Comprehensive Hospital Increase Reimbursement Program
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.
The Texas Health and Human Services Commission (HHSC) announces enrollment for the Comprehensive Hospital Increase Reimbursement Program (CHIRP). The application 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).
Methodology/Rules for CHIRP
HHSC is adopting 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 will be published in the March 26, 2021 issue of the Texas Register and become effective on March 28, 2021. The adoption preamble is available here (.pdf) and the final rules are available here (.pdf)
HHSC is providing the CHIRP modeling for example purposes only; these are not the final program values. The program values are subject to changes based on actual enrollment, data changes and approval issued by the Centers for Medicare and Medicaid Services (CMS). The CHIRP modeling is updated to reflect the final rules and is available here (.pdf) (excel version of the file here (.xslx)) and the summary visualizations of the modeling are available here (.pdf).
Uniform Hospital Rate Increase Program
The Texas Health and Human Services Commission (HHSC) has approval from the Centers for Medicare and Medicaid Services (CMS) to implement the Uniform Hospital Rate Increase Program (UHRIP) for hospital services. At this time, only STAR and STAR+PLUS Medicaid Managed Care Programs participate in UHRIP. HHSC rolled out a 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.
Please refer to the UHRIP Information and Checklist (.pdf) for more information on the March 1, 2018 statewide rollout of UHRIP.
The applications for the March 1, 2019 rollout of UHRIP was sent to SDA liaisons and was due to HHSC by September 5, 2018. The CMS-approved ranges for the each hospital class can be viewed here.
Each SDA has nominated one governmental IGT entity to act as the primary conduit of communications between HHSC and the hospitals and MCOs in each SDA. This liaison is responsible for disseminating information on the program to all stakeholders in the SDA, in concert with HHSC as necessary.
HHSC will be working through the nominated governmental IGT entity in rolling out UHRIP. Please see the current list of SDA liaisons here.
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.