Overview

The Comprehensive Hospital Increase Reimbursement Program (CHIRP) is a statewide program that increases Medicaid payments to hospitals for inpatient and outpatient services provided to persons with Medicaid. Texas Medicaid managed care organizations (MCOs) receive additional funding through their monthly capitation rate from the Texas Health and Human Services Commission (HHSC) and are directed to increase payment rates for participating hospitals. As designed, eligible hospitals receive a percent increase paid on claims submitted to a Medicaid MCO. CHIRP’s purpose is to advance goals and objectives in the state’s Medicaid quality strategy by incentivizing improved quality and access for hospitals that serve persons with Medicaid.

Texas Response to CMS Round 1 Questions for SFY 2023 CHIRP (April 21, 2022) (.pdf)
Texas Response to CMS Round 2 Questions for SFY 2023 CHIRP (May 16, 2022) (.pdf)
Texas Response to CMS Round 3 Questions for SFY 2023 CHIRP (June 8, 2022) (.pdf)
Texas Response to CMS Round 4 Questions for SFY 2023 CHIRP (July 11, 2022) (.pdf)
CMS CHIRP Approval Letter (March 25, 2022) (.pdf)
CMS Renewal Approval Letter for SFY 2023 CHIRP (August 1, 2022) (.pdf)
Texas and CMS Responses to Questions for SFY 2025 CHIRP (August 16-22, 2024) (.pdf)
Texas Response to CMS Round 3 Questions for SFY 2025 CHIRP (August 30, 2024) (.pdf)
Texas Response to CMS Round 1 Question for SFY 2025 CHIRP Amendment (September 26, 2024) (.pdf)
Texas Response to CMS Round 2 Question for SFY 2025 CHIRP Amendment (September 30, 2024) (.pdf)

SFY2026: HHSC announces enrollment for CHIRP from February 3, 2025, through February 24, 2025. The SFY 2026 CHIRP application should take about 10-15 minutes to complete and is for the eligibility period from Sept. 1, 2025 to Aug. 31, 2026. A PDF version of the SFY 2026 application (.pdf) is also available.

Pre-Print Packages

CHIRP Application Fee

HHSC will be collecting a CHIRP application fee of $15,000 for State Fiscal Year (SFY) 2026 to defray the cost of administering the program. This application fee will apply to all non-public hospitals that choose to participate in the program. As outlined in Title 1 of the Texas Administrative Code (1 TAC) Section 353.1301(l), “To the extent authorized under state and federal law, HHSC will collect the state's cost of administering a program authorized under this subchapter from participants in the program generating the costs.”

The enrollment fee from participating non-public hospitals is due when the enrollment application is submitted. The application fee deadline is February 24, 2025. If no payment is received by the deadline, your hospital’s application will be removed, and you will not be eligible to participate in CHIRP.

Payment must be made in the manner determined by HHSC and in compliance with the Enrollment Fee Payment Instructions (.pdf). One check may be submitted for multiple providers; however, a voucher for each provider must also be submitted.

Providers in Recoupment Status

The providers listed in the attached file did not meet the Conditions of Participation due to withdrawal or failure to respond to reporting requirements. They are not eligible to receive payment through CHIRP, so all CHIRP increases paid to these providers should be recouped by the applicable Medicaid Managed Care Organizations.

SFY 2022

The SFY 2022 List of Ineligible Providers (.pdf) is available.

SFY 2023

Round 1

The SFY 2023 List of Ineligible Providers (.pdf) is available.

For questions regarding the Conditions of Participation determination, contact the Delivery System Quality and Innovation Department.

Methodology/Rules

HHSC has adopted the new 1 TAC Section 353.1306, concerning the Comprehensive Hospital Increase Reimbursement Program for program periods on or after September 1, 2021 and the new 1 TAC Section 353.1307, concerning Quality Metrics and Required Reporting Used to Evaluate the Success of the CHIRP. The new rules were published in the March 26, 2021 issue of the Texas Register and became effective on March 28, 2021.

The new TAC updates effective January 2024 are available here: 1 TAC Sections 353.1306 and 353.1307 Preamble and Rule Text (.pdf).

