Monthly Archive: January 2016

Jan 27

Clarification – Projects Under Review Results

Dear Region 2,

HHSC has sent the following clarification email.  As always, should you have any specific questions about what is known on the Transition Year so far, please contact our office and we will do our best to help you resolve the concern.

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Anchors-

We have received questions regarding the projects under review results and wanted to clarify the following:

  • HHSC reviewed a limited number of projects. These projects scored a 4 or 5 in the midpoint assessment; have a DY5 Category 1 or 2 valuation over $5 million; were flagged by HHSC staff during reporting review or change request review; did not report achievement of any Category 1 or 2 metrics during April DY4 or October DY4 reporting; or were from a removed Project Area (2.4, 2.5, 2.8, and 1.10 unless it is a learning collaborative projects) and had one of the other flags. HHSC notified the providers of projects under review in July and August 2015.
  • Other projects from removed Project Areas (2.4, 2.5, 2.8, and 1.10 unless it is a learning collaborative project) that were not listed in the email results may continue in DY6 based on DY6 Transition Year requirements but will be required to submit a replacement project to begin in DY7 up to the same valuation as the previous project with a maximum of $5M per DY from the extension menu, contingent on CMS approval.
  • Remaining active projects not included in HHSC review may continue in DY6 based on DY6 Transition Year requirements at DY5 valuation.
  • HHSC has not fully defined the requirements for DY7 onward, including replacement projects or continuing valuation. We will continue to work with stakeholders and CMS throughout DY5 and DY6 to finalize the requirements.
  • If a project was indicated only as “eligible to continue in DY6 based on DY6 Transition Year requirements”, then no further action is needed at this time.
  • The requested changes noted in the email results are for implementation in DY6 unless noted as required changes for DY7.

Please let us know if there are other common questions that need to be addressed.

Thanks,

Healthcare Transformation Waiver Operations
Texas Health and Human Services Commission

Permanent link to this article: https://blogs.utmb.edu/1115/2016/01/27/clarification-projects-under-review-results/

Jan 27

Waiver extension documents posted to HHSC’s waiver website

Dear Region 2,

HHSC has posted additional information to their website regarding the proposals for the DY6 Transition Year.

As of today, the following are available (new documents highlighted in blue):

  • Transition Year (DY6) Proposal – Program Mechanics and Funding Protocol (1/26/16)
  • Proposed Regional Performance Bonus Pool Measures (1/26/16)
  • Updated Transformational Extension Protocol (Menu) with Best Practices/Models (1/26/16)
    o   Please note that this version contains only those project options that are allowed to be created as new (replacement) projects under the HHSC proposal to CMS
  • Summary of the Transformational Extension Protocol (Menu) for Replacement Projects – HHSC Proposal (9/4/15)
  • DSRIP Extension Planning and Protocols Webinar (9/30/15)

Additionally, HHSC has two survey links on their website regarding the Transition Year and Extension.

Thank you,

Craig

Permanent link to this article: https://blogs.utmb.edu/1115/2016/01/27/waiver-extension-documents-posted-to-hhscs-waiver-website/

Jan 25

1/22/16 Anchor Notes

Good afternoon Region 2,

Attached are the notes from the Anchor call held on Friday, January 22nd.  Some of this information was sent to you from our office last week as well.

DY 4 October Reporting: Payments for approved metric achievement will be made on or before January 29th.

Combining Projects:  Certain projects may be eligible to be combined with other projects within RHP 1 or across regions.  For those eligible projects, the deadline to submit templates (on HHSC Waiver website) is Monday, February 1st.

Compliance Monitoring: Myers and Stauffer LC has provided a summary of activities and projected timeline for Cat 1 and Cat 2 validation over the next few months.  Please see the attached file.

Category 3 Corrections: Last Wednesday (January 20th), the HHSC Cat 3 Team sent out guidance on a new category 3 summary template and the opportunity for certain projects to correct reported baselines before the next reporting period.  Please refer back to the instructions and timeline in this message to determine whether or not your projects require a correction template to be submitted.  The deadline for doing so is Sunday, February 14th.

Waiver Renewal Planning:  HHSC has begun notifying Providers with the results of their final review of projects for eligibility to continue into DY6.

  • Please review the Anchor notes for greater detail on which projects were reviewed.
  • HHSC Waiver leadership expect for all affected providers to be notified by early next week.
  • In addition to those that were reviewed based on the criteria provide in the Notes, all projects that are from removed Project Areas (2.4, 2.5, 2.8, and 1.10 unless it is a learning collaborative project) may continue in DY6 based on DY6 Transition Year requirements but will be required to submit a replacement project to begin in DY7 up to the same valuation as the previous project with a maximum of $5M per DY from the extension menu, contingent on CMS approval. If you have a project in one of these option areas, please continue to review Waiver Renewal information as it becomes available and begin considering your options for project replacement.

