Comprehensive Hospital Increase Reimbursement Program

Overview

The Comprehensive Hospital Increase Reimbursement Program (CHIRP) is a statewide program that provides for increased 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 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.

Enrollment

SFY2022: The Texas Health and Human Services Commission (HHSC) announces enrollment for the Comprehensive Hospital Increase Reimbursement Program (CHIRP). The application (view here) should take about 10-15 minutes to complete and is for the eligibility period from September 1, 2021 to August 31, 2022. A PDF version of the application is available here (.pdf).

SFY2023: The Texas Health and Human Services Commission (HHSC) announces enrollment for the Comprehensive Hospital Increase Reimbursement Program (CHIRP) from March 02, 2022, through March 29, 2022. The application (view here) should take about 10-15 minutes to complete and is for the eligibility period from September 1, 2022 to August 31, 2023. A PDF version of the application is available here (.pdf).

SFY2024: The Texas Health and Human Services Commission (HHSC) announces enrollment for the Comprehensive Hospital Increase Reimbursement Program (CHIRP) from February 01, 2023, through February 21, 2023. The application (view here) should take about 10-15 minutes to complete and is for the eligibility period from September 1, 2023 to August 31, 2024. A PDF version of the application is available here (.pdf).

CHIRP Application Fee

HHSC will be collecting an application fee of $8,500 for FY2024 for CHIRP to defray the cost of administering the program. This application fee will apply to all non-public hospitals who choose to participate in the program. As outlined in Title 1 of the Texas Administrative Code, §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 at the time of the submission of the enrollment application. The deadline to submit the application fee is no later than February 21, 2023. 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 payment instructions here (.pdf).

One check may be submitted for multiple providers, however a voucher for each provider must be submitted.

Providers in Recoupment Status

Coming soon. 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 should be recouped by applicable Medicaid Managed Care Organizations. The listed providers are will be available here.

For questions regarding the Conditions of Participation determination, please contact the Delivery System Quality and Innovation Department at dppquality@hhs.texas.gov.

Methodology/Rules

HHSC has adopted new §353.1306, concerning Comprehensive Hospital Increase Reimbursement Program for program periods on or after September 1, 2021; and new §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 final rules are available here: §353.1306 and §353.1307

Pre-Print Packages

View Approved SFY2022 CHIRP Pre-Print Package as of 4/21/2022 (.zip) (Posted 05/20/2022)

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

SFY 2023

First Half Year 2 (SFY2023) Suggested IGT Transfer

Suggested Intergovernmental Transfer (IGT) amounts per provider is available here (.xlsx). (Updated 05/27/2022)

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). 

Awarded Rate Increases for CHIRP

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

View SFY2023 CHIRP Rate Increases – STAR (.pdf)

View SFY2023 CHIRP Rate Increases – STAR+PLUS (.pdf)

View SFY2022 CHIRP Rate Increases – STAR (.pdf)

View SFY2022 CHIRP Rate Increases – STAR+PLUS (.pdf)

Uniform Hospital Rate Increase Program

Overview

Approval from the Centers for Medicare and Medicaid Services (CMS), the Texas Health and Human Services Commision (HHSC) implemented the Uniform Hospital Rate Increase Program (UHRIP) The pilot UHRIP program 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 with effect from March 1st, 2018. The rate increases for each SDA and each class of hospitals can be viewed here.

The UHRIP program was superseded by the CHIRP Program in SFY 2022.

Methodology / Rules

Rules governing the operation of UHRIP are at Title 1 of the Texas Administrative Code, Part 15, Chapter 353, Subchapter O, Rules 1301 and 1305.

RULE §353.1301 General Provisions

RULE §353.1305 Regional Uniform Rate Increases for Hospital Services