Waiver Updates and Important Information – Region 2

Dear Region 2:

Thank you to our amazing and dedicated performing providers in Region 2 who collectively submitted $71,600,633 (total value) for metric achievement during the recent DY3 October Reporting Period.  169 of the 243 total submitted metrics were “approved,” with 59 “provisionally approved” and 15 flagged for “Needs More Information.”   Please see additional details re: DY3 October Reporting below.

Attached to this e-mail are the [notes from the Anchor] call hosted by HHSC last Friday, December 12, 2014.  I am also attaching a spreadsheet with the statewide [Category 3 Selection Summary] for all projects.  Please review both documents in detail; however, I would like to highlights a few important items below:

DY3 October Reporting & IGT Information:

  • The deadline for providers to submit additional information for metrics marked “Needs More Information” is 11:59 pm CST on Friday, January 16, 2015.  As with DY3 October reporting, all additional information is to be submitted using the Online Reporting System.
  • IGT will be due on January 5th and payments will occur on January 30th for metrics approved in the current round or approved but unpaid in previous rounds.  The IGT due amounts will be sent out by Rate Analysis the week of December 15, 2014 using an FMAP of 58.05. 
  • Provisional approval was granted for approximately 45% of projects and metrics in our region.  Carefully review the details in the attached Anchor Meeting notes about “provisionally approved” metrics and the timelines for full review of those metrics, including the possibility of recoupment of funds if metric achievement is not demonstrated.
  • If any IGT entities have changes in DSRIP funding, please submit an IGT Entity Change Form prior to Thursday, January 1, 2015.  The form can be found on the Waiver website at:  http://www.hhsc.state.tx.us/1115-docs/DY3-Templates/April2014/IGT-Entity-Change-Form.xlsx.  If you submit a change form, kindly send a courtesy copy to Bobbie Guyton at bjguyton@utmb.edu so we may update our RHP plan and master file.

 Category 3 Baseline Reporting:

Any provider who has recognized errors in baseline data that was reported during the DY 3 October reporting period should send an email to the waiver inbox with the subject line “Updated Baseline Information” and include an updated baseline template with the corrected data.  The deadline for these requests is Thursday, January 15, 2015.  Please send a courtesy copy to Susan Seidensticker at smseiden@utmb.edu, as she will be most willing to assist from the Region 2 Anchor Office, if needed.

Category 4 Certifications for “UC Only” Providers:

Category 4 PPA and PPR reports were sent to providers participating in the Waiver as UC-only facilities on Friday, December 12, 2014 along with instructions on how to complete the certification process for DY3 UC payments.  If you are a UC-only facility and did not receive your reports, please send a request immediately to the HHSC Waiver mailbox at:  TXHealthcareTransformation@hhsc.state.tx.us.

Mid-Point Assessment, On-Site Audit/Visits & Regional Call:

Region 2 Anchor Office staff meets with Myers and Stauffer to discuss the mid-point assessment process and the timeline for completion tomorrow, Tuesday, December 16, 2014.  If you have not been contacted directly by Myers and Stauffer regarding an on-site visit, you will not be subject to one at this time; however, desk audits and follow-up communication can be expected and we will discuss more about this on the regional call this Friday, December 19, 2014 at 10 am CST.  If you are a performing provider with an active DSRIP project, please ensure someone on your staff participates in this important call this Friday morning.   

If you have any questions related to the information above or attached, please do not hesitate to contact me personally by phone or e-mail (409.766.4047 or cskovace@utmb.edu).  Likewise, general information, regional updates and archived data regarding the 1115 Waiver can be found on the Region 2 website at http://www.utmb.edu/1115/.

Thank you,
Craig

Update on UC Deferral

Transformation Waiver Stakeholders –

We want to give you a brief update on the September UC deferral.  HHSC expects to receive from CMS next week the letter formalizing the lifting of the deferral.  This is very encouraging, and we want to thank those of you that helped get the deferral lifted by providing supporting documentation and/or helping HHSC to develop the position we conveyed to CMS.

Earlier this week, HHSC sent a more detailed letter to CMS outlining HHSC’s position on the issues presented in the deferral (attached).  CMS has indicated that in the coming weeks it will review the information HHSC sent in comparison to the supporting documentation that led to the deferral in order to begin more detailed discussions early next year.

We’ve discontinued the bi-weekly UC deferral update meetings, but will keep you informed as we have updates.

