STAR+PLUS Cost Reporting

In accordance with Title 1 of the Texas Administrative Code (TAC), beginning with the 2014 Cost Reporting Period the Texas Health and Human Services Commission ( HHSC) Rate Analysis Department (RAD)  is requesting cost reports from providers contracted with Managed Care Organizations (MCO) to provide certain STAR+PLUS services.

TAC 1, Part 15, Chapter 355, Subchapter A, Rule §355.101(d):  Providers contracted with Managed Care Organizations.  To ensure that HHSC has adequate financial and statistical information upon which to base reimbursement, each provider that has contracted with a Managed Care Organization (MCO) to provide Long-Term Services and Supports to State of Texas Medicaid clients must submit to HHSC periodic cost reports and supplemental reports as required by this subchapter.  This required cost reporting must follow rules and requirements as set forth in this subchapter.  An MCO will be responsible for enforcing the vendor hold and administrative penalties relating to cost reporting violations as described in this subchapter, and §355.403 of this chapter (relating to Vendor Hold), if HHSC notifies the MCO that a violation has occurred.

The list of services for which HHSC RAD will collect costs reports consists of the following programs

  • Community Living Assistance and Support Services (CLASS) Case Management Agency (CMA)
  • CLASS Direct Service Agency (DSA)
  • Day Activity and Health Services (DAHS)
  • Early Childhood Intervention - Case Management
  • Early Childhood Intervention - Specialized Rehabilitative Services
  • Nursing Services (not including Private Duty Nursing (PDN)
  • Occupational Therapy (OT)
  • Physical Therapy (PT)
  • Primary Home Care (PHC)
  • Residential Care (RC)
  • Speech Therapy (ST)
  • Service Coordination – Individuals with an Intellectual Disability or Related Conditions
  • Rehabilitation Services - Mental Health
  • Targeted Case Management - Mental Health

Below is a list of Long-Term Services and Supports services and the corresponding HHSC RAD Cost Report types that STAR+PLUS providers will be responsible for completing.  Clicking on the cost report type links will take you to the specific cost report webpage where additional information about the required cost report can be found.

Cost Report Type:  CPC - CBA/PHC/CLASS

  • Nursing Services
  • Occupational Therapy
  • Physical Therapy
  • Personal Assistance Services
  • Speech Therapy

Cost Report Type:  DAHS - Day Activity and Health Services

  • Adult Day Care

Cost Report Type: RC - Residential Care

  • Assisted Living

Cost Report Type:  MEI - Mental Health/Early Childhood Intervention/Individuals with an Intellectual Disability

  • Early Childhood Intervention - Case Management
  • Early Childhood Intervention - Specialized Rehabilitative Services
  • Service Coordination – Individuals with an Intellectual Disability or Related Conditions
  • Rehabilitation Services - Mental Health
  • Targeted Case Management - Mental Health

On April 16, 2014, HHSC RAD sent requests to MCO contracted providers via email to submit a cost report that will cover their 2014 operating fiscal year.  The cost reports will be due to HHSC RAD on April 15th.

Information emailed to the MCO contracted providers included content to familiarize them with cost reporting, the State of Texas Automated Information Reporting System (STAIRS) used to complete and submit the cost reports, the mandatory training requirement for those who actually prepare the cost reports, the schedule for available training sessions and how to register, and contact information on how to obtain additional information and assistance. 

RESOURCES:

Questions regarding contracts and cost report groupings that have been assigned to your entity should be directed to HHSC RAD at (512) 490-3193 or rateanalysisdept@hhsc.state.tx.us

Questions regarding Preparer or the list of Preparers should be directed to HHSC RAD at (512) 490-3193 or rateanalysisdept@hhsc.state.tx.us

Questions regarding cost report training should be directed to HHSC RAD at (512) 490-3193 or costreporttrain@hhsc.state.tx.us

Questions regarding the proper completion of your cost report in STAIRS should be directed to the appropriate HHSC contact for your program.