Long-term Services & Supports

Announcements

Financial Management Services Agency (FMSA) Cost Survey

The Health and Human Services Commission (HHSC) Provider Finance Department has contracted with Deloitte Consulting to administer a cost survey for all FMSAs in Texas. 

Deadline Extended: The FMSA Cost Survey template is available to download here(Please note, if you are using Google Chrome, you will need to right-click the link and Open in a new Tab or Open in a New Window.) All Surveys are due by email by 11:59 p.m. on May 19th, 2021.

Please return all completed cost surveys to Deloitte Consulting at FMSACostReporting@deloitte.com

FMSA Cost Survey Webinar Video (.wmv) (3/19/2021)

FMSA Cost Survey FAQs

What is the purpose of the cost survey?

The purpose of the cost survey is to collect FMSA costs for calendar years 2019 and 2020. This cost information will be used in the development of a new rate methodology for FMSA rates for Medicaid and Non-Medicaid programs.

Are all FMSAs expected to participate in this cost survey?

Yes, all FMSAs that delivered services in 2019 and/or 2020 are expected to participate.

As an FMSA, who will contact me and when?

If you are an FMSA contracted with HHSC or a managed care organization (MCO), you should have received Gov Delivery notice requesting that you complete and submit a cost survey.

What should an FMSA do if they did not receive an email notification related to the cost survey template?

If you are an FMSA contracted with HHSC or an MCO, please complete and submit a cost survey even if you have not received Gov Delivery notice.. The cost survey template will allow FMSAs the opportunity to provide email info for future correspondence.

Who do I contact if I have questions regarding this cost survey?

Please contact Deloitte Consulting at FMSACostReporting@deloitte.com.

Overview of the Foster Care Rate Methodology Study

View the Overview of the Foster Care Rate Methodology Study Webinar Slides (.pdf) (02/24/2021)

View the Overview of the Foster Care Rate Methodology Study Webinar Video (.wmv) (02/24/2021)

Cost/Accountability Reports Information

For your convenience, Provider Finance has provided links to the webpages 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.

COVID-19 Temporary Rate Increases:

Temporary COVID-19 rate increases for Nursing Facilities (NF) and the Home and Community-Based Services (HCS) Waiver Program effective April 1, 2020.

The payment rate add-ons for the HCS waiver only apply to providers delivering in-home day habilitation services to persons with intellectual disabilities or related conditions residing in three or four-bed group homes and receiving Supervised Living or Residential Support Services. These rate increases will apply to the current day habilitation rates so that providers delivering services in group homes can maintain hourly direct care staff wages due to reduced client to staff ratios.

NF providers may utilize the additional funding for COVID-related expenses; including direct care staff salary and wages, personal protective equipment (PPE), and dietary needs/supplies.  As it relates to direct care staff salary and wages, NF providers may only use the additional funding to increase staff compensation through reimbursement of overtime or lump sum bonuses, including bonuses for hazard pay, or other methodologies that will not result in future reductions in hourly wages when the temporary rate increases are discontinued.
Per 355.205 - Emergency Rule for Emergency Temporary Reimbursement Rate Increases and Limitations on Use of Emergency Temporary Funds for Medicaid in Response to Novel Coronavirus (COVID-19), HCS and NF providers receiving increased funding associated with add-on payments for COVID-19 must submit an attestation affirming that the rate increases will be used only in the manner prescribed above. HCS and NF providers who receive add-ons but fail to complete the required attestation will be subject to recoupment of the associated payment add-ons. The attestation form can be here. Please utilize Chrome (Preferred Browser), Firefox or Safari.

The temporary COVID-19 rate increases were effective April 1, 2020, and is estimated to conclude at the end of the federally-declared public health emergency (PHE). The PHE is anticipated to end on July 20, 2021, unless the PHE is withdrawn before this date or extended. The official PHE notifications can be viewed here.

Overview

The Rate Analysis Department (RAD) develops reimbursement methodology rules for determining payment rates or rate ceilings for recommendation to the Health and Human Service as Commission (HHSC) for Medicaid payment rates and non-Medicaid payment rates for programs operated by the Department of Aging and Disability Services (DADS) and the Department of Family and Protective Services (DFPS). RAD develops payment rates or rate ceilings in accordance with these rules and agency policy guidelines.

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 Rate Analysis Department (RAD) 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 Rate Analysis 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 as long as they continue to be non-participants in the rate enhancement program.

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.

Please note that due to the schedule of the implementation of the change in submission requirements, preparers of the following programs will be required to take the 2020 Cost Report Training regardless of whether or not they attended the 2019 Cost Report Training:

Cost Reporting Cycle

Primary Home Care (PHC), Day Activity and Health Services (DAHS), Community Living Assistance and Support Services (CLASS)-Direct Service Agency (DSA), and Community Living Assistance and Support Services (CLASS)-Case Management Agency (CMA) 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 and 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.

Below is the cost reporting cycle for all LTSS programs:

Cost Reporting Cycle

Report Type          

Reports Collected               

Even-Year Cost Reports

2020 cost reports, collected in 2021:

 

 

 

CR

24RCC

HCS/TxHmL

ICF/IID

NF

RC

 

AR

CPC

DAHS

DBMD

Odd-Year Cost Reports

Beginning with 2019 cost reports, collected in 2020: 

 

 

CR

24RCC

CPC

DAHS

 

 

AR

DBMD

HCS/TxHmL

ICF/IID

NF

RC