October 1, 2022: SHARS Effective Changes

Texas Education Agency sent this bulletin at 09/26/2022 08:00 AM CDT

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September 26, 2022

Division of Financial Compliance
1

Reimbursement Methodology Update

In May 2022, the Health and Human Services Commission (HHSC) proposed changes to the SHARS Reimbursement Methodology Stakeholder comments were received and considered. Major changes include: 

  • a revision of the IEP and one-way trip ratios;
  • a requirement to submit interim claims for all SHARS specialized transportation and Personal Care Services (PCS);
  • a requirement to submit at least 1 claim for SHARS services received by each student;
  • a reinforcement of the requirement to follow Random Moment Time Study guidance.

HHSC  shares their plan to release a notice through Fairbanks on September 30, 2022  which will indicate the effective date of these changes will be October 1, 2022.
Info

Contact Info

TEA - Angela Foote  Financial Compliance Department (SHARS Program)  (512) 463-6639 angela.foote@tea.texas.gov   

HHSC - SHARS Help Line (512) 730-7400 providerfinanceSHARS@hhs.texs.gov

HHSC - SHARS Policy medicaidbenefitrequest@hhsc.state.tx.us

HHSC - Time Study Unit  (737) 867-7794 TimeStudy@hhs.texas.gov

TEA - Federal Fiscal Compliance and Reporting Department (IDEA_B MOE) (512) 463-9127 compliance@tea.texas.gov 
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 Referrals and Prescriptions

Medicaid has required providers to obtain a referral for speech and audiology services, and a prescription for occupational and physical therapy services. Beginning November 1, 2022, all referring and prescribing providers for these services must obtain a National Provider Identifier (NPI) number and must be enrolled in Medicaid as individual practitioners. All interim claims for these services must include the referring or prescribing provider’s NPI number.

The speech and audiology referral can be completed by an eligible Texas licensed speech pathologist, audiologist, or by a physician, Physician’s Assistant (PA), or Advanced Practice Registered Nurse (APRN). HHSC reminds providers that the physician options are acceptable to meet the November 1, 2022 deadline. For further information on this requirement, please review the following provider notice: Update to "SHARS - Updates to Interim Claiming and Cost Reporting Requirements for SHARS PT, OT, ST, and Audiology Services". 

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504 Audiology

Guidance for 504 Audiology has been provided.  Pending federal approval, the effective date is October 1, 2022.  If federal approval is delayed, notice will be distributed.