DY11 and DY12 Cost Report Technical Correction Federal Approval – 9/28/22
On September 15, 2022, HHSC identified an error in the federally approved Year 1 and Year 2 PHP-CCP Cost Reporting Tools that caused a reduction in the Cost Settlement Calculations. HHSC has resolved this error and submitted a technical correction request to CMS for updated federal approval of the adjusted PHP-CCP Cost Reporting Tools for Years 1 and 2.
View the Technical Correction Cover Letter (.pdf)
View the Previous Year 1 PHP-CCP Cost Reporting Tool (.pdf)
View the Previous Year 2 PHP-CCP Cost Reporting Tool (.pdf)
On September 28, 2022, HHSC received federal approval of the technical corrections to the Year 1 and Year 2 PHP-CCP Cost Reporting Tools from CMS. Please note that providers participating in Demonstration Year (DY) 11 of the PHP-CCP must submit the federally approved Year 1 PHP-CCP Cost Reporting Tool no later than November 14, 2022.
View the Technical Correction Federal Approval Letter (.pdf)
View the Approved Adjusted Year 1 PHP-CCP Cost Reporting Tool
View the Approved Adjusted Year 2 PHP-CCP Cost Reporting Tool
Overview
The Texas Health and Human Services Commission (HHSC) is working to develop the Public Health Provider – Charity Care Program (PHP-CCP) that is designed to allow qualified providers to receive reimbursement for the cost of delivering healthcare services, including behavioral health services, immunizations, and other preventative services, when those costs are not reimbursed by another source. The program is authorized under the 1115 waiver. Year 1 of the program will consist of uncompensated care and Medicaid shortfall. In year 2, the program will transfer to charity care only.
In accordance with the Special Terms and Conditions of the 1115 waiver, to participate in the program, providers must be funded by a unit of government able to certify public expenditures. Publicly-owned and operated providers eligible to participate include:
• Established under the Texas Health and Safety Code Chapters 533 and 534 and are primarily providing behavioral health services:
- Community Mental Health Clinics (CMHCs)
- Community Centers
- Local Behavioral Health Authorities (LBHAs)
- Local Mental Health Authorities (LMHAs)
• Local Health Departments (LHDs) and Public Health Districts (PHDs) established under the Texas Health and Safety Code Chapter 121
Beginning October 1, 2021, the PHP-CCP will be operational and allow certain providers to receive a supplemental payment for certain medical services. Payments from the pool are to defray the cost of uncompensated costs of providing medical services to Medicaid eligible or uninsured individuals. Total funding will not exceed 500 million (total computable) in each of the first two years of the program. In future years, this pool is subject to resizing based on actual charity care costs incurred by eligible providers.
Federal Approval
On December 22, 2021, Texas Health and Human Services Commission (HHSC) received federal approval of the Public Health Providers – Charity Care Program (PHP-CCP) Protocol from the Center for Medicaid and Medicare Services (CMS).
The approved protocol will be incorporated into the January 15, 2021 1115 Waiver as Attachment T which can be viewed here (.pdf).
Enrollment
The initial cost report training was conducted in August 2021. The training was mandatory to qualify for participation in the program, no exception was made or makeup training provided. For questions regarding the content of the training, please email to PHP-CCP@hhs.texas.gov with “PHP-CCP Initial Cost Report Training” in the subject line.
Please find a copy of the training slides here (.pdf). Please find a FAQ that we’ve put together from questions that were received during the trainings here (.pdf).
Methodology/Rules
HHSC has adopted new §355.8215, concerning the PHP-CCP, which is published in the Texas Administrative Code here. HHSC has adopted this new rule under the 1115 waiver to reimburse certain costs for qualifying providers associated with providing care, including behavioral health, immunizations, chronic disease prevention, and other preventative services for the uninsured.
HHSC has adopted new §355.8217, concerning the PHP-CCP payments being available for eligible providers to help defray the uncompensated costs of charity care beginning October 1, 2022, which is published in the Texas Administrative Code here.
Year 1 (DY11) Trained Preparers
The initial cost report training was conducted in August 2021. Please note that an entity is eligible to submit the PHP-CCP cost reporting tool if at least one individual from their organization is on the Trained Preparer list.
An additional training opportunity was offered on June 30th, 2022 to complete the training requirements for Year 1 of the program.
Please find a copy of the training slides here (.pdf).
Providers must submit their Year 1 PHP-CCP Cost Reporting Tool and Supporting Documentation to the PHP-CCP Globalscape EFT server to HHSC by November 14th, 2022. Each person/client needing access to one of our Globalscape EFT sites will have to go through the HHS Enterprise Portal. Requesting Globalscape EFT access is a 2-step process.
(1) You will need to register with the Enterprise Portal Account Registration And Management (pdf). You will receive an initial email from the Enterprise Portal stating that an account request has been completed. This is not the email for Globalscape access but instead the completion of the Enterprise Portal request. Log in with the credentials received for the Enterprise Portal and
(2) Follow the instructions to submit for Globalscape access via the portal How to submit a Portal Request wo New Transfer (.pdf). Once the request is approved and our team receives the request, a ticket will be opened and an admin will provide you with Globalscape account credentials.
Please note that the folder for PHP-CCP Cost Report document submission is /”Usr/PHP-CCP”.
View the PHP-CCP Cost Reporting Tool Supporting Documentation Companion Guide and FTP User Guide here (.pdf).
Please find a FAQ that we’ve put together from questions that were received during the trainings here (.pdf).
View a list (in Excel) of persons who have completed the training requirements to prepare cost reports for Year 1 of the PHP-CCP program.
Refresher trainings in preparation for the Year 1 (Demonstration Year 11) of the Public Health Provider – Charity Care Program (PHP-CCP) were offered on August 8th, 2022 and September 22nd, 2022.
The refresher trainings do not count as credit towards the training requirement and is only offered as a refresher training.
Year 2 (DY12) Charity Care Transition
On June 8th, 2022 HHSC received federal approval of the Addendum to Attachment T and the PHP-CCP Cost Reporting Tool for Year 2 of the PHP-CCP.
View the approved Addendum to Attachment T (.pdf)
Year 2 (DY12) of the PHP-CCP will transition from all uncompensated care to charity care only. Starting with Year 2 and subsequent years, providers will be required to create a charity care policy for their organization and submit their policy to HHSC in addition to the PHP-CCP Cost Reporting tool.
HHSC held a training on Wednesday, May 25, regarding the transition to Charity Care for Year 2.
View the Charity Care Transition PowerPoint slides (.pdf)
View Charity Care Sample Policy 1 (.pdf)
View Charity Care Sample Policy 2 (.pdf)
View the Healthcare Financial Management Associated (HFMA) Statement 15 (.pdf) – Valuation and Financial Statement Presentation of Charity Care, Implicit Price Concessions and Bad Debts by Institutional Healthcare Providers.
HHSC offered initial training webinars in preparation for Year 2 of the PHP-CCP on August 10th, 2022, August 29th, 2022, and September 15th, 2022. Per TAC §355.8217 providers are required to have at least one financial contact attend one training annually.
Please find a copy of the training slides here (.pdf).
View a list (in Excel) of persons who have completed the training requirements to prepare cost reports for Year 2 of the PHP-CCP program.
Please reach out to PHP-CCP@hhs.texas.gov for additional information or questions.
Please call 737-867-7999 to speak with a PFD staff member regarding the PHP-CCP.