DY6 DSRIP Rules Public Hearing Webcast Information – Friday 8/26 @ 9:00am

Good afternoon Region 2,

Please see the email below with the webcast directions for the HHSC public hearing to be held tomorrow morning on the DY6 DSRIP Rules.  Also, please see the attached file on page 4 for the comments that Craig Kovacevich (who will be attending the meeting in person) intends to give.

 

Susan Seidensticker, BSIE, MSHAI, CPHQ, CSSBB, PMP
Director, Waiver Quality Operations
University of Texas Medical Branch (UTMB)
409-766-4041
smseiden@utmb.edu

**********************************************************************

Dear Anchors,

Please note that the public hearing on the proposed DSRIP rules will be held tomorrow, August 26, 2016, at 9:00 AM at HHSC, Brown Heatly Building, Public Hearing Room, 4900 N. Lamar Blvd., Austin, TX.   The public hearing will be webcast.

To access the webcast, please go to the following link – http://www.hhsc.state.tx.us/news/meetings.asp.

The rules are available here – http://www.sos.state.tx.us/texreg/pdf/backview/0729/0729prop.pdf.  They begin at the bottom of p. 2 (or 5486).

Thank you,

 

Healthcare Transformation Waiver Operations
Texas Health and Human Services Commission

8/19/16 Anchor Update

Good afternoon Region 2:

Below please find the Anchor Updates from HHSC, including two documents related to Category 3 operations in DY6 as well as the newly released Statewide Learning Collaborative (SLC) agenda.

Please note the deadline noted by HHSC for the Alternate Achievement Request Form, in order to adhere to their deadline, we asked that you forward those to us by close of business on Tuesday, September 6th.  Regarding the deadline for Stretch Activity Selections, our office will contact those providers that need to respond to this.

In addition, please see the letter from HHSC to CMS to begin discussions on the longer term extension of the Medicaid 1115 Demonstration Waiver.  Thanks.

 

Craig S. Kovacevich, MA
Associate Vice President,
Waiver Operations &
Community Health Plans
UTMB Health
409.766.4047 (Office)
cskovace@utmb.edu

Representing:

1115 Medicaid Waiver – RHP 2
UTMB HealthCare Systems
UTMB Community Health Plans

 

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Dear Anchors,

Here are a few updates for you this week:

Category 3

Alternate Achievement Requests for DY6

  • The Alternate Achievement Request Form for DY6 has been posted to the waiver website (http://www.hhsc.state.tx.us/1115-Waiver-Guideline.shtml, under the Category 3 section halfway down the page) . Providers with a currently approved alternate achievement request must submit an updated request for DY6 goals. Providers with a P4P QISMC outcome with a baseline below the MPL may also submit an alternate achievement request to change DY6 goals to a 12.5% gap closure towards perfect, similar to a P4P IOS outcome. HHSC will take into account achievement reported as of April DY5 when reviewing these request.
  • The form will indicate eligibility to submit an alternate achievement request based on the above criteria. If a provider believes an outcome should be eligible, but is not showing as eligible in the form, please contact HHSC. One form should be completed for each alternate achievement request.
  • Alternate Achievement Requests should be submitted by Anchors to HHSC by September 9th, along with responses to HHSC comments regarding the DY6 Participation Form.

Stretch Activity Selections for DY6

  • The Stretch Activity DY6 Selection template is attached. This template should be completed by Anchors as it is organized at an RHP level. HHSC is extending the submission deadline for the Stretch Activity Selection Template to September 30th, pending submission of the RHP Planning Protocol updates for DY6. The deadline is being extended so that providers will have a chance to review the PFPM and Stretch Activity menu in the RHP Planning Protocol as submitted to CMS prior to making final selections. Prior to submission to CMS, HHSC has updated the Draft Category 3 operational details document with the detailed PFPM and Stretch Activity menus.

