Directed Payment Program for Behavioral Health Services

Overview

The Directed Payment Program for Behavioral Health Services (DPP BHS) is a new value-based payment program for CMHCs to incentivize them to continue providing services to Medicaid-enrolled individuals that are aligned with the Certified Community Behavioral Health Clinic (CCBHC) model of care. The program will continue successful Delivery System Reform Incentive Payment (DSRIP) innovations by CMHCs to promote and improve access to behavioral health services, care coordination, and successful care transitions. DPP BHS payments will be included in MCO capitation rates and distributed through two components to enrolled CMHCs who meet program requirements. DPP BHS must be approved by the Centers for Medicare and Medicaid Services (CMS). 

Enrollment

The Texas Health and Human Services Commission (HHSC) collected enrollment applications for DPP BHS from March 24, 2021, through April 13, 2021. The application period is now closed. 

Methodology/Rules

The Texas Health and Human Services Commission (HHSC) has adopted new §353.1320, concerning Directed Payment Program for Behavioral Health Services; and new §353.1322, concerning Quality Metrics for the Directed Payment Program for Behavioral Health Services. The new rules were published in the April 16, 2021 issue of the Texas Register and become effective on April 21, 2021. 
DPP BHS rules §353.1320 and §353.1322.

Modeling

To assist potential applicants, HHSC has drafted a model of the potential earning of each CMHC under the program. Please note: the modeling is only an example and does not reflect the final program values. The program values in the model are subject to change based on the actual enrollment, data changes, and approval issued by CMS. The proposed DPP BHS modeling is available here (.pdf) (excel version of the file here (.xslx)).

Suggested IGT 

Suggested Intergovernmental Transfer (IGT) amounts per provider is available here (.pdf), and excel file can be located here (.xlsx). The modeling is available here (.pdf), and the excel can be located here (.xlsx) (Updated 05/04/2021)
IGT Commitment form is available here (.pdf), and excel file can be located here (.xlsx).