The January 15, 2021, approved extension also included: new authority for the state to receive federal financial participation for payments made through the Public Health Providers Charity Care Pool, and new reporting and transparency requirements for Home and Community-Based Services to further ensure beneficiary safeguards by adding Long Term Services and Supports-specific performance measures. for processing Supplemental Nutrition Assistance Program (SNAP) and Medicaid applications within federally-required timeframes was consistently above 90%. The program includes testing and treatment provided on or after Feb. 4, 2020 and began accepting claims May 6, 2020. To permit section 1915(c)-like Home and Community Based Services (hereinafter HCBS) members to self-direct expenditures for HCBS long-term care and supports as specified in paragraph 43(h) of the STCs. 1-800-252-8263 Quick Info. HHSC will provide more information if there are changes. The extension years better align the DSRIP transition timeline with the overall goals to create a sustainable program. STAR Kids. Proposed DPPs for state fiscal year 2022 include CHIRP, TIPPS Program, RAPPS Program, Directed Payment Program for BHS, QIPP for Nursing Facilities, and an Ambulance Services Directed Payment Program. To evaluate specific answers, refer to policies in the Texas Works Handbook. HHSC has submitted to CMS an addendum to Attachment I of the RHP Planning Protocol for Demonstration Year 6A. Since 2011 when the waiver was initially approved, the managed care model in Texas has been expanded statewide and includes more services under capitation. Expenditures for Inpatient Hospital Services and Prescription Drugs for STAR, STAR Kids, and STAR+PLUS Enrollees that Exceed State Plan Limits. The approval letter from CMS and the approved PFM are linked to below. Through QIPP, MCOs are directed to make payments to eligible nursing facilities once the facilities demonstrate meeting the required goals. Texas will develop a new evaluation design for the extension period and plans to incorporate the following updates into the design to reflect recent or future changes to the THTQIP demonstration waiver. The Biden Administration rescinded what's called a 1115 waiver that . Superior HealthPlan wants to help you get well and stay well. On Jan. 19, 2018, CMS approved the DSRIP Protocols - the Program Funding and Mechanics Protocol and the Measure Bundle Protocol. In September 2021 the Urban Institute estimated that 1.3 million Texas enrolled in Medicaid at the end of 2021 would be ineligible and, therefore, disenrolled in 2022 when the continuous coverage provisions ended. STAR is the primary managed care program providing acute care services to low-income families, children, pregnant women, adoption assistance and permanency care assistance, and former foster care children. For example, a single non-emergency ambulance trip would not be extended, but a recurring non-emergency ambulance authorization for dialysis would be extended. Medicaid Supplemental Payment & Directed Payment Programs, Texas Healthcare Transformation and Quality Improvement Program on the federal Medicaid website, Texas Healthcare Transformation and Quality Improvement 1115 Demonstration Waiver, 1115 Transformation Waiver Extension Cover Letter (PDF), 1115 Transformation Waiver Extension Appendices (PDF), 1115 Transformation Waiver Preliminary Evaluation Findings (Supplement A-Preliminary Draft Results) (PDF), Updated THTQIP 1115 Extension Special Terms and Conditions Technical Corrections (PDF), Updated THTQIP 1115 Extension Special Terms and Conditions (PDF), Updated THTQIP 1115 Expenditure Authorities Extension (PDF), Updated THTQIP 1115 Waiver List Extension (PDF), Attachment A Demonstration Deliverables (PDF), Attachment B Quarterly and Annual Report Template (PDF), Attachment C HCBS Service Definitions (PDF), Attachment F Fair Hearing Procedures (PDF), Attachment G HCBS Participant Safeguards (PDF), Attachment H Waiver Renewal UC Claiming Protocol (PDF), Attachment I Regional Healthcare Partnership Planning Protocol (PDF), Attachment K Administrative Cost Claiming Protocol (PDF), Attachment L Independent Consumer Support Plan (PDF), Attachment M Historical Demonstration of Information (PDF), Attachment N Health IT Strategic Plan (PDF), Attachment O Developing the Evaluation Design (PDF), Attachment P Preparing the Evaluation Report (PDF), Attachment Q DSRIP Sustainability Plan (PDF), Attachment R Texas DSRIP