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Long-term Services & Supports

Overview

The Provider Finance Department (PFD) develops reimbursement methodology rules for determining payment rates or rate ceilings for recommendation to the Health and Human Services Commission (HHSC) for Medicaid payment rates and non-Medicaid payment rates for programs operated by the Health and Human Services Commission (HHS) and the Department of Family and Protective Services (DFPS). PFD develops payment rates or rate ceilings in accordance with these rules and agency policy guidelines.

Announcements

Cost/Accountability Reports Information 

The 2023 Cost Report Training information is available. For more information, please click here.
For your convenience, Provider Finance has provided links to the web pages routinely utilized for cost/accountability reports. In addition, these links can also be found on your program webpage. Links to your program and to the cost report training page can be found on the left-hand navigation.
•    Cost and Accountability Report Training Information and Instructions 
•    2023 Cost Report Training Registration Information
•    Report Worksheets and Instructions
•    View COVID Related Information and Updates (.pdf) (Updated 11/03/2022)

Rider 150: Semi-Annual COVID-19 Reporting for Nursing Facilities and Hospitals (updated 2/21/2024)

Nursing facilities and hospitals must submit semi-annual COVID-19 federal fund reports in accordance with the 2024-25 General Appropriations Act, House Bill 1, 88th Legislature, Regular Session, 2023 (Article II, HHSC, Rider 150).
The reporting schedule is as follows:

  1. Due Mar. 1, 2024: data for Sep. 1, 2023 – Jan. 31, 2024
  2. Due Sep. 1, 2024: data for Feb. 1, 2024 – Aug. 31, 2024 
  3. Due Mar. 1, 2025: data for Sep. 1, 2024 – Jan. 31, 2025

Only nursing facilities and hospitals are subject to this reporting requirement; other health care institutions are not subject to this Rider 150 reporting requirement.

The update to the reporting requirement is reflected in an amendment to Texas Administrative Code, Title 1, Part 15, Chapter 355, Subchapter I, Section 355.7201, concerning Novel Coronavirus (COVID-19) Fund Reporting. The rule text and preamble is available here (pdf).

Instructions:

There are two ways to submit the Rider 150 report.

  1. To submit on behalf of multiple hospitals and/or nursing facilities that received $0 during the reporting period: submit the Authorized Representative Designation document. To do so, complete this spreadsheet (.xlsx) and email it to HHSC_RAD_Survey@hhs.texas.gov.
  2. To submit on behalf of an individual hospital or nursing facility: Submit the form at this link. You will receive a confirmation page once your report is submitted; no email confirmation will be sent.

If you have any questions about this required reporting for nursing facilities and hospitals, please contact the Provider Finance Department at HHSC_RAD_Survey@hhs.texas.gov.

American Rescue Plan Act (ARPA) Home and Community-Based Services (HCBS) Provider Retention Payments (Updated 05/18/2023)

The Health and Human Services Commission (HHSC) American Rescue Plan Act (ARPA) Home and Community-Based Services (HCBS) Provider Retention Payments is part of the HHSC APRA Spending Plan.

The ARPA HCBS Provider Retention Payments were distributed as a temporary rate add-on on eligible service claims with dates of service from March 1, 2022 to August 31, 2022, to agency providers and consumer-directed services (CDS) employers. ARPA HCBS Provider Retention payments should support recruitment and retention efforts for direct care staff delivering HCBS services. Eligible providers can use the temporary add-on to provide one-time financial compensation to direct care staff. Compensation can include lump-sum bonuses, retention bonuses, and paid time off to receive a COVID-19 vaccination or to isolate after receiving a positive COVID-19 test.

HHSC adopted Texas Administrative Code rule 1 TAC 355.207 governing the HCBS ARPA Retention Payments, including the attestation and reporting requirements. Eligible providers who receive the add-ons, but fail to complete the required attestation and reporting, will be subject to recoupment of the associated payment add-ons.

HHSC requires providers who deliver eligible HCBS services with service dates between March 1, 2022, and August 31, 2022, to submit an attestation, an initial report, and a final report. The attestation, initial, and final reports are due 90 calendar days after the end of the federally-declared COVID-19 Public Health Emergency (PHE), which expired on May 11, 2023. The deadline for the attestation and reports has been extended to Wednesday, August 9, 2023.

Attestation and Initial Report Submission

Provider Agencies and CDS Employers who wish to submit individually, Click here to submit the required attestation and initial report.  A PDF copy of the attestation and initial report can be previewed under  ARPA HCBS Provider Retention Payment Resources below.

Final Report Submission

Provider Agencies and CDS Employers who wish to submit individually, Click here to submit the required final report.  A PDF copy of the attestation and initial report can be previewed under  ARPA HCBS Provider Retention Payment Resources below.

 ARPA HCBS Provider Retention Payments Compliance List

HHSC will  post a list of providers whose Attestation, Initial Report, and Final Report submissions have been reviewed. The list will be updated every 14 calendar days.

Financial Management Services Agencies (FMSAs)

FMSA/CDS Employer Attestation and Initial Report Submission Template

Click here (.xslx) to download the template to submit the attestation and initial report for multiple CDS employers. Please return the completed template via email to PFD-LTSS@hhs.texas.gov.