Thank you,

Craig

Permanent link to this article: https://blogs.utmb.edu/1115/2016/01/25/12216-anchor-notes/

Jan 20

DY4 UC IGT Commitment Notification

Good Afternoon RHP2,

Please see the email below from the HHSC Rate Analysis team regarding “2015 DY 4 UC IGT Commitment Amounts” and required commitment forms due by COB January 25, 2016.

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

If you have any questions please don’t hesitate to contact us.

Thank you,

Craig

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Anchors:

The purpose of this e-mail is to provide demonstration year 4 (DY 4) uncompensated care (UC) and intergovernmental transfer (IGT) data to all UC providers and Anchors for the UC payment to be processed in February 2016.  The attached file contains the maximum UC payment for this round of the DY 4 payment, the maximum IGT commitment for each provider and a request for the final IGT commitment from providers.  This is not the final DY 4 UC payment.  There will be a final DY 4 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 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 4 UC payment based on the court decision.

At this point, eligible providers and/or their government entities are asked to view the “2015 DY 4 UC IGT Commitment Amounts for Publication” tab of the attached workbook, locate their hospital and its associated “Maximum IGT for February 2016 DY 4 UC Payment (Prior to Haircut)” amount in Column K and complete the IGT commitment form by entering the IGT amount they are committing for the February 2016 DY 4 UC payment.  The commitment form must be returned to HHSC at  RAD_UC_Payments@hhsc.state.tx.us by close of business on January 25, 2016.

Please determine the IGT amount you wish to commit up to the limit contained in Column K.  While you may commit to IGT the maximum amount in Column K, 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 DY4 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 DY4 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 DY4 UC payment:

  • January 25           DY4 UC IGT Commitment Due
  • January 27           DY4 UC IGT Notification sent to industry
  • February 4          Last date to transfer funds into TexNet
  • February 5           DY4 UC IGT Settlement Date
  • February 16        DY4 Transferring Entities (Big 6) Payment Date
  • February 29        Latest DY4 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 January 27, 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

Permanent link to this article: https://blogs.utmb.edu/1115/2016/01/20/dy4-uc-igt-commitment-notification/

Jan 20

1/15/16 Anchor Update

Good afternoon Region 2,

We wanted to make sure that everyone was aware of the latest information received from HHSC regarding combining projects in the Transition Year (DY6) and the ability to correct Category 3 information for those measures that have already reported DY4 performance.  Additionally, please also note below the extension from CMS for Medicaid provider re-enrollment; the previously announced deadline of March 24th has now been replaced with September 25th.

The attached zip file contains 4 items:

    • Cat-3-Interim-Corrections-Template-DY5R1-20160115.xlsx, which can pull, by each Category 3 metric, the previously reported information.
      o   It does appear that HHSC has enabled the ability to modify the date range of the baseline.
      o   Please note that if you are correcting more than one Category 3 metric, you will need to save each one as a unique file. File naming convention per HHSC should be RHP02_ProjectID_Cat3Correction
      o   All corrections that are proposed must be sent to the HHSC mailbox by COB on Friday, February 12th
    • Cat-3-Summary-Goal-Calculator-20160115.xlsx.  This is for informational purposes only, as it is intended to allow providers to confirm current reporting information and determine new goals if corrections are anticipated.
    • Combining Projects Companion Document.pdf.  This is the how-to guide for combining projects either within a provider, across providers and/or across regions.
    • DSRIP-Project-Combination-Template.xlsm, which is the template for proposing project combinations.
      o   Please note that if you elect to do this, you will be asked to confirm the expected MLIU (or provide a new number with an explanation – the template appears to default to the highest MLIU of the projects being combined)
      o   Please note that the template defaults to indicate that all current Category 3 metrics continue.
      o   One project combination template per TPI.  If you’re not combining projects, no action is needed.
      o   All requests to combine projects must be sent to the HHSC mailbox by COB on Monday, February 1st using the subject line Combination Template, and a recommended file naming convention of RHP02_TPI_Project_Combination_Template.

As additional guidance becomes available, the Anchor Office will share it via email and our website (http://www.utmb.edu/1115).

Please feel free to reach out to our Waiver Analysts (Andrew Herndon, Anh Tu Pham, Karen Wong) or our Waiver Quality Director (Susan Seidensticker) if you have questions regarding this process.