Measure Bundle Protocol Demonstration Years 7 10 (PDF), Attachment T PHP CCP Payment Protocol (PDF), Attachment U Estimated Without Waiver Per Member Per Month Expenditures MEG Trend (PDF), Attachment VCOVID-19 Amendment Evaluation Design (PDF), TAMU Preliminary Evaluation Findings (PDF), To participate virtually, members of the public must register here, Members of the public must register for the meeting here, CMS webpage for the Texas Healthcare Transformation and Quality Improvement Program, Texas THTQIP 1115 Extension Standard Terms and Conditions (PDF), Section 1115 Fast Track Extension Application (PDF), Click here to register for the public hearing, Click here for public comment registration, Attachment J FINAL PFM DY9-10 COVID-19 Changes (PDF), Summary of Stakeholder Feedback on Proposed DY9-10 PFM Changes (PDF), Category C Estimated Average Achievement Values by Measure or Bundle (Excel), Attachment J PFM DY9-10 Cat B and C COVID-19 Changes (PDF), Category C Estimated Average Achievement Values by Measure Class (Excel), Summary of Stakeholder Feedback on the initial draft DY7-10 MBP (PDF), Final DY9-10 PFM with Changes for Provisional Approvals (PDF), Summary of DY9-10 PFM Requirements (Excel), Final Provider DY9-10 Valuations and MPTs (Excel), Summary of Stakeholder Feedback on the first draft DY9-10 PFM (PDF), Summary of Proposed Changes to the DY9-10 PFM (PDF), Proposed Changes to the DY9-10 PFM Webinar, DY9-10 PFM Webinar Frequently Asked Questions (Excel), Attachment R - Measure Bundle Protocol (PDF), Attachment J - Program Funding and Mechanics Protocol (PDF), Accessible Version of Summary of DY7-8 Requirements (PDF), CMS Approval Letter for DSRIP Protocols (PDF), Revised Draft DY7-8 Measure Bundle Protocol (PDF) (8/4/17), Summary of Stakeholder Feedback on first Draft DY7-8 Measure Bundle Protocol (PDF) (8/4/17), Revised Draft Value Based Purchasing Roadmap (PDF) (8/4/17), Draft DY7-8 Measure Bundle Protocol (PDF) (6/22/17), Presentation for 6/20/17 Webinar on Draft DY7-8 Protocols (PDF) (6/22/17), Draft Category C Measure Specifications (PDF) (6/22/17), Draft Category C Measures (Excel) (6/22/17), Draft Value Based Purchasing Roadmap (PDF) (6/22/17), Revised Draft DSRIP DY7-8 PFM (PDF) (updated 8/4/17 to reflect changes in the DY7-8 Measure Bundle Protocol), Summary of Proposed DY7-8 Requirements (PDF) (5/17/17), Accessible version of Summary of Proposed DY7-8 Requirements (PDF) (5/17/17), Summary of Stakeholder Feedback on the First Draft DY7-8 PFM (PDF) (5/17/17), Budget Neutrality Summary (Excel) (12/21/17), Letter to CMS Requesting an Additional 21 Months (PDF), Letter to CMS on Waiver Negotiations - Oct. 6, 2016 (PDF), HHSC Letter to CMS about 1115 Waiver Extension (PDF), Texas Waiver Extension Approval Letter (PDF), Request for 15-Month Extension of the Texas 1115 Waiver (PDF), Addendum to RHP Planning Protocol for DY6A (PDF), CMS Approval Letter for the DY6 PFM Protocol (PDF), Updated Transformational Extension Protocol (Menu) with Best Practices/Models (PDF), Texas DSRIP Transition Year (DY6) Proposal Submitted to CMS (PDF), Summary of the Transformational Extension Protocol (Menu) for Replacement (PDF), DSRIP Extension Planning and Protocols Webinar (PDF), 1115 Waiver Extension Request Stakeholder Feedback (Excel), 1115 Transformation Waiver Extension Application (PDF), 1115 Transformation Waiver Interim Evaluation Report (PDF), Attachment A - Texas DSRIP Projects (PDF), Attachment B - Quality Monitoring Reports and Deliverables (PDF), Attachment C - Performance Indicator Dashboards and Pay-for-Quality Measures (PDF), Attachment D - 1115 Waiver Extension Budget Neutrality Calculations (PDF), Summary of Comments from Public Meetings on 1115 Waiver Extension (PDF), Waiver Renewal - Discussion of Key DSRIP Issues (PDF). Childrens primary and preventive Medicaid dent al services are delivered through a capitated statewide dental services program (the Childrens Dental Program) to most children under 21. Sharing Facts About Me and My Case with a Community Partner. