Fairbanks Announcements – SHARS: RMTS PL

Stasia ViatorMedicaid

Fairbanks and HHSC released several notifications to Texas school districts and charter schools outlining updates and changes regarding the Random Moment Time Study process.  Below you will find three topics regarding the Participant List.  Please review the information below.

Participant List Audits

Earlier this year, Texas Education Agency (TEA) began auditing the RMTS PL. During the first round of participant list (PL) audits, TEA identified several common errors on the RMTS PL.  Many districts have been identified as including staff on the participant list that are not providing an actual billed SHARS service to Medicaid. These participants should not be included on the participant list.

Beginning October 2022, The HHSC Time Study Department will begin sending corrective action plans to each district to include information that will assist each district with meeting PL requirements, which are as follows:

  • Providing a SHARS service as a part of the regular duties, at least on a weekly basis that is actually billed to Medicaid.
  • If an LEA does not update/certify its PL by the deadline, they are ineligible to submit a SHARS reimbursement for the entire federal fiscal year (FFY). All monetary reimbursements received during the current FFY will have to be returned.
  • Remove any vacant positions on the current PL open quarter that were not filled during the previous quarter.
  • Staff should only be included once on the PL. If more than one job function is performed by the participant, include it only once on the PL in the category/function performed majority of the time.
  • Review your PL for duplicate staff before certifying the PL.
  • Substitutes must be in that one specific position 51% of the time per quarter (7 weeks consecutive weeks).
  • Bus Monitors who provide a SHARS billable service to Medicaid.
  • Bus Drivers are not permitted on the PL and must be removed.

Once an LEA receives their Corrective Action Plan, the open quarter PL should be reviewed to make the necessary changes by the required due date.

The HHSC Time Study Department will continue to provide ongoing monitoring of positions on the participant list to ensure staff are providing a SHARS billable service. Districts may be required to submit additional supporting documentation to ensure the PL requirements are being met.

Oct – Dec 2022 Time Study Samples Selected & Posted

The fiscal year 2023 first quarter (OD22) RMTS sample has been selected and posted on the State of Texas Automated Information Reporting System (STAIRS) located on the Fairbanks website.  To view the sample selected for your entity, log into STAIRS and select the “Time Study Sample” tab.

As a reminder, the OD22 quarter begins on Monday, October 3, 2022, and will conclude on Friday, December 09, 2022.

Contacts

Health and Human Services Commission, Time Study Unit at 737- 867-7794 or timestudy@hhs.texas.gov.

Fairbanks Client Information Center at 888-321-1225 or by email at info@fairbanksllc.com.

Adoption of Rule — Reimbursement Methodology for School Health and Related Services (SHARS)

The Texas Health and Human Services Commission (HHSC) has adopted amendments to Title 1, Texas Administrative Code (TAC) §355.8443, concerning the Reimbursement Methodology for School Health and Related Services (SHARS).

Background and Purpose

The rule amendment to §355.8443 adds text to align with the implementation of House Bill (H.B.) 706, 86th Legislature, Regular Session, 2019. H.B. 706 amended the Texas Education Code to permit SHARS providers to bill and receive reimbursement for allowable audiology services provided to Medicaid-eligible children as prescribed in a plan created under Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. §794). H.B. 706 requires HHSC to adopt rules necessary to implement Texas Education Code Section 38.033 (redesignated as Section 38.034 by H.B. 3607, 87th Legislature, Regular Session, 2021) in consultation with the Texas Education Association and as approved by the Centers for Medicare and Medicaid Services.

The rule amendment also implements changes to increase the integrity of the program by requiring additional detail to be collected regarding services reimbursed through the SHARS program, including data related to both individual recipients and specific services. This rule update also adds detail to increase transparency by clarifying definitions and processes for the SHARS program and includes new language on informal review processes and further information on appeals.

Rule Effective Date

Rule §355.8443 will be published in the Texas Register on September 30, 2022 with an effective date of October 9, 2022.

Contact

For further information, please call (512) 730-7400, or email providerfinanceSHARS@hhs.texas.gov.

As always, you are welcome to contact your ONWARD Account Manager or Finance Representative if you have questions involving any aspect of the SHARS or MAC Medicaid programs.  We are here to serve you!