Thank you,

Craig

Permanent link to this article: https://blogs.utmb.edu/1115/2016/01/20/11516-anchor-update/

Jan 08

DSRIP 1/8/16 Anchor Notes

Good afternoon Region 2,

A special thank you to all of those who were able to join us in Galveston today.  Our Region continually demonstrates its strength and commitment to improving the health of those in our 16 counties.  As a reminder, the slides from today are available on our website (http://www.utmb.edu/1115/).    Also, we look forward to seeing many of you at our Behavioral Learning Collaborative event in Lufkin next Friday; please contact Susan Seidensticker (smseiden@utmb.edu) by COB Monday, January 11th, if you still need to RSVP.

Attached you will find three documents that were received today from HHSC.

      1. Anchor notes (PDF) dated January 8th. Please note the following:
        • October DY4 Reporting Timeline for payments to be processed.
        • Category 3 baseline correction timelines have been updated.  Please note that the “Interim Category 3 Correction template” will NOT be for those measures that held reporting of DY4 performance in the October cycle; these corrections are to be done as part of the April DY5 reporting template. If you have additional questions after reviewing the HHSC information on page 3 of the Anchor notes, please contact Susan Seidensticker (smseiden@utmb.edu).
        • Waiver Renewal updates:
            o   Please note that the information will come out in increments, with the first components expected to be available by the end of next week (Combining Projects and the draft DY6 proposal document).
            o   HHSC has asked us to remind you that their stakeholder feedback survey is still available; please see the link on page 3 of the Anchor notes.
        • Medicaid Provider Re-Enrollment.  This information was sent to you from our office yesterday as a reminder that each DSRIP provider must be an enrolled Medicaid provider, and that providers must re-enroll by March 2016 to remain active in Texas Medicaid.  Please see the information on page 4 of the Anchor notes.

 

      1. DY4 Reporting Data (Excel):
        • This is the statewide summary, by Region, for the metrics and payments approved.
        • Please note that there appears to be a typo in column I for RHP2 – that should read “DY4 Payment Amount Approved”.

 

      1. DY5 Monitoring IGT (Excel):
        • This is the amount of IGT owed by each performing provider TPI number for DY5.  The Regional total for monitoring for this current demonstration year is $5M.
        • Please note that on page 2 of the Anchor notes. HHSC has noted that they expect to refund some of the monitoring IGT funds from DY3.

Thank you,

Craig

Permanent link to this article: https://blogs.utmb.edu/1115/2016/01/08/dsrip-1816-anchor-notes-2/

Jan 08

Region 2 Meeting on January 8, 2016

Dear RHP 2 providers and stakeholders:

Please find Region 2’s [meeting materials] on 1/8/2016 attached.

Thank you.

Permanent link to this article: https://blogs.utmb.edu/1115/2016/01/08/region-2-meeting-on-january-8-2016/

Jan 07

Medicaid Provider Re-Enrollment Requirement

Dear RHP 2:

In order to participate in DSRIP, each DSRIP provider must be an enrolled Medicaid provider. Based on federal requirements, tens of thousands of Texas providers must re-enroll by March 2016 in order to remain active providers for Texas Medicaid. There are many providers who have not yet submitted re-enrollment applications. We encourage all DSRIP providers who enrolled in Texas Medicaid prior to January 1, 2013, and have not yet re-enrolled, to do as soon as possible. The sooner a provider submits complete re-enrollment information, the greater the chance that HHSC will be able to re-enroll the provider by the March 2016 deadline.

For more information visit:

To check your re-enrollment status, follow the instructions under question 1.6 in the Re-enrollment FAQs link. If you have additional questions about re-enrollment, please review the FAQs and if needed call the TMHP Contact Center at 1-800-925-9126, option 2 or the TMHP CSHCN Services Program Contact Center (1-800-568-2413). HHSC plans to send additional reminder information out to all Medicaid providers soon regarding re-enrollment and will include DSRIP providers in any additional communications.

Craig

 

Permanent link to this article: https://blogs.utmb.edu/1115/2016/01/07/medicaid-provider-re-enrollment-requirement/

Jan 04

DSRIP Payment/TexNet Delay

Dear RHP 2:

Please review HHSC’s email message below.

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All,

I have been advised by the Comptroller’s office that there was a system error and the funds scheduled to settle on January 4th did not sweep. These funds will be swept tomorrow. This will not cause a delay in the DSRIP Payments.

Please share this email with the providers in your RHP.

Thank you.

Permanent link to this article: https://blogs.utmb.edu/1115/2016/01/04/dsrip-paymenttexnet-delay/