Texas Hospital-at-Home Program Is Official & HHSC Again Extends Emergency Rule

Recently we published a post, titled "Texas Legislature Provides Pathway for Continuation of Hospital-at-Home Program," which discussed House Bill 1890 that passed both houses of the Texas Legislature and was pending the governor’s signature. By way of update, House Bill 1890 was signed by the Texas governor on May 27 and immediately became effective upon signing. 

Texas hospitals officially have a pathway for hospitals to provide Acute Hospital Care at Home Program services (commonly known as the Hospital-at-Home program) without Texas Health and Human Services Commission (HHSC) needing to have an emergency rule in place. Under the legislation, Texas will allow for Hospital-at-Home programs (i) for as long as the Centers for Medicare and Medicaid Services (CMS) continues to permit it either under the existing waiver or under a successor program; and (ii) with approval of the executive commissioner of the Texas Health and Human Services Commission (HHSC).

However, HHSC needs time to establish the processes outlined under the legislation and to approve hospitals under the new process. As we predicted in our previous post, HHSC has given itself time by extending the existing emergency rule which has been allowing for Hospital-at-Home programs to exist in Texas by waiving certain state regulatory requirements. As noted previously, the most recent emergency rule was made effective on January 29, 2023 and was set to expire on May 29, 2023 (i.e., 120 days later). However, under the emergency rule HHSC was permitted to extend the rule by an additional 60 days. On May 26, 2023, HHSC published a letter that became effective May 29, 2023, to extend the existing emergency rule for an additional sixty (60) days, until July 27, 2023.

Depending on whether HHSC is able to establish a process to effectuate House Bill 1890 and begin to provide approvals to existing programs, it may be possible that HHSC publishes a new emergency rule to be effective July 28, 2023 for another 120 days.

While an emergency rule is in place, Texas hospitals will not have to go through the processes outlined in House Bill 1890, including payment of certain fees to HHSC. However, the letter does note the existing application process which requires completion of Form 3230 and obtaining written approval from HHSC before implementing a Hospital-at-Home program. Overall, it will be important that all Texas stakeholders monitor for any regulations/guidance or applications that HHSC puts forward under House Bill 1890 and any other changes to Texas Hospital-at-Home requirements.

More details about the new legislation (House Bill 1890) can be found in our previous post.