Provider Finance Communications

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Overview

The information included on this webpage includes communications sent out by HHSC Provider Finance (formerly Rate Analysis), meeting materials, GovDelivery archives and other reference information. Any questions should be directed to ProviderFinanceDept@hhs.texas.gov.

Announcements

Monthly COVID-19 Reports

Introduction:

The 87th Texas Legislature directed the Health and Human Services Commission (HHSC) to report federal COVID-19 funding from specific health care institutions, and certain costs those providers have spent related to COVID-19 public health emergency. HHSC has developed a monthly report to obtain the information required by Rider 143 (.pdf) (2022-23 General Appropriations Act, Senate Bill (S.B.) 1, 87th Legislature, Regular Session, 2021 (Article II, HHSC, Rider 143) and S.B. 809 (.pdf) (87th Legislature, Regular Session, 2021). 

Frequently Asked Questions (FAQ):

View the HHSC created list of “frequently asked questions ” (FAQ) (.pdf) with the answers to common questions to assist providers in completing the report.

Reporting: 

The initial report located here includes funding and cost data covering the period January 2020 through August 2021 and is due October 1, 2021. The subsequent reports (located here) will be ongoing and will cover a single month; each monthly report will be due on the 15th of the month following the end of the month (for example, the report for October 2021 data will be due November 15, 2021.

You will receive a confirmation page once your report has been fully completed and submitted. No email confirmation will be sent. 

A pdf version of the initial report is available here (.pdf) for review prior to submitting the report. A pdf version of the ongoing report is available here (.pdf) for review prior to submitting the reports.

If you are unable to meet the reporting deadline, please contact the Provider Finance Department at HHSC_RAD_Survey@hhs.texas.gov for assistance.

Failure to submit:

Failure to complete and/or submit the required monthly report(s) on-time will result in:

A report to the Department of State Health Services or HHSC Regulatory Services and potential adverse actions on your licensure and/or  HHSC may initiate payment holds for providers who fail to submit the required monthly reports.

 

HHSC is granting a “grace period” to allow providers time to come into compliance if they fail to meet any deadlines between October 1, 2021, and November 30, 2021. While the deadlines to report will not change, HHSC will not take any of the actions listed above against a provider as long as the provider submits all the required reports due between October 1, 2021, and November 30, 2021. The grace period ends December 1, 2021.

List of Providers Required to Complete Reports: 

The following entities are required to complete the report:

  • Ambulatory Surgical Centers;
  • Assisted Living Facilities licensed under Chapter 247, Health and Safety Code;
  • Emergency Medical Services Providers;
  • Health Services Districts created under Chapter 287, Health and Safety Code;
  • Home and Community Support Services Agencies;
  • Hospice Providers;
  • Hospitals;
  • Hospital Systems;
  • Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID);
  • Community Living Assistance and Support Services (CLASS) or Case Management Agency (CMA) Providers;
  • Deaf-Blind with Multiple Disabilities (DBMD) Providers;
  • Home and Community-Based Services (HCS) Providers;
  • Texas Home Living (TxHmL) Providers;
  • Nursing Facilities; and
  • End-Stage Renal Disease Facilities licensed under Section 251.011, Health and Safety Code

Please email the HHSC Provider Finance Survey for assistance at HHSC_RAD_Survey@hhs.texas.gov.

Initial Uncompensated Care Pool Resizing Submission (STC 41)

Texas Notes and Changes to the UC Limit Calculation Model Template (.pdf)
Letter from Provider HHSC Finance Department to CMS (.pdf)
DY12 UC Sizing Template- CMS (.pdf)

The following pre-prints are UPDATED to CMS as of 10/15/2021

State Fiscal Year 2022 Multiple DPP Pre-Print (.zip)

The following pre-prints are UPDATED to CMS as of 10/13/2021

State Fiscal Year 2022 QIPP Pre-Print (.zip)

The following pre-prints are UPDATED to CMS as of 09/29/2021

State Fiscal Year 2022 QIPP Pre-Print (.zip)
State Fiscal Year 2022 DPP-BHS Pre-Print (.zip)
State Fiscal Year 2022 TIPPS Pre-Print (.zip)
State Fiscal Year 2022 RAPPS Pre-Print (.zip)
State Fiscal Year 2022 CHIRP Pre-Print (.zip)

The following pre-prints were UPDATED for CMS 9/15/2021
Reconciliation Visual applicable to all pre-prints (.pdf)

State Fiscal Year 2022 QIPP Pre-Print (.pdf)
State Fiscal Year 2022 DPP-BHS Pre-Print (.zip)
State Fiscal Year 2022 TIPPS Pre-Print (.zip)
State Fiscal Year 2022 RAPPS Pre-Print (.zip)
State Fiscal Year 2022 CHIRP Pre-Print (.zip)
 

The following pre-prints are PROPOSED to CMS as of 07/13/2021

State Fiscal Year 2022 QIPP Pre-Print (.zip)
State Fiscal Year 2022 DPP-BHS Pre-Print (.zip)
State Fiscal Year 2022 TIPPS Pre-Print (.zip)
State Fiscal Year 2022 RAPPS Pre-Print (.zip)
State Fiscal Year 2022 CHIRP Pre-Print (.zip)

Reporting Requirements and Auditing

All recipients of Provider Relief Fund (PRF) payments must comply with the reporting requirements described in the Terms and Conditions and specified in directions issued by the Secretary.