Category 3 Interim Corrections and PFPM Baselines

  • HHSC has completed reviews of Category 3 Interim corrections that were submitted to HHSC by August 11th . We will be notifying providers of approval or any needed follow up the week of the 22nd.
  • HHSC has also completed reviews of PFPM Baseline templates hat were submitted August 15th. We will be notifying providers of approval or any needed follow-up the week of the 22nd.

DY6 DSRIP Rule Set #2

  • Just a reminder that the public comment period for the second set of DY6 DSRIP rules, which closely mirror the DY6 Program Funding and Mechanics (PFM) protocol language, ends August 29, 2016.   These rules were published as proposed in the July 29, 2016, issue of the Texas Register, and are available here – http://www.sos.state.tx.us/texreg/pdf/backview/0729/0729prop.pdf.
  • Please note that the public hearing date listed in the initial Texas Register posting is inaccurate.  The public hearing on these rules will be held on August 26, 2016, at 9:00 AM at HHSC, Brown Heatly Building, Public Hearing Room, 4900 N. Lamar Blvd., Austin, TX.   The public hearing will be webcast.

2016 Statewide Learning Collaborative

  • The Statewide Learning Collaborative is right around the corner!  Thank you to all of the anchors for facilitating reservations for all of your providers.  Attached is the final agenda!
  • HHSC has arranged for the Statewide Learning Collaborative Summit to be available for viewing on-line, in real time, in order to allow all interested individuals to watch the proceedings.  To access the Summit via webcast on August 30th and/or 31st , please click on the Summit Webcast link: https://player2.streamspot.com/?playerId=92a4a38d. The webcast will only stream the sessions that are occurring in the Grand Ballroom.  A test stream will be available on August 22 – 24 each day between the hours of 8:00AM and 10:00PM at the same link (https://player2.streamspot.com/?playerId=92a4a38d) in order for viewers to troubleshoot any firewall issues prior to the Summit.  If issues are encountered during the test stream, we recommend facilities wanting to watch the Summit open up the ability to offer streaming through their firewall and test again to make sure it is working. When you access this site during the test period or the Summit hours, please press play to begin watching on-going sessions. If at any time a participant leaves the webcast and returns later, you will need to click on the same link and press play to re-join. During the webcast, participants may submit questions through an online chat function. Questions will be answered after the Summit concludes.
  • We will send the SLC agenda and livestream link to our provider distribution list and post on the website, but feel free to also share with your providers.

As always, thanks for all of your help.  We will follow-up early next week on the questions you sent in response to my inquiry (although the Cat 3 questions are likely answered above), and please let us know if you have additional questions.  We hope you have a great weekend.

 

Healthcare Transformation Waiver Operations
Medicaid/CHIP
Texas Health and Human Services Commission

 

 

RHP 2 Announcement/Reminder – Immediate Action Required DY5 UC IGT Commitment Notification

Dear RHP 2 Providers (Related to Uncompensated Care):

Just a quick reminder that IGT commitment forms are due today, Friday August 19, 2016 by 5 PM CT.

Below, I have noted the updated dates that HHSC shared with us and providers yesterday. Please note there have been changes for both TexNet entries and settlements.

If you have any questions please do not hesitate to contact HHSC Rate Analysis or the RHP 2 Anchor Office.

August 19th                  IGT Commitments Due
August 25th                  UC IGT Notification
September 8th             Last Day to Enter into TexNet
September 9th             IGT Settlement Date
September 30th               Latest Date for DY5 UC Payments

 

Craig S. Kovacevich, MA

Associate Vice President
Waiver Operations & Community Health Plans
Office of the President
The University of Texas Medical Branch at Galveston

Representing

UTMB Multi-Share, UTMB ChoiceONE Select and UTMB HealthCare Systems
Region 2, 1115 Medicaid Waiver
University of Texas Medical Branch
301 University Blvd., Galveston, TX 77555-0985
P 409.766.4047
F 409.747.0896
E cskovace@utmb.edu

 

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Subject: Immediate Action Required DY5 UC IGT Commitment Notification

Anchors:

