June 2015 archive

Jun 25

HHSC Webinar on Change Request Process for 3-Year Projects

HHSC has announced the date and time of the webinar regarding the Change Request Process for 3-year projects. As a reminder, changes to metrics may only be requested for DY5 deliverables. The webinar will be next Thursday, July 2nd, from 10:00AM – 11:30AM, Central Daylight Time.

To join the online meeting:
1) Go to Join WebEx meeting
2) Click on Attend Meeting
3) Enter Meeting Number: 734 441 728
4) Call 866-430-8535

To join the audio conference only: All participants should dial 866-430-8535 (no password necessary). You will be placed directly into the audio conference.

Participants can choose to log in online to view the slides and listen to the audio conference OR to call in only for the audio portion. Participants should dial in to the audio portion of the meeting 15 minutes prior to the start of the Webinar. They automatically will be connected to the meeting room and will hear music until the start of the webinar.

If you experience technical difficulties accessing the webinar or should you have any questions, please email HHSC waiver staff at: TXHealthcareTransformation@hhsc.state.tx.us. For updated materials and to sign up for email alerts, please refer to the HHSC waiver website: http://www.hhsc.state.tx.us/1115-waiver.shtml.

Permanent link to this article: https://blogs.utmb.edu/1115/2015/06/25/hhsc-webinar-on-change-request-process-for-3-year-projects/

Jun 24

DY4 DSRIP IGT Notification

Dear Government Entities & Performing Providers:

Please carefully review this message in its entirety making note of the information provided which pertains to the DY4 Delivery System Reform Incentive Payments (DSRIP). Government entities that owe monitoring will need to submit two separate transactions for monitoring and DSRIP projects. Failure to do so may result in a delayed payment for the providers.

Attached are the following files: DSRIP Notification-[April DY4 Reporting Affiliation Summary] and [April DY4 Reporting IGT Summary] spreadsheets. These spreadsheets include DY4 DSRIP payments for DY4 Reporting (April), DY2 Carryforward Reporting, DY3 Carryforward Reporting, and DSRIP Monitoring.

The April DY4 Reporting Affiliation Summary spreadsheet has separate tabs for each Regional Healthcare Partnership (RHP) and contains the Intergovernmental Transfer (IGT) needed, by affiliation, for DY 4 DSRIP payments for DY 4 Reporting (April), DY2 Carryforward Reporting, and DY 3 Carryforward Reporting.

The April DY4 Reporting IGT Summary spreadsheet has separate tabs for each RHP and contains the total IGT needed by IGT Entity Name for the DY 4 DSRIP payments for DY 4 Reporting (April), DY2 Carryforward Reporting, DY3 Carryforward Reporting, and DSRIP Monitoring.

**Please note that this is the final opportunity to IGT for DY2 DSRIP payments**

The Transformation Waiver Team will be emailing providers information regarding how much will be paid by project. Health and Human Services Commission (HHSC) Rate Analysis is unable to answer questions regarding this information.

HHSC requires that two separate transactions be submitted into TexNet. One for the IGT due for DSRIP payment, which should be placed in the DSRIP bucket and the other for DSRIP Monitoring, which should be placed in the DSRIP Audit Cost bucket. Failure to submit two separate transactions may result in a delayed payment for the providers that an IGT Entity is funding as additional steps are required to move the funds to the correct Funding Bucket. If the full DSRIP Monitoring amount is not received in the DSRIP Audit Cost bucket, HHSC will reduce the IGT available for DY 4 DSRIP by the amount due for the DSRIP monitoring. Since this requires additional manual work, payment to the IGT Entity’s affiliated providers may be delayed.

IGT Entities may choose to IGT less than the required amount; however, all affiliated providers and projects will be paid proportionately. IGT may not be directed towards specific providers, projects or metrics.

A screen shot/.pdf of the confirmation/trace sheet or email of the confirmation number if the TexNet is submitted over the phone is required and must be emailed to Rate_Analysis_DSRIP_Payments@hhsc.state.tx.us. We are requesting that all government entities enter their IGT transactions into TexNet no later than July 7th with a Settlement Date of July 8th. No IGT’s submitted after July 8th will be accepted.

