Acute Care

Overview

The Health and Human Services Commission (HHSC) Provider Finance Department (PFD) for Acute Care Services develops reimbursement methodology rules for determining payment rates/fees for Medicaid Acute Care Services. HHSC PFD develops payment rates/fees in accordance with published rules and policy guidelines.

Announcements

SB 809 / Rider 143 COVID-19 Reporting Healthcare Institution List (Updated 09/27/2022)

SB809/Rider 143 Submission List as of September 27, 2022

The Health and Human Services Commission (HHSC) has posted the list of healthcare institutions who must submit reports in compliance with Senate Bill 809 or Rider 143. The list shows providers who haven’t submitted a SB 809 / Rider 143 Report as well as those HHSC staff are helping complete the report. The list can be found here (.xslx).This list was updated with completed reports received by September 27, 2022.

Note that this list is derived at a point in time and not all inclusive as providers may enroll or change at various times. Any provider that is identified as a “Health Care Institution” defined in Section 74.001 of the Civil Practice and Remedies Code is required to complete the reports. The list has been updated to align with licensing agencies. All questions related to SB 809 / Rider 143 should be emailed to HHSC_RAD_Survey@hhs.texas.gov. There may be a delay in response due to volume.

HHSC has the authority to pursue disciplinary actions for facilities that fail to report. The health and safety of those we serve is always our top priority.

The first quarterly report for SB809/Rider 143, titled “Coronavirus Disease (COVID-19) Public Health Emergency Reporting” was published March 1, 2022 and can be found here.

The second quarterly report for SB809/Rider 143, titled “Coronavirus Disease (COVID-19) Public Health Emergency Reporting” was published June 1, 2022 and can be found here.

The third quarterly report for SB809/Rider 143, titled “Coronavirus Disease (COVID-19) Public Health Emergency Reporting” was published September 1, 2022 and can be found here.

SB 8, from the 87th Legislature’s third special session, authorizes grants to rural hospitals, nursing homes, home health agencies, intermediate care facilities and community attendants from the Coronavirus State Fiscal Recover Fund, established under the American Rescue Plan Act. We are required to prioritize grants to grantees who are compliant with the reporting requirements identified above. Failure to submit reports required by Senate Bill 809 or Rider 143 could limit the funding a provider may receive from the grants or disqualify them completely. Providers must submit an Initial Form, which includes funding and cost data covering the period January 2020 through August 2021. If you are delinquent in submitting the Initial Form, please email us at HHSC_RAD_Survey@hhs.texas.gov. Providers must also submit this monthly form every month. The reports are due one month after the reporting period ends. (for example, the report for December 2021 data will be due Feb. 1).

Monthly SB 809 / Rider 143 COVID-19 Reporting (Updated 02/25/2022)

November 8, 2021 Update:

The 87th Texas Legislature directed the Health and Human Services Commission (HHSC) to report federal COVID-19 funding from specific health care institutions, and certain costs those providers have spent related to COVID-19 public health emergency. HHSC has developed a monthly report to obtain the information required by Rider 143 (.pdf) (2022-23 General Appropriations Act, Senate Bill (S.B.) 1, 87th Legislature, Regular Session, 2021 (Article II, HHSC, Rider 143) and S.B. 809 (.pdf) (87th Legislature, Regular Session, 2021). 

Frequently Asked Questions (FAQ):

View the HHSC created list of “frequently asked questions ” (FAQ) (.pdf) (Updated 03/18/2022) with the answers to common questions to assist providers in completing the report.

Reporting: 

Providers must submit an Initial Form, which includes funding and cost data covering the period January 2020 through August 2021. If you are delinquent in submitting the Initial Form, please contact us at HHSC PFD Survey. The ongoing monthly reports (located here) will be ongoing and will cover a single month; each monthly report will be due on the 1st of the second following month following the end of the month (for example, the report for January 2022 data will be due March 1, 2022.)

For those providers with multiple submissions, the offline form here (.xlsx) can be used. Do not change the format in any way as this might cause your information to not be submitted. Complete the questions that apply to your specific provider type and send to HHSC_RAD_Survey@hhs.texas.gov once complete.

You will receive a confirmation page once your report has been fully completed and submitted. No email confirmation will be sent.

A pdf version of the ongoing report is available here (.pdf) for review prior to submitting the reports.

If you are unable to meet the reporting deadline, please contact the Provider Finance Department at HHSC_RAD_Survey@hhs.texas.gov for assistance.

Failure to submit:

Failure to complete and/or submit the required monthly report(s) on-time will result in:

A report to the Department of State Health Services or HHSC Regulatory Services and potential adverse actions on your licensure and/or  HHSC may initiate payment holds for providers who fail to submit the required monthly reports.

List of Providers Required to Complete Reports: 

The following entities are required to complete the report:

  • Ambulatory Surgical Centers;
  • Assisted Living Facilities licensed under Chapter 247, Health and Safety Code;
  • Emergency Medical Services Providers;
  • Health Services Districts created under Chapter 287, Health and Safety Code;
  • Home and Community Support Services Agencies;
  • Hospice Providers;
  • Hospitals;
  • Hospital Systems;
  • Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID);
  • Community Living Assistance and Support Services (CLASS) or Case Management Agency (CMA) Providers;
  • Deaf-Blind with Multiple Disabilities (DBMD) Providers;
  • Home and Community-Based Services (HCS) Providers;
  • Texas Home Living (TxHmL) Providers;
  • Nursing Facilities; and
  • End-Stage Renal Disease Facilities licensed under Section 251.011, Health and Safety Code

Please email the HHSC Provider Finance Survey for assistance at HHSC_RAD_Survey@hhs.texas.gov.