Thanks,
Lisa Kirsch
Chief Deputy Medicaid/CHIP Director for Policy and the Transformation Waiver
Texas Health and Human Services Commission
512-707-6096

 

RHP 2 Regional Meeting Information-December 3, 2014

Below is the link to review the information and attachments from RHP 2’s Regional Meeting on Wednesday, December 3, 2014.

 https://ispace.utmb.edu/xythoswfs/webview/_xy-8665668_1

 

1115 Waiver – 12/05/14 Anchor Update

October Reporting and Review

  • HHSC will complete its review by Dec. 8.  Providers will be able to login to the DSRIP Online Reporting System to view the HHSC Signoff and HHSC Comments for each metric.  HHSC will also send summary information to anchors and providers during the week of December 8 with the signoff status of each metric.
  • For metrics marked “Need More Information,” providers will have until 11:59 p.m. on Friday, January 16, to submit additional information using the Online Reporting System.  HHSC will provide additional instructions with the summary information next week.
  • For metrics that were approved in the current round, or approved but unpaid in previous rounds, IGT will be due from IGT entities on Monday, January 5, and payments will occur on January 30. HHSC Rate Analysis will send out the IGT due based on our review the week of Dec. 15th using FMAP of 58.05.
  • As noted previously, language has been added to the Program Funding and Mechanics Protocol (PFM) to specify that HHSC and CMS may determine that a subset of not less than half of the projects and metrics will be reviewed during the 30 days after a reporting period.  In such instances, HHSC and CMS will designate those projects and metrics that are not reviewed within 30 days as “provisionally approved.”  Such “provisionally approved” projects and metrics will be reviewed in full by HHSC prior to the next reporting due date in April 2015.
  • For metrics that are “provisionally approved,” the HHSC Signoff will show “Approved,” but the HHSC Comment will indicate that the approval was provisional.  The Performing Provider is eligible for full DSRIP payment for these metrics in January, and the IGT for these metrics will be included in the request for IGT that is due on January 5.  After review of any “provisionally approved” metrics, HHSC will request additional information if necessary, most likely in late February or early March 2015.  If the initial supporting documentation, and any additional information, does not form a sufficient basis for actual metric achievement, HHSC will recoup the associated overpayments from the Performing Provider.  As described in waiver rules, HHSC will withhold future payments until the recoupment occurs.
  • Some providers have asked about the “Achievement Value” shown under each metric in the Online Reporting System.  Please note that the achievement value shows 100% only after the HHSC signoff shows “Approved.”  During previous reporting periods, the reporting templates showed an achievement value of 100% when the provider reported “Yes-Completed” for the metric.

 Change Requests

  • Just a reminder that the responses to the change request NMIs are due to HHSC by Tuesday, December 9Responses are due to the Anchor by Monday, December 8th at 10 AM
  • Providers have submitted a number of QPI-related change request questions to the Transformation Waiver mailbox.  Please remind them that detailed information regarding how to calculate pre-DSRIP baseline and QPI goals is included in the October DY3 Quantifiable Patient Impact (QPI) Reporting Companion Document available on the Transformation Waiver website at http://www.hhsc.state.tx.us/1115-Waiver-Guideline.shtml.

 Mid-point Assessment

  • The schedule for onsite visits and entrance conferences for the remaining regions has not changed significantly since our last update (see below for most recent schedule). Myers and Stauffer will be contacting regions to schedule these.

o   Week of December 8th: RHPs 4 and 5

o   Week of December 15th : RHPs 2

o   Week of January 5th: RHPs 3,7,9,10,12,14 and 15 (tentative)

o   Week of January 19th: RHP 6 (tentative- may be contacted earlier in January)

Amanda Broden

Healthcare Transformation Waiver Operations

Medicaid/CHIP

Texas Health and Human Services Commission

(512) 462-6388

 

RHP 2 – Mid-Point Assessment Update

Dear RHP 2:

As you know, Mid-Point Assessments of DSRIP waiver projects in Texas are actively being done.  As part of this assessment, Myers and Stauffer are conducting site visits of selected providers in each RHP on behalf of CMS as well as visiting with anchoring entities.  Region 2 is scheduled for next week.  Given that the auditors are doing much of our region via desk reviews, they will have a very limited scope in Region 2 for on-site visits; therefore, we will not host a meeting with the Myers and Stauffer staff with the region as previously anticipated.  The anchor team will host the Myers and Stauffer team in Galveston to discuss our role within the region and also answer any questions they might have.  The audit team will then visit independently with any organization(s) they identify.

If you have been identified for an on-site (in-person) visit, you should have received notification by today.  If you have not received such notification, you will not have Myers and Stauffer staff on-site (in-person) next week.   

If anything changes, we will advise the region; however, we anticipate this Mid-Point Assessment to be a smooth process based on discussions with other regional anchors and providers in the state.