HHSC Accounting will request the Comptroller to issue payments according to the below estimated schedule:
July 7, 2015: Last Date for Public Entities to enter TexNet and submit Trace Numbers
July 8, 2015: TexNet Sweeps (Settlement Date of funds)
July 21, 2015: Payment issue date for Top 20 Entities for DY4 payments (Transferring Hospitals “Big 6” and Remaining entities up to 20) ** We will not know who the other 14 entities are until the payment is processed**
July 31, 2015: Payment issue date for remaining DSRIP Providers for DY4 and all providers for DY3 and DY2 payments

Thank you,

HHSC Hospital Rate Analysis

Permanent link to this article: https://blogs.utmb.edu/1115/2015/06/24/dy4-dsrip-igt-notification/

Jun 16

DY4/2015 DSH/UC Application Request Link

Dear RHP2 Providers & Stakeholders:

Each year the Texas Health and Human Services Commission (HHSC) collects information to identify which hospitals in Texas qualify for payment under the Disproportionate Share Hospital (DSH) and Uncompensated Care waiver (UC) programs and separately collects information to calculate DSH and UC payments for qualifying hospitals. This year HHSC will continue to use one data collection application to determine DSH and UC qualification and to calculate payments. In addition, HHSC will be using information in the application to conduct the interim reconciliation for all providers that received a FFY 2013 Demonstration Year (DY) 2 UC payment as required under the CMS UC waiver claiming protocol. The objective of using one data collection application is so that providers will not need to complete separate data collection instruments in order for HHSC to determine DSH and UC qualification and payment.

All providers that wish to participate in the FFY 2015 DSH and/or in the DY 4 UC program are required to complete the application. In addition, all providers that received a DY 2 UC payment will need to request and complete the application. Attached to this letter is a list of providers who received a DY 2 UC payment that must submit a tool for reconciliation. Providers that received a DY 2 UC payment but do not submit an application might be subject to recoupment of all DY 2 UC payments. Each hospital should complete and submit the application no later than Monday, June 22, 2015.

HHSC has posted a form on the Rate Analysis website for providers to request the application.

Providers can access this request form via the following link: http://registration.hhsc.state.tx.us/uc-tool-request1.aspx

A hospital that fails to request an application by the deadline of Monday, June 22, 2015, will not be eligible to participate in the 2015 DSH and DY 4 UC programs or to appeal HHSC’s non-qualification decisions. As part of the provider request for the application, HHSC is asking for contact information of the Primary Hospital Contact, who is the person requesting the DSH/UC Application and who can make decisions on the hospital’s behalf (this person cannot be a contractor and is usually the hospital’s CEO, CFO, or reimbursement manager.). HHSC is also asking for the contact information of the person designated to complete the DSH/UC Application on behalf of the Primary Hospital Contact. This person can be a contractor or consultant at the discretion of the Primary Hospital Contact. Please note that HHSC is asking that the Primary Hospital Contact be an authorized staff member employed by the facility who can make binding decisions on behalf of the hospital.

HHSC will distribute the applications to the Primary Hospital Contact and to the person designated to complete the application in early July, 2015. A webinar regarding application completion, the HSL appeal period, and methodology changes for DY 4 will take place shortly after the applications have been distributed. The webinar is currently being scheduled and details are forthcoming.

For providers who are unaware of the qualification criteria for DSH and UC, the rules governing both programs can be found here:

1 TAC 355.8065 Relating to DSH Reimbursement Methodology

1 TAC 355.8201 Relating to Uncompensated Care Reimbursement Methodology

If you have questions about the Application process, please submit them to the UC Tools mailbox at uctools@hhsc.state.tx.us . Thank you for your continued interest in the Texas Medicaid Supplemental Payment Programs.

Thank You,

HHSC Rate Analysis Department

Permanent link to this article: https://blogs.utmb.edu/1115/2015/06/16/dy42015-dshuc-application-request-link/

Jun 02

DY3 UC IGT Notification

Dear Region 2 Performing Providers and Stakeholders:

Attached you will find a workbook titled [Final-2014 DY 3 UC Payment Calculation -6-1-15] that contains the DY3 UC payment with the haircut applied. The applicable tab for the IGT amounts, with the haircut, is titled “IGT Commitment by Affiliation” and contains all of the amounts submitted by governmental entities in the IGT commitment forms and have been reduced to the final IGT amounts based on the haircut applied by HHSC. The amount that needs to be submitted into TexNet is in Column H. These amounts are by affiliation and there may be multiple affiliations for providers that comprise their final IGT amount. If you are unable to find your provider within the “IGT Commitment by Affiliation” tab, the provider either (a) exceeded their UC limit paid in the DY3 Advance UC Payment (see the “Recoupments” tab), or (b) the IGT source did not commit to funding the Final DY3 UC Payment (see the “No IGT Source” tab). If the provider is located on the “Recoupments” tab, HHSC will be sending the provider a recoupment letter with specific instructions to return the funds.

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

HHSC is holding back 5 percent of the total DY 3 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 3 UC payment based on the court decision.

