Provider Finance Communications

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 rad_operations@hhsc.state.tx.us.

Announcements

The Texas Health and Human Services Commission (HHSC) will conduct stakeholder engagement meetings on January 21, 2021, beginning at 9:00 a.m. CST, to receive comments on Medicaid payment rates that may be addressed at the May 2021 rate hearings. The agenda can found here.

CHIRP Modeling

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.

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 proposed CHIRP modeling is available here (.pdf(excel version of the file here (.xslx)) and the summary visualizations of the modeling are available here (.pdf)

TIPPS Modeling

Texas Incentives for Physician and Professional Services (TIPPS) is a proposed physician-directed payment program (DPP) that may serve as a transition for Network Access Improvement Program (NAIP) and Delivery System Reform Incentive Payment (DSRIP) for physician practice groups. The program is intended to serve as a performance incentive and value-based payment arrangement, with a small component of a uniform rate increase.

HHSC is providing the TIPPS 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 proposed TIPPS modeling is available here (.pdf).

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.

GovDelivery Archives

Provider Finance has begun to use the GovDelivery communications system for routine and non-routine alerts and announcements regarding rate hearing schedules and other important information. To begin receiving GovDelivery alerts from HHS Provider Finance, please:
1.    Visit the HHS GovDelivery registration site;
2.    Select Medicaid Reimbursement Rates and Non-Medicaid Reimbursement Rates as preferences; and 
3.    Enter the other requested information.

Provider Reimbursement Tables (.pdf) (Sent 11/05/2020)

Proposed Medicaid Payment Rates for the Medicaid Biennial Calendar Fee Review (.pdf) (Sent 11/02/2020)

HHSC Requests Comments on Draft Monitoring Plan for Local Funds (.pdf) (Sent 10/22/2020)

Foster Care Rates Methodology Study (.pdf) (Sent 09/28/2020)

Upcoming Deadline for RMTS Staff Roster Submissions (.pdf) (Sent 09/14/2020)

Healthcare Common Procedure Coding System (HCPCS) Updates (.pdf) (Sent 09/09/2020)

Rural Hospital Proposed Standard Dollar Amounts Realignment (.pdf) (Sent 09/08/2020)

Meeting Materials Available from 08-14-2020 Provider Finance Stakeholder Meeting (.pdf) (Sent 09/02/2020)

Provider Relief Fund - Application Deadline Extended Until 09-13-2020 (.pdf) (Sent 09/01/2020)

Provider Relief Fund - Application Deadline Extended Until 08-28-2020 (.pdf) (Sent 08/04/2020)

Provider Relief Fund - Application Deadline Extended Until 08-03-2020 (.pdf) (Sent 07/22/2020)

Provider Relief Fund - Application Deadline Notification (.pdf) (Sent 07/15/2020)

COVID-19 Medicaid Rate Notifications (.pdf) (06/22/2020)

Meeting Information

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)