FMSA/CDS Employer Final Report Submission Template

Click here (.xslx) to download the template to submit the required final report for multiple CDS employers.

The CDS participant, as the employer of record, may choose to submit the required attestation and reports or work with the Financial Management Services Agency (FMSA) to submit the attestation and reports on the CDS participant’s behalf. FMSAs may also reach out to the CDS participants to offer assistance in submitting the attestation and reports. FMSAs can submit the required information for multiple CDS participants in the FMSA  ARPA  HCBS Attestation and Initial Report Template.  If completing the attestation and reports on behalf of a CDS participant, FMSAs should work with the CDS participant to collect all required data. 

HCBS ARPA Provider Retention Payment Resources

Please contact the HHSC Provider Finance Department, Long-term Services and Supports Customer Information Team at PFD-LTSS@hhs.texas.gov or (737) 867 7817 if you have questions regarding HCBS ARPA Provider Retention Payments.

2022 COVID-19 Grant Programs

December 16, 2021

Pursuant to Senate Bill (S.B.) 8, 87th Legislature, 3rd Called Session, 2021, the Health and Human Services Commission will administer one-time grants for the following providers:

  • $75,000,000 million for rural hospitals (S.B. 8, Section 12);
    • $38,000,000 ($250,000 per rural hospital) via direct grant awards;
    • $37,000,000 distributed via a competitive grant process;
  • $200,000,000 for nursing facilities (S.B. 8, Section 33);
    • $90,000,000 ($75,000 per licensed facility) in direct grant awards;
    • $110,000,000 distributed via a competitive grant process;
  • $178.3 million for assisted living facilities, home health agencies, intermediate care facilities for individuals with intellectual and developmental disabilities or related conditions, and providers of community attendant services (S.B. 8, Section 33) distributed via a competitive grant process.

More information will be published at the following link under “COVID-19 in Healthcare Relief Grants” as it becomes available: https://www.hhs.texas.gov/business/grants/grants-awarded-hhs

Cost Report Reform Training and Cycle

Introduction to Cost Report Reform

Beginning with the 2018 cost reports, cost report reform began as a pilot for Home and Community-based Services and Texas Home Living (HCS/TxHmL) waiver programs and the Intermediate Care Facilities for Individuals with an Intellectual or Developmental Disability or Related Conditions (ICF/IID) program providers to submit cost reports biennially rather than annually. The Texas Health and Human Services Commission (HHSC) Executive Commissioner directed the Provider Finance Department (PFD) to expand cost report reform to all Long-term Services and Supports (LTSS) programs. The intended frequency of cost report submission is on a biennial basis rather than annual basis. 

The Attendant Compensation Rate Enhancement and Direct Care Staffing Compensation Participants

A provider who participates in the Attendant Compensation Rate Enhancement or the Direct Care Staff Compensation programs (rate enhancement) are required to submit accountability reports in the years that they are not required to submit full cost reports. Providers are notified of the requirement to submit this report in an HHSC Provider Finance Department letter that specifically requests this report.

Providers who do not participate in the rate enhancement program are only required to submit cost reports every two years; no reports will be required in the interim years if they continue to be non-participants in the rate enhancement program. 

Cost Reporting Cycle

CPC (Primary Home Care (PHC), Community Living Assistance and Support Services (CLASS)-Direct Service Agency (DSA), Community Living Assistance and Support Services (CLASS)-Case Management Agency (CMA)), and Day Activity and Health Services (DAHS) providers will be required to submit cost reports to HHSC Rate Analysis Department in odd-numbered years. 
Nursing Facility (NF), Residential Care (RC), HCS/TxHmL, and ICF/IID providers will be required to submit cost reports in even years.

NF providers who are members of the Pediatric Care Facility class, The Department of Family and Protective Services’ (DFPS) 24-Hour Residential Child Care (24-HR RCC) providers will continue to submit their cost reports every year.

Deaf-Blind Multiple Disabilities Waiver providers enrolled in the Rate Enhancement program will submit their accountability reports every year.

Below is the cost reporting cycle for all LTSS programs:

Even-Year Cost Reports

Even Year cost reports collected in the Odd Year. (i.e. 2020 reports collected in 2021)

Report Type Reports Collected
CR 24RCC
CR HCS/TxHmL
CR ICF/IDD
CR NF
CR RC
   
AR CPC
AR DAHS
AR DBMD

Odd-Year Cost Reports

Odd Year cost reports collected in the Even Year. (i.e. 2019 reports collected in 2020)

Report Type Reports Collected
CR 24RCC
CR CPC
CR DAHS
   
AR DBMD
AR HCS/TxHmL
AR ICF/IDD
AR NF
AR RC

Cost Report Training

The Long-term Services and Supports (LTSS) cost report reform initiative requires preparers of most LTSS cost reports and accountability reports to attend state-sponsored cost report training in the same year that a cost report is required to be submitted to HHSC. Preparers of LTSS cost reports and accountability reports are required to attend training on a schedule that is related to their cost reporting deadlines.

There are no substantive changes to the Department of Family Protective Services (DFPS) 24-hour Residential Child Care program, and the Deaf-Blind with Multiple Disabilities (DBMD) training requirements.