The purpose of this e-mail is to provide demonstration year 5 (DY 5) uncompensated care (UC) and intergovernmental transfer (IGT) data to all UC providers for the UC payment to be processed in September 2016.  The attached file contains the maximum UC payment for this round of the DY 5 payment, the maximum IGT commitment for each provider and a request for the final IGT commitment from providers.  This is not the final DY 5 UC payment.  There will be a final DY 5 UC payment pending the resolution of Texas Children’s Hospital and Seattle Children’s Hospital vs. Burwell et al., Civil Action No. 14-2060, in the US District Court for the District of Columbia. HHSC is holding back 5 percent of the total DY 5 UC allocation to address possible changes to all hospitals’ HSLs pending the resolution of Texas Children’s Hospital and Seattle Children’s Hospital vs. Burwell et al., Civil Action No. 14-2060, in the US District Court for the District of Columbia.  Upon final resolution of this case, HHSC will make a final DY 5 UC payment based on the court decision.

At this point, eligible providers and/or their government entities are asked to view the “IGT Commitments by TPI” tab of the attached workbook, locate their hospital and its associated “Maximum IGT (Commitment Cannot Exceed this Amount)” in Column E and complete the IGT commitment form by entering the IGT amount they are committing for the September 2016 DY 5 UC payment.  The commitment form must be returned to HHSC at RAD_UC_Payments@hhsc.state.tx.us by close of business on August 19, 2016.

Please determine the IGT amount you wish to commit up to the limit contained in Column E.  While you may commit to IGT the maximum amount in Column E, providers have the option to commit less than the maximum in order to ensure that they do not exceed their HSLs at the time of the UC interim and final reconciliations or if they do not have enough IGT available to fund the maximum amount.  Provider’s IGT commitments should take into consideration their own determinations of whether they might be paid above their HSLs at the time of the interim and final UC reconciliations.  Being paid above their HSLs would subject providers to recoupment at the time of the reconciliations.

It is the responsibility for each provider to coordinate with their Government entities to determine the amount(s) that each Government entity is committing to. This is necessary to ensure that providers do not exceed their maximum IGT commitment. It is the responsibility of the provider receiving the payment to submit this form to HHSC by the designated due date.

HHSC will impose a “haircut” to determine the actual DY 5 UC payments upon receipt of their proposed IGT commitments. The size and distribution of the haircut will be dependent on amount the IGT commitments and the DY 5 funds available.

To ensure that all government entities receive this notification, HHSC strongly encourages anchors and providers to send this information to any government entity who is IGT’ing on their behalf. 

 

Below are the pertinent dates associated with the DY 5 UC payment:

  • August 19                                  DY 5 UC IGT Commitment Due
  • August 25                                  DY 5 UC IGT Notification sent to industry
  • August 30                                  Last date to transfer funds into TexNet
  • September 1                             DY 5 UC IGT Settlement Date
  • September 12                           DY 5 Transferring Entities (Big 6) Payment Date
  • September 30                           Latest DY 5 UC Payment Date

To avoid having to revise your TexNet entries, do not enter your IGT amount into TexNet until you receive the final version of the calculation workbook from HHSC.  The final version, with the haircut, is expected to be released on August 25, 2016.

If you have questions regarding the UC payment process, please send an email to RAD_UC_Payments@hhsc.state.tx.us

 

Thank you,

 

HHSC Hospital Rate Analysis
Texas Health and Human Services Commission
P.O. Box 149030, Mail Code H-400
Brown-Heatly Building
4900 N. Lamar Blvd.
Austin, TX 78714-9030

8/5/16 Anchor Notes

Good morning Region 2,

Attached please find the latest Anchor Notes received from HHSC.

Craig S. Kovacevich, MA
Associate Vice President,
Waiver Operations &
Community Health Plans
UTMB Health
409.766.4047 (Office)
cskovace@utmb.edu

Representing:
1115 Medicaid Waiver – RHP 2
UTMB HealthCare Systems
UTMB Community Health Plans

******************************************************************

Anchors –

Thank you for joining us on today’s call.  Attached are the final anchor notes.
As always, let us know if you have any questions.  Have a great weekend.