Below are the pertinent dates associated with the DY3 UC payment:
• June 5 Last date to transfer funds into TexNet
• June 8 DY3 UC IGT Settlement Date
• June 19 DY3 Transferring Entities (Big 6) Payment Date
• June 30 Latest DY3 UC Payment Date

Please ensure you select the applicable UC bucket in TexNet when you enter your IGT. It is imperative that you send a screen shot/PDF copy of the confirmation/trace sheet from TexNet or an email with the confirmation number and IGT amount if the TexNet is submitted over the phone, to RAD_UC_Payments@hhsc.state.tx.us. Please include two contacts and their phone numbers and email addresses, should HHSC have any questions regarding the TexNet received.

Government Entities that are IGT’ing for multiple providers may submit one lump sum IGT for their affiliates, if the IGT entity completes the attached [allocation form] using the “IGT Commitment Amount” tab. By completing this form, HHSC Rate Analysis Department can calculate the allocation of the lump sum to apply to each provider. If a Trace Sheet is received without an IGT allocation form HHSC will allocate the IGT received in accordance with 1 Tex. Admin. Code §355.8201(h)(ii). In the absence of the notification described in 1 Tex. Admin. Code §355.8201(h)(i), each hospital owned by or affiliated with the governmental entity will receive a portion of its payment amount for that period, based on the hospital’s percentage of the total payment amounts for all hospitals owned by or affiliated with that governmental entity.

In accordance with 1 Tex. Admin. Code §355.8201(h)(ii)(C), if a government entity transfers more than the maximum IGT amount that can be provided for that hospital, and that hospital is affiliated with multiple governmental entities, then HHSC will calculate the amount of IGT funds necessary to fund the hospital’s payment and HHSC will issue a pro-rata refund to the governmental entity/entities identified by HHSC. HHSC will determine the pro-rata refund, not the government entity/entities or their representative(s).

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

Permanent link to this article: https://blogs.utmb.edu/1115/2015/06/02/dy3-uc-igt-notification/

Jun 01

DSRIP Mid-Point Assessment Report – Conducted by Myers and Stauffer for Texas HHSC

Dear Region 2 Performing Providers and Stakeholders:

Late Friday, HHSC shared the DSRIP Mid-Point Assessment completed by Myers and Stauffer with the twenty (20) anchoring entities. This was a CMS requirement related to projects under the Texas 1115 Healthcare Transformation Waiver. As HHSC has indicated previously, and as we have discussed at the regional level, the Myers and Stauffer assessment was based on data through April 2014, and did not take into account metric achievements reported after this date. So, please keep this important fact in mind, as you review the project assessment results broken up by region in the attachments. If the assessment were redone now, after two additional reporting periods had passed (October 2014 and April 2015), the results would most likely be different in many cases. Additionally, Myers and Stauffer did a sampling of projects by region versus an overall review of the more than 1,400 projects statewide. In Region 2, for example, they selected thirty (30) projects.

Based on Myers and Stauffer’s assessment, 79% of the projects they reviewed statewide are at low or moderate risk, meaning that they are on track for meeting their project outcome objectives at the time the review was done (based on data through April 2014). As you begin to review the report, it is critical that you take time to review the risk assessment methodology and ranking scale that Myers and Stauffer used. This information can be found on pages 3-5 of the first attachment, titled [MPA Final Report]. Likewise, information for each RHP is also included in the report starting on page 12, with our region’s overview on pages 15-16. Of additional interest, a description of HHSC’s approach to Myers and Stauffer recommendations is included at the end of the report on page 52. The second and third attachments, labeled [Appendix 1] and [Appendix 2], include risk scoring for each project reviewed during the mid-point assessment as well as the Myers and Stauffer’s recommendation for each project and HHSC’s response.

I would like to add that I personally think the DSRIP project impact summaries that HHSC and the Clinical Champions Workgroup have requested from performing providers are even more critical, and will supplement the DSRIP Mid-Point Assessment conducted by Myers and Stauffer. If you have not yet completed and submitted them for your projects, please consider doing so as soon as possible. These impact summaries, along with the results from the recent DY4 April reporting period, will help paint the most current picture of the true impact of the Texas 1115 Healthcare Transformation Waiver. In turn, this will assist HHSC as they work with CMS in negotiating an extension or renewal.

If you have questions, please do not hesitate to contact me or a member of the Region 2 Anchor Office team.

Thank you,

Permanent link to this article: https://blogs.utmb.edu/1115/2015/06/01/dsrip-mid-point-assessment-report-conducted-by-myers-and-stauffer-for-texas-hhsc/