than the approved rates for the CBA HCSS for RN, LVN, and non-participant PAS, the higher MDCP rates will remain in effect on September 1, 2007. Effective September 1, 2007, the reimbursement rate for independent RNs will be equal to 80 percent of the MDCP rate for HCSS agency RNs, and the reimbursement rate for independent LVNs will be equal to 80 percent of the MDCP rate for HCSS agency LVNs.
3. (c) The rate ceiling for camp services will be equivalent to the Community Living Assistance and Support Services direct service agency (CLASS DSA) out-of-home respite rate. Actual payments for this service will be the lesser of the rate ceiling or the actual cost of the camp.
4. (d) Facility-based respite care rates are determined on a 24-hour basis. The rates for facility-based respite care are calculated at 77 percent of the daily nursing facility base rates by level of care. The base rates used in this calculation do not include nursing facility rate add-ons.
5. (e) 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).
6. (f) 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; amended to be effective September 1, 2007, 32 TexReg 5340.