Thanks,

 

Healthcare Transformation Waiver Operations
Medicaid/CHIP
Texas Health and Human Services Commission

7/29/16 Anchor Update

Good afternoon Region 2,

Please see the email below that HHSC sent out late Friday.

  • Note the extension on the room block for SLC
  • Note the request for feedback for to help them prepare for an August 30th
  • In the attachment:
    • Please see that on page 3 there is reference to submitting Alternate Achievement requests; this will be an Anchor-level submission due September 9th (form to be released by HHSC sometime this month).
    • On page 4, note the new information on the Population Focused Priority Measures that may replace a DY5 Stretch Activity in DY6.  As with the Alternate Achievement requests, it will be an Anchor-level submission due September 9th with the selection template to be made available sometime in August.

 

Susan Seidensticker, BSIE, MSHAI, CPHQ, CSSBB, PMP
Director, Waiver Quality Operations
University of Texas Medical Branch (UTMB)
409-766-4041
smseiden@utmb.edu

*********************************************************

Anchors –

Just a couple of updates today:

Statewide Learning Collaborative

  • The deadline for reservations for the block of rooms at the Hampton Inn & Suites Austin @ The University/Capitol has been extended to August 5th.
  • One of the SLC panels on August 30th will be a discussion on Value Based Contracting: Perspectives from National, State, MCO and Provider Levels.  In order to help the panelists prepare information most helpful to DSRIP providers, we’re asking for feedback about challenges and opportunities in the effort to align with MCOs.  Please see the questions below.  HHSC would appreciate feedback on these by COB next Friday, August 5th. You can send your answers to the waiver mailbox.
  • What barriers are you facing with the effort to align with MCOs?
  • What types of tools/assistance/investment  do you think would be helpful in accelerating this effort?  Consider solutions from the following angles:
  • From HHSC
    • Short term
    • Long Term
  • From MCOs
    • Short term
    • Long Term
  • From Anchors or DSRIP providers
    • Short term
    • Long Term
  • Looking at your RHP, where do you see the biggest opportunities for success in aligning with MCOs?

Category 3

  • Attached is an updated Cat 3 operational details for DY6, including newly approved IOS -Survey goals and a few additional details answering common questions for you to share with providers. We’ve made a correction to the standard QISMC goal for outcomes with a baseline below the MPL; the previous draft was incorrect. Changes are highlighted in yellow. DY6 goals in the Category 3 summary workbook and RHP summary already reflect the corrected goal calculation.

Please let us know if you have any questions. Have a great weekend!

Thanks,

Healthcare Transformation Waiver Operations
Medicaid/CHIP
Texas Health and Human Services Commission

Aug 25

DY6 DSRIP Rules Public Hearing Webcast Information – Friday 8/26 @ 9:00am

Good afternoon Region 2, Please see the email below with the webcast directions for the HHSC public hearing to be held tomorrow morning on the DY6 DSRIP Rules.  Also, please see the attached file on page 4 for the comments that Craig Kovacevich (who will be attending the meeting in person) intends to give.   …

Continue reading »

Permanent link to this article: http://blogs.utmb.edu/1115/2016/08/25/dy6-dsrip-rules-public-hearing-webcast-information-friday-826-900am/

Aug 22

8/19/16 Anchor Update

Good afternoon Region 2: Below please find the Anchor Updates from HHSC, including two documents related to Category 3 operations in DY6 as well as the newly released Statewide Learning Collaborative (SLC) agenda. Please note the deadline noted by HHSC for the Alternate Achievement Request Form, in order to adhere to their deadline, we asked …

Continue reading »

Permanent link to this article: http://blogs.utmb.edu/1115/2016/08/22/81916-anchor-update/

Aug 22

RHP 2 Announcement/Reminder – Immediate Action Required DY5 UC IGT Commitment Notification

