Committee conditionally approves DHHS interim Medicaid reimbursement rule; agency urged to file emergency rule

The committee gave conditional approval to an interim Department of Health and Human Services rule (HEC 64 20) that implements reimbursement procedures for residential treatment services under Medicaid, after staff warned the rule cites an interim rule that has expired.

Staff said HEC 64 20 points to HEC 63 55 (certification for payment of foster care programs), which expired in September, leaving uncertainty about how the department would implement the interim rule. Nicole Valenzuela of DHHS told the committee the department is working to reimplement 63 55 and that routine payments to programs have continued in the interim.

Legislators raised concerns about citing federal rules and not specifying the version or date; one member noted the state constitution and questioned relying on federal agency rules without legislative approval. Other members discussed legal pathways, including the supremacy clause and federal challenge processes, and asked whether an expired citation could affect Medicaid error rates and federal match amounts.

Committee members conditionally approved HEC 64 20 and asked the agency to consider filing an emergency rule to cover fee references while regular rulemaking proceeds, to reduce risk of payment disruption for foster-care and residential-treatment providers.