Update: The PRF Reporting Portal is now open for recipients who are required to report during Reporting Period 1. PRF recipients may use payments for eligible expenses and lost revenues to prevent, prepare for, and respond to coronavirus.

HRSA will host recorded Reporting Technical Assistance Sessions to provide technical assistance on reporting requirements for PRF recipients and stakeholders:

July 14, 2021 at 3 PM ET (Register here) July 20, 2020 at 3 PM ET (Register here)

New HHSC Provider Finance Payments Calendar

The Provider Finance Department has created a comprehensive payments calendar that includes all programs and expected dates related to notification, collection of Intergovernmental Transfers (IGT) and payments. Please see the updated calendar here (.pdf)

Intergovernmental Transfer (IGT) Set Up Instructions

To submit funds via Intergovernmental Transfer (IGT) as part of participation in Medicaid Directed Payment Programs, qualifying providers must ensure they have set up an account with TexNet. If you are not set up with TexNet, please use the link below and follow the instructions provided. 

https://texnet.cpa.texas.gov/psp/eptxnprd/?cmd=login&languageCd=ENG& 

In addition to an active TexNet account, providers must be sure they have an active Texas Identification Number (TIN) set up.  Your entity name, address, and phone number must match on both the application for your Texas Identification Number and Direct Deposit Authorization/Advance payment form(s).

https://www.trs.texas.gov/TRS%20Documents/contract_tin_form.pdf 

Medicaid Directed Payment Programs include:

Comprehensive Hospital Increase Reimbursement (CHIRP) Texas Incentives for Physicians and Professional Services (TIPPS) Quality Incentive Payment Program (QIPP) Rural Access to Primary and Preventive Service (RAPPS) Directed Payment Program for Behavioral Health Services (DPP for BHS)

Ambulance Provider Average Commercial Rate (ACR) Application

Enrollment for the Enhanced supplemental payment program will begin on April 14, 2021. The application is available here. A PDF version of the application is available here (.pdf). The Reimbursement Methodology for Ambulance Services rule is available here (.pdf).

HHSC Publishes IGT Deadlines for Directed Payment Programs

HHSC is providing the first intergovernmental transfer (IGT) due dates and other related deadlines for the state fiscal year 2022 directed payment programs here (.pdf). The IGT due dates published are for the first half of IGT only. HHSC will publish the IGT due dates for the second half of IGT in the upcoming future.

Effective September 1, 2021, HHSC will operate five directed payment programs: 

• Comprehensive Hospital Increase Reimbursement Program (CHIRP)
• Texas Incentives for Physician and Professional Services (TIPPS)
• Quality Incentive Payment Program (QIPP)
• Rural Access to Primary and Preventive Services (RAPPS)
• Directed Payment Program for Behavioral Health Services (DPP for BHS)

Additional information about the directed payment programs is available on the HHSC web site.

HHSC Models Estimated Hospital Program Payments for Federal Fiscal Year 2021 and 2022

HHSC has received many inquiries asking about the total impact of the modeled CHIRP and FFS payments on the DSH and UC payments.  While the models for both program are illustrative only and actual payments would be subject to actual enrollment, approval by CMS, and other decisions that have not yet been made, HHSC has modeled the impact on DSH and UC payments if payments are made as modeled. HHSC has modeled the DSH and UC payments two ways – first with only CHIRP included in the state payment cap or hospital specific limits and second with both CHIRP and the FFS supplemental payment program payments included in the state payment cap or hospital specific limit calculations.  At the beginning of the visualizations, there are a few graphics showing the change in DSH and UC payments from the inclusion of the FFS payments in the state payment cap or hospital specific limit. The remaining visualizations focus on modeling total program payments with the inclusion of the FFS payments in the state payment cap or hospital specific limit.  HHSC has not yet decided whether the proposed FFS supplemental payment program will include a quality incentive arrangement, which may influence whether the payment must be applied to the SPC or HSL.  HHSC looks forward to finalizing the proposal for the FFS supplemental payment program that was announced last week and continuing to work with all providers to explore financial solutions that support Texans access to high quality care. A copy of the model can be found here (.pdf) and here (.xslx), and the summary of the visualizations are posted here (.pdf).

Notice of Public Hearing on Proposed Rule for the Public Health Provider – Charity Care Program

The Texas Health and Human Services Commission (HHSC) will conduct a public hearing on March 26, 2021, at 11:30 a.m. CDT, to receive public comments on the proposed rule for the Public Health Provider – Charity Care Program (PHP-CCP). Persons interested in attending may register for the public hearing here. Please click here (.pdf) for more information.

Monitoring Plan for Local Funds Used to Support Medicaid Payments

To increase oversight of local funds used as the non-federal share, the Health and Human Services Commission (HHSC) is proposing to implement a process to monitor the financing structures that underlie the local funding. This effort is part of HHSC’s initiative in the Blueprint for a Healthy Texas to improve accountability and sustainability of supplemental and directed payment programs to achieve positive outcomes. 

The Draft Monitoring Plan for Local Funds Used to Support Medicaid Payments (.pdf) is published for public comment on October 22, 2020. Comments will be accepted until 5 p.m. on November 12, 2020 and can be sent by email to RAD_1115_Waiver_Finance@hhsc.state.tx.us.

Materials from the August 14th stakeholder meeting

View the Webinar Recording (.wmv) (8-14-2020)
View the Webinar Presentation (.pdf) (8-14-2020)
View the Webinar Frequently Asked Questions (.pdf) (8-14-2020)