Overview
View the Rate Analysis Digital Signature Authorization information.
The purpose of a Medicaid Accountability Report is to gather financial and statistical information for HHSC to use in the determination of accountability under the Attendant Compensation Rate Enhancement program or Direct Care Staffing Enhancement Program.
For all CLASS, DAHS, DBMD, HCS, ICF/IID, PHC, RC, and TxHmL providers, Title 1 of the Texas Administrative Code (1 TAC) §355.112(h)(2)(E) states that "Existing providers who become participants in the Attendant Compensation Rate Enhancement as a result of the open enrollment process on any day other than the first day of their fiscal year are required to submit an Attendant Compensation Report with a reporting period that begins on their first day of participation in the enhancement and ends on the last day of the provider's fiscal year." This report is in addition to the provider's 2019 Cost Report and will be used to determine compliance with Attendant Compensation Rate Enhancement spending requirements for the period beginning September 1, 2020, and ending on the last day of the provider's fiscal year that encompasses September 1, 2021.
For all NF providers, Title 1 of the Texas Administrative Code (TAC) §355.308(f)(2)(F) states that "Existing facilities which become participants in the enhancement as a result of the open enrollment process on any day other than the first day of their fiscal year are required to submit a Staffing and Compensation Report with a reporting period that begins on their first day of participation in the enhancement and ends on the last day of the provider's fiscal year." This report is in addition to the provider's 2019 Cost Report and will be used to determine compliance with Direct Care Staff Rate Enhancement spending requirements for the period beginning September 1, 2020, and ending on the last day of the provider's fiscal year that encompasses September 1, 2021.
All requested Accountability Reports will be submitted electronically using the State of Texas Automated Information Reporting System (STAIRS).
As described in Title 1 of the Texas Administrative Code (TAC) 355.112(h) and 355.308(f), contracts that were participating in the Attendant Compensation Rate Enhancement program or the Direct Care Staffing Enhancement program may be required to submit an acceptable report in certain circumstances, such as a change of ownership, contract terminations, mid-year withdrawal from the Rate Enhancement, new participants for a partial year or other reason specified by the Health and Human Services Commission (HHSC) Provider Finance Department (PFD). Providers are notified of the requirement to submit this report in an HHSC Provider Finance letter that specifically requests this report.
- Cost Report Reform Training and Cycle
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Introduction to Cost Report Reform
Beginning with the 2018 cost reports, cost report reform began as a pilot for Home and Community-based Services and Texas Home Living (HCS/TxHmL) waiver programs and the Intermediate Care Facilities for Individuals with an Intellectual or Developmental Disability or Related Conditions (ICF/IID) program providers to submit cost reports biennially rather than annually. The Texas Health and Human Services Commission (HHSC) Executive Commissioner directed the Provider Finance Department (PFD) to expand cost report reform to all Long-term Services and Supports (LTSS) programs. The intended frequency of cost report submission is on a biennial basis rather than annual basis.
The Attendant Compensation Rate Enhancement and Direct Care Staffing Compensation Participants
A provider who participates in the Attendant Compensation Rate Enhancement or the Direct Care Staff Compensation programs (rate enhancement) are required to submit accountability reports in the years that they are not required to submit full cost reports. Providers are notified of the requirement to submit this report in an HHSC Provider Finance Department letter that specifically requests this report.
Providers who do not participate in the rate enhancement program are only required to submit cost reports every two years; no reports will be required in the interim years if they continue to be non-participants in the rate enhancement program.
Cost Reporting Cycle
CPC (Primary Home Care (PHC), Community Living Assistance and Support Services (CLASS)-Direct Service Agency (DSA), Community Living Assistance and Support Services (CLASS)-Case Management Agency (CMA)), and Day Activity and Health Services (DAHS) providers will be required to submit cost reports to HHSC Rate Analysis Department in odd-numbered years.
Nursing Facility (NF), Residential Care (RC), HCS/TxHmL, and ICF/IID providers will be required to submit cost reports in even years.NF providers who are members of the Pediatric Care Facility class, The Department of Family and Protective Services’ (DFPS) 24-Hour Residential Child Care (24-HR RCC) providers will continue to submit their cost reports every year.
Deaf-Blind Multiple Disabilities Waiver providers enrolled in the Rate Enhancement program will submit their accountability reports every year.
Below is the cost reporting cycle for all LTSS programs:
Even-Year Cost Reports
Even Year cost reports collected in the Odd Year. (i.e. 2021 reports collected in 2022)
Report Type Reports Collected CR 24RCC CR HCS/TxHmL CR ICF/IDD CR NF CR RC AR CPC AR DAHS AR DBMD Odd-Year Cost Reports
Odd Year cost reports collected in the Even Year. (i.e. 2020 reports collected in 2021)
Report Type Reports Collected CR 24RCC CR CPC CR DAHS AR DBMD AR HCS/TxHmL AR ICF/IDD AR NF AR RC Cost Report Training
The Long-term Services and Supports (LTSS) cost report reform initiative requires preparers of most LTSS cost reports and accountability reports to attend state-sponsored cost report training in the same year that a cost report is required to be submitted to HHSC. Preparers of LTSS cost reports and accountability reports are required to attend training on a schedule that is related to their cost reporting deadlines.
There are no substantive changes to the Department of Family Protective Services (DFPS) 24-hour Residential Child Care program, and the Deaf-Blind with Multiple Disabilities (DBMD) training requirements.
2022 Accountability Reports Documents
View the Program Specific Methodology Rules
View the Accountability Report Program Specific Instructions
View the Accountability Report Worksheets and Worksheet Instructions
View the Accountability Report Schedules (NF only) (Coming Soon)
Due Date and Submission Address
This report is due at HHSC Provider Finance as specified in the HHSC Provider Finance email requesting the Accountability Report. All attachments and signed and notarized certification pages must be uploaded into STAIRS. Reports will not be considered “received” until the online report has been finalized and all required supporting documents uploaded. Documentation mailed rather than uploaded into the system will not be accepted.