Dear RHP 2 Providers (Related to Uncompensated Care): Just a quick reminder that IGT commitment forms are due today, Friday August 19, 2016 by 5 PM CT. Below, I have noted the updated dates that HHSC shared with us and providers yesterday. Please note there have been changes for both TexNet entries and settlements. If …

Continue reading »

Permanent link to this article: http://blogs.utmb.edu/1115/2016/08/22/rhp-2-announcementreminder-immediate-action-required-dy5-uc-igt-commitment-notification/

Aug 08

8/5/16 Anchor Notes

Good morning Region 2, Attached please find the latest Anchor Notes received from HHSC. Craig S. Kovacevich, MA Associate Vice President, Waiver Operations & Community Health Plans UTMB Health 409.766.4047 (Office) cskovace@utmb.edu Representing: 1115 Medicaid Waiver – RHP 2 UTMB HealthCare Systems UTMB Community Health Plans ****************************************************************** Anchors – Thank you for joining us on …

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Permanent link to this article: http://blogs.utmb.edu/1115/2016/08/08/8516-anchor-notes/

Aug 01

7/29/16 Anchor Update

Good afternoon Region 2, Please see the email below that HHSC sent out late Friday. Note the extension on the room block for SLC Note the request for feedback for to help them prepare for an August 30th In the attachment: Please see that on page 3 there is reference to submitting Alternate Achievement requests; …

Continue reading »

Permanent link to this article: http://blogs.utmb.edu/1115/2016/08/01/72916-anchor-update/

Jul 27

Population Health Improvement Initiative

Dear Region 2 Stakeholders: Please see the request below from UTMB’s Department of Preventive Medicine and Community Health to participate in a survey regarding health-related needs in the region.  Thank you in advance for your assistance in this study. Survey link:  CLICK HERE   Craig S. Kovacevich, MA Associate Vice President, Waiver Operations & Community …

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Permanent link to this article: http://blogs.utmb.edu/1115/2016/07/27/population-health-improvement-initiative/

Jul 25

7/22/16 Anchor Notes

Good morning Region 2, Please see the attached for the information received after the Anchor call with HHSC last Friday. Please note that: HHSC has provided a draft copy of the Statewide Learning Collaborative agenda.  If your organization plans to send representation but have not yet registered, the cut-off date is August 8th. From the …

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Permanent link to this article: http://blogs.utmb.edu/1115/2016/07/25/72216-anchor-notes/

Jul 22

Important DY 5 UC Deadlines and Timeline

All: Please see the information below for HHSC.  Also, please advise Bobbie Guyton (bjguyton@utmb.edu) by  close of business on Wednesday, July 27th if your TPI changed between DY4 and DY5.  Thanks.   Craig S. Kovacevich, MA Associate Vice President, Waiver Operations & Community Health Plans UTMB Health 409.766.4047 (Office) cskovace@utmb.edu Representing: 1115 Medicaid Waiver – …

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Permanent link to this article: http://blogs.utmb.edu/1115/2016/07/22/important-dy-5-uc-deadlines-and-timeline/

Jul 11

7/8/16 Anchor Update

Good morning, Thank you to everyone who joined us for the Regional Meeting in Galveston; we hope it was beneficial for your ongoing DSRIP efforts. Please see the brief Anchor update that was issued by HHSC late on Friday, as well as the attachments.  The draft DY6 Core Components questions are now open for review …

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Permanent link to this article: http://blogs.utmb.edu/1115/2016/07/11/7816-anchor-update/

Jul 11

DSRIP Category 3 Update – DY6 Operational Details, Updated Category 3 Summary Workbook, & Interim Correction Template Available

Good morning Region 2, Please see the guidance below on the DY6 Operational Details for Category 3. Additionally, please note that the latest Interim Correction window for Category 3 is now open.  For your convenience, I’m attaching the correction template and the reporting summary/goal calculator files (which, as stated below, solidifies *most* of the DY6/PY3 …

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Permanent link to this article: http://blogs.utmb.edu/1115/2016/07/11/dsrip-category-3-update-dy6-operational-details-updated-category-3-summary-workbook-interim-correction-template-available/

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