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Uncompensated Care Payments

Overview

Historically every private hospital that participates in the waiver must execute an affiliation agreement with the governmental entity that provides the Intergovernmental Transfer (IGT) for any type of payment (transition, Uncompensated Care (UC) or Delivery System Reform Incentive Payment (DSRIP)). Hospitals receiving transition payments already have the necessary affiliation agreements on file. Read more about overview(.pdf). Beginning in the Demonstration Year (DY) 12, this is no longer a requirement.

Methodology/Rules

The Waiver Payments to Hospitals and Waiver Payments for Physician Services rules are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 355, SubChapter J, Division 11.

The 1115 Waiver rules are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 354, SubChapter D.

Allocation Form

1115 Transformation Waiver IGT Allocation Confirmation Sheet: The waiver payment team has developed a new allocation confirmation spreadsheet for governmental entities to complete as a step in the payment process. Read more about allocation form(.pdf)

Hospital Affiliations

View Hospital Affiliations (.pdf), a comprehensive listing of each affiliation between a hospital or provider and a government entity. This will provide all information needed to complete the allocation form, such as the unique affiliation number, TIN number, TPI, account number, and region associated with the affiliation.

UC Withheld Payments

The DY3-DY6 UC withheld payment amounts can be found here(.pdf). Please note that these amounts are subject to change when ineligible providers are removed and when HHSC caps providers at the final UCC calculated in the UC reconciliation for the applicable program year.

UC IGT Commitments

DY12

View DY12 UC IGT Commitments File for Hospitals and Physician Groups (xlsx) (Updated 8/1/2023)

DY11

View DY11 UC IGT Commitments File for Hospitals and Physician Groups (xlsx) (Updated 8/30/2022)

UC Final Calculation Files

DY12

View DY12 UC Final Calculation File for Hospitals and Physician Groups (xlsx) (Updated 8/16/2023)

DY11

View DY11 UC Final Calculation File for Hospitals and Physician Groups (xlsx)

View DY11 UC TXPUC withheld and additional hospital payment (xlsx)

UC Advance Calculation Files

View DY12 UC Advance Calculation File for Hospitals and Physician Groups (xlsx)

 

Payment Information

View the 2022 DY11 Uncompensated Care Expenditures (.pdf)

View the 2021 DY10 Uncompensated Care Expenditures (.pdf)

View the 2020 DY9 Uncompensated Care Expenditures (.pdf) (Updated 09/15/2020)

View the 2019 DY8 Uncompensated Care Expenditures (.pdf)

View the 2018 DY7 Uncompensated Care Expenditures (.pdf)

View the 2017 DY6 Uncompensated Care Expenditures (.pdf)

View the 2016 DY5 Uncompensated Care Expenditures (.pdf)

View the 2015 DY4 Uncompensated Care Expenditures (.pdf)

View the 2014 DY3 Uncompensated Care Expenditures (.pdf)

View the 2013 DY2 Uncompensated Care Expenditures (.pdf)

View the 2012 DY1 Uncompensated Care Expenditures (.pdf)

Additional Information

Providers that have a payment recoupment will be notified separately by HHSC regarding the process for recouping amounts owed.

UC SDA Allocation Form (xlsx)

UC Payment Protocol Attachment H (.pdf) (Updated 04/23/2020)

View the Final 2012 UC IGTs (.pdf)

Waiver Payment Forms for UC/DSRIP Providers

Guidelines for Participating in Transformation Waiver Payments (.pdf)