Suggested IGT

SFY 2022

Suggested Intergovernmental Transfer (IGT) amounts per provider is available here (.xlsx). (Updated 11/02/2021)

Additional Year 1 (SFY 2022) Suggested IGT Transfer

Suggested Intergovernmental Transfer (IGT) amounts per provider is available here (.xlsx). (Updated 07/14/2022)

1st Reconciliation – IGT Call

Suggested Intergovernmental Transfer (IGT) amounts by governmental entity is available here. (.xlsx)

SFY 2023

First Half Year 2 (SFY 2023) Suggested IGT Transfer

Suggested Intergovernmental Transfer (IGT) amounts per provider is available here (.xlsx). (Updated 5/27/2022)

Second Half Year 2 (SFY 2023) Suggested IGT Transfer

Suggested Intergovernmental Transfer (IGT) amounts per provider is available here (.xlsx). (Updated 11/02/2022)

IGT Commitment form is available here (.pdf), and the excel version can be located here (.xlsx).

Year 2 Additional (SFY 2023) Suggested IGT Transfer

Suggested Intergovernmental Transfer (IGT) amounts per provider is available here (.xlsx). (Updated 7/19/2023)

CHIRP Year 2 First Reconciliation (.xlsx) (Updated 01/12/2024)

SFY 2024

First Half Year 3 (SFY 2024) Suggested IGT Transfer

Suggested Intergovernmental Transfer (IGT) amounts per provider is available here (.xlsx). (Updated 06/13/2023)

IGT Commitment form is available here (.pdf), and the excel version can be located here (.xlsx).

Second Half Year 3 (SFY 2024) Suggested IGT Transfer

Suggested Intergovernmental Transfer (IGT) amounts per provider is available here (.xlsx). (Updated 11/03/2023)

CHIRP Year 3 First Reconciliation (.xlsx) (Updated 12/23/2024)

SFY 2025

First Half Year 4 (SFY 2025) Suggested IGT Transfer

Suggested Intergovernmental Transfer (IGT) amounts per provider is available here (.xlsx). (Updated 05/30/2024)

IGT Commitment form is available here (.pdf), and the excel version can be located here (.xlsx).

Second Half Year 4 (SFY 2025) Suggested IGT Transfer

Suggested Intergovernmental Transfer (IGT) amounts per provider is available here (.xlsx). (Updated 10/24/2024)

Awarded Rate Increases for CHIRP

The links below are the awarded rate increases for CHIRP according to each provider.

View SFY 2025 CHIRP Rate Increases - STAR (.pdf)

View SFY 2025 CHIRP Rate Increases - STAR+PLUS (.pdf)

View SFY 2024 CHIRP Rate Increases - STAR (.pdf)

View SFY 2024 CHIRP Rate Increases - STAR+PLUS (.pdf)

View SFY 2023 CHIRP Rate Increases - STAR (.pdf)

View SFY 2023 CHIRP Rate Increases - STAR+PLUS (.pdf)

View SFY 2022 CHIRP Rate Increases - STAR (.pdf)

View SFY 2022 CHIRP Rate Increases - STAR+PLUS (.pdf)

APHRIQA Scorecards

SFY 2025: First Interim Payment (SFY2025) Scorecard (.xlsx) (Updated 01/10/2025)

Uniform Hospital Rate Increase Program

Overview

After approval from the Centers for Medicare and Medicaid Services (CMS), the Texas Health and Human Services Commission (HHSC) implemented the Uniform Hospital Rate Increase Program (UHRIP). The pilot UHRIP program began on December 1, 2017, in the El Paso and Bexar managed care service delivery areas (SDA). A rollout of UHRIP across the remaining SDAs was implemented and was effective as of March 1, 2018. The List of Rate Increases for Each SDA and Hospital Class is available.

The CHIRP Program superseded the UHRIP program in SFY 2022.

Final Reconciliation SFY21 (.xlsx)

Methodology / Rules

1 TAC, Part 15, Chapter 353, Subchapter O, Rules 1301 and 1305 contains the rules governing the operation of UHRIP.

1 TAC Section 353.1301 – General Provisions

1TAC Section 353.1305 – Regional Uniform Rate Increases for Hospital Services