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. TANF and TANF Level Families Medicaid. Additional inpatient hospital care during COVID-19 Public Health Emergency. The site is secure. To calculate the new rebased amount, without waiver PMPMs will be adjusted to account for annualized amounts of approved state-directed payments (pending state legislative approval) made in FFY 2022. HHSC may continue to examine DSRIP using a revised hypothesis and measure set focused on the DSRIP transition process occurring under the THTQIP extension. If you have any questions or need help with your Texas Medicaid or CHIP renewal, call Member Services: CHIP, STAR and STAR+PLUS: (877) 373-8977. Enrollment On Jan. 15, 2021, HHSC received Federal approval for the Texas Healthcare Transformation and Quality Improvement 1115 Demonstration Waiver. HHSC must also ensure that individuals who are no longer eligible for Medicaid are successfully transitioned to other coverage options. Beneficiary Groups and Eligibility Requirements Title. The site is secure. The extension does not make any changes to eligibility requirements. Pursuant to CMS direction, HHCS has submitted that document for re-approval. All rights reserved. To serve as a recertification application for Supplemental Nutrition Assistance Program (SNAP) households in TIERS. The recipient is also instructed to provide any required . Medical Care Advisory Committee will be held on June 10, 2021 at 9:00 am. The 21 additional months also allows for the 86th Legislature to respond to any federal changes and sufficient time for Texas to develop a new 1115 Waiver proposal. The approved protocols are below. These processes will ensure that budget neutrality will continue to support funding needs and flexibility moving forward. DPP BHS is a proposed value-based payment program to incentivize Community Mental Health Centers to continue providing services that are aligned with the Certified Community Behavioral Health Clinic model of care to persons enrolled in Medicaid STAR, STAR+PLUS, and STAR Kids programs. HHSC has updated the draft DSRIP PFM that describes proposed requirements for DSRIP participation in DY 7-8. More information is available on the HRSA website. The forms can only be reprinted upon request through the TIERS Correspondence functional area. Subject to an overall cap on the Uncompensated Care (UC) Pool, the following expenditure authorities are granted for the period of the Demonstration: Through September 30, 2019, expenditures for care and services that meet the definition of medical assistance contained in section 1905(a) of the Act that are incurred by hospitals and other providers for uncompensated costs of medical services provided to Medicaid eligible or uninsured individuals, and to the extent that those costs exceed the amounts paid to the hospitals pursuant to section 1923 of the Act. The following are temporary expenditure authorities that will expire 60 days after the conclusion of the Secretarys Public Health Emergency, and are effective March 1, 2020: Expenditure authority for inpatient hospital stays related to COVID-19 (i.e. to HHSC on how it can best achieve these goals by creating a comprehensive plan that follows federal law, regulations, guidance, and established best practices. At the Executive Waiver Committee held on May 14, 2015, HHSC outlined several proposed components on how to continue and strengthen the DSRIP program in the waiver renewal period. The proposed waiver extension application is posted at the link provided below. The document below contains summaries of comments received during the statewide public meetings, including the webinar, that were held on the 1115 Waiver Extension Application. The form is client-completed and self-explanatory. The letter specifies that HHSC is on track to submit the required independent report analyzing the Uncompensated Care pool and Delivery System Reform Incentive Payment program on Aug. 31, 2016. You can also call 2-1-1. HHSC should take proactive steps to get updated contact information and mailing addresses for Medicaid clients, including getting address updates from the US Postal Service and Managed Care Organizations, and making it much easier and quicker for Medicaid clients to update their contact information. To avoid further overloading Texas eligibility and enrollment systems, HHSC should follow federal guidance and limit the number of renewals they attempt in any given month after the Medicaid continuous coverage provision is lifted. Children receiving SSI and disability-related (including SSI-related) Medicaid who do not participate in a 1915(c) waiver: these children will receive their state plan acute care services and their state plan long term services and supports (LTSS) through STAR Kids. HHSC also requires all health plans to accept oral requests for appeals without the member having to provide a written request through Nov. 30, 2022. Unfortunately, before