Thank you,
Craig

Dec 16

Waiver Updates and Important Information – Region 2

Dear Region 2: Thank you to our amazing and dedicated performing providers in Region 2 who collectively submitted $71,600,633 (total value) for metric achievement during the recent DY3 October Reporting Period.  169 of the 243 total submitted metrics were “approved,” with 59 “provisionally approved” and 15 flagged for “Needs More Information.”   Please see additional details …

Continue reading »

Permanent link to this article: http://blogs.utmb.edu/1115/2014/12/16/waiver-updates-and-important-information-region-2/

Dec 16

Update on UC Deferral

Transformation Waiver Stakeholders – We want to give you a brief update on the September UC deferral.  HHSC expects to receive from CMS next week the letter formalizing the lifting of the deferral.  This is very encouraging, and we want to thank those of you that helped get the deferral lifted by providing supporting documentation …

Continue reading »

Permanent link to this article: http://blogs.utmb.edu/1115/2014/12/16/update-on-uc-deferral/

Dec 15

RHP 2 Regional Meeting Information-December 3, 2014

Below is the link to review the information and attachments from RHP 2’s Regional Meeting on Wednesday, December 3, 2014.  https://ispace.utmb.edu/xythoswfs/webview/_xy-8665668_1  

Permanent link to this article: http://blogs.utmb.edu/1115/2014/12/15/rhp-2-regional-meeting-information-december-3-2014/

Dec 10

1115 Waiver – 12/05/14 Anchor Update

October Reporting and Review HHSC will complete its review by Dec. 8.  Providers will be able to login to the DSRIP Online Reporting System to view the HHSC Signoff and HHSC Comments for each metric.  HHSC will also send summary information to anchors and providers during the week of December 8 with the signoff status …

Continue reading »

Permanent link to this article: http://blogs.utmb.edu/1115/2014/12/10/1115-waiver-120514-anchor-update/

Dec 10

RHP 2 – Mid-Point Assessment Update

Dear RHP 2: As you know, Mid-Point Assessments of DSRIP waiver projects in Texas are actively being done.  As part of this assessment, Myers and Stauffer are conducting site visits of selected providers in each RHP on behalf of CMS as well as visiting with anchoring entities.  Region 2 is scheduled for next week.  Given …

Continue reading »

Permanent link to this article: http://blogs.utmb.edu/1115/2014/12/10/rhp-2-mid-point-assessment-update/

Dec 02

IMPORTANT UPDATE: HHSC announces that CMS Plans on Lifting UC “Deferral” in Texas

Dear Region 2 Providers: Many of you may have already seen the HHSC announcement below related to the ongoing UC “deferral” issue in Texas ; but, just in case you did not, I wanted to share Lisa Kirsch’s note sent to anchors yesterday evening.  Based on the communication below, CMS told HHSC that they are …

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Permanent link to this article: http://blogs.utmb.edu/1115/2014/12/02/important-update-hhsc-announces-that-cms-plans-on-lifting-uc-deferral-in-texas/

Nov 10

Anchor Call Notes-November 7, 2014

[Attached] are the notes from the Anchor Call on Friday, November 7, 2014 along with the [STC 48 (Pool Transition Plan) document] discussed with EWC this week.

Permanent link to this article: http://blogs.utmb.edu/1115/2014/11/10/anchor-call-notes-november-7-2014/

Nov 10

HHSC 10/31 letter to CMS Re: UC deferral

Dear RHP2 Performing Providers and Stakeholders: For your reference, [attached] is a letter that Texas’ Medicaid Director Kay Ghahremani sent to Cindy Mann at CMS on October 31st in advance of HHSC’s November 3rd meeting with CMS related to the UC deferral. HHSC is working to provide CMS the remaining requested documents and we’ll provide …

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Permanent link to this article: http://blogs.utmb.edu/1115/2014/11/10/hhsc-1031-letter-to-cms-re-uc-deferral/

Nov 07

REGION 2 UPDATE: DSRIP 1115 Waiver Renewal Survey due 11/26/14

Dear Region 2 Performing Providers and Stakeholders: You may have received the message below and link to the HHSC waiver renewal survey earlier this week from HHSC.  However, I am sharing once again because it is very important for HHSC to hear from providers/stakeholders, like you.  I strongly encourage you to take a few minutes …

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Permanent link to this article: http://blogs.utmb.edu/1115/2014/11/07/region-2-update-dsrip-1115-waiver-renewal-survey-due-112614/

Oct 27

Anchor Call Notes 10/24/14

Dear RHP 2 Performing Providers and Stakeholders: Attached are the anchor call notes from the call hosted by HHSC on Friday, October 24th. [Anchor Notes]

Permanent link to this article: http://blogs.utmb.edu/1115/2014/10/27/anchor-call-notes-102414/

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