Adoption Preamble - 1
. HEALTH SERVICES
. TEXAS DEPARTMENT OF STATE HEALTH SERVICES
. PRIMARY HEALTH CARE SERVICES PROGRAM
TEXAS WOMEN’S HEALTH PROGRAM
New §39.31 - 39.45
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), onbehalf of the Department of State Health Services (DSHS), adopts new §§39.31 - 39.45
concerning the Texas Women’s Health Program (TWHP).
The following sections are adoptedwithout changes to the proposed text as published in the July 6, 2012, issue of the
(37 TexReg 5074) and will not be republished: §39.31, Introduction; §39.32, Non-entitlementand Availability; §39.34, Client Eligibility; §39.36, Financial Eligibility Requirements; §39.37,Denial, Suspension, or Termination of Services; Client appeals; §39.39, Covered Services;§39.40, Non-
covered Services; §39,42, Provider’s Request for Review of Claim Denial;
§39.43,Confidentiality, and §39.44, Audits; Reports.The following sections are adopted with changes to the proposed text as published in the July 6,2012, issue of the
r (37 TexReg 5074) and will be republished: §39.33, Definitions;§39.35, Application Procedures; §39.38, Health-Care Providers; §39.41, Reimbursement; and§39.45, Severability.The changes respond to comments received and do not materially alter issues raised by aproposed rule. Accordingly, HHSC, on behalf of DSHS, may adopt the new text withoutrepublishing as a proposed rule.
See Tex. Workers’ Comp. Comm’n v. Patient Advocates of Tex.
,136 S.W.3d 643, 650 (Tex. 2003);
Tex. Med. Ass’n v. Tex. Worker’s Comp. Comm’n
, 137S.W.3d 342, 355 (Tex. App.
Austin 2004, no writ);
State Bd. of Ins. v. Deffebach
, 631 S.W.2d794, 801 (Tex. App.
—Austin 1982, writ ref’d n.r.e.).
Background and Justification
In 2005, the Texas Legislature enacted Human Resources Code, §32.0248, which directed HHSCto seek a five-year Medicaid demonstration waiver to implement a project to expand access topreventive health and family planning services for non-pregnant, non-sterile women who werenot eligible to receive Medicaid services but who, following pregnancy, would be presumptivelyeligible for Medicaid services along with their newborn infant(s). In accordance with thestatutory directive, HHSC requested a waiver from the Secretary of Health and Human Servicespursuant to section 1115 of the Social Security Act (42 U.S.C. §1315). The Secretary approvedthe request for a five-year period beginning December 21, 2006. Human Resources Code,§32.0248 expired by its terms on September 1, 2011.The 82
Texas Legislature enacted two laws to govern the Medicaid Women’s Health Program
or a successor to that program following the expiration of Human Resources Code, §32.0248.The first was a contingency rider to the General Appropriations Act (Rider 62 to Article II) that
instructs HHSC to continue providing Women’s Health Program services contingent upon the