the pandemic, enrollment in Medicaid and CHIP was declining. Financial Management Services Agencies (FMSAs) can help you make CDS budget revisions as needed. Effective October 1, 2019, expenditures for care and services that meet the definition of medical assistance contained in section 1905(a) of the Act that are incurred by hospitals and other providers for uncompensated costs of medical services provided to uninsured individuals as charity care, and to the extent that those costs exceed the amounts paid to the hospitals pursuant to section 1923 of the Act. Re-sizing will allow for adjustments to uncompensated care pool based on actual charity care. H0090-I. PEMS Assistance Experiencing High Request Volumes. Under normal circumstances. Prescreening Tool. Extending the waiver will not have a significant impact on enrollment. Members of the public must register for the meeting here. The purpose of this initial extension is to allow time for state and federal governments to work through a longer term agreement, which is most important for Medicaid beneficiaries in Texas. In response to COVID-19, HHSC requires all health plans to extend the timeframes for the number of days members, legally authorized representatives or authorized representatives can request an appeal through Nov. 30, 2022: Effective July 1, 2021, health plans must enforce the normal, regular and established timeframes that members have to request for continuation of benefits. 9/02/2022. The following Medicaid recipients are excluded from the Childrens Dental Program, and will continue to receive their Medicaid dental services outside of the Demonstration: Medicaid recipients age 21 and over; all Medicaid recipients, regardless of age, residing in Medicaid-paid facilities such as nursing homes, state supported living centers, or Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/ID); and STAR Health Program recipients. Expenditures Related to Managed Care Organization (MCO) Enrollment and Disenrollment. No prior authorization will be required on the COVID-19 lab test by Medicaid and CHIP health plans or by traditional Medicaid. Eligibility Work with your provider and your service coordinator or case manager to develop a backup plan if one is not in place. The Build Back Better (BBB) legislation passed by the House would remove the connection between Medicaid enrollment and the federal PHE. The last list will be sent at the beginning of January. The requested extension will allow Texas continued flexibility to pursue the established goals of the 1115 waiver, which are to: expand risk-based managed care to new populations and services, support the development and maintenance of a coordinated care delivery system, improve outcomes while containing cost growth, and transition to quality-based payment systems across managed care and providers. To the extent necessary to enable the state to provide a greater duration of hospital services for individuals with severe and persistent mental illness. Click here for instructions on opening this form. Coverage losses of this magnitude would be devastating for the low-income children and families who rely on Medicaid and would only deepen existing racial and ethnic disparities. Families. The letter also states that HHSC seeks a clear understanding of CMS' vision for DSRIP integration into Medicaid managed care and HHSC's vision for the longer term extension. Copyright 2016-2022. Expenditures made under contracts that do not meet the requirements in section 1903(m) of the Act specified below. To obtain a copy of additional waiver attachments, ask questions, obtain additional information, obtain a hard copy of the waiver extension, or submit comments regarding this proposed extension application individuals may contact Basundhara Raychaudhuri by U.S. mail, telephone, fax, or email at: U.S. Mail Fee-for-service Medicaid 1915(c) waiver case managers and service coordinators for Community Living Assistance and Support Services (CLASS), Texas Home Living (TxHmL), Deaf-Blind with Multiple Disabilities (DBMD) and Home and Community-based Services (HCS), Community First Choice service coordinators, Preadmission Screening and Resident Review (PASRR) habilitation coordinators, Community Living Assistance and Support (CLASS), Deaf Blind with Multiple Disabilities (DBMD), Home and Community-based Services Program (HCS), Normally 60 days to request an MCO internal appeal, now. 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