March 2016 archive

Mar 31

Received from HHSC: 1115 Waiver Renewal Updates and Public Meeting Notification

Good afternoon RHP2 Stakeholders,

Please review below for the latest information regarding Waiver Renewal.

HHSC is developing two DSRIP transition year (demonstration year [DY] 6) rule packets.  The implementation of the waiver extension is contingent on approval from the Centers for Medicaid and Medicare Services (CMS) and changes would be proposed as needed based on final negotiations with CMS.

The first set of DSRIP transition year rules proposed to be effective June 1, 2016, were published in the March 25, 2016 issue of the Texas Register.  They are available here – This first rule packet specifies actions that current DSRIP performing providers must undertake in preparation for DY6 of the anticipated waiver extension period, which begins October 1, 2016.  Such actions include determining if a DSRIP project will continue into the extension, requests for adjustments to certain milestone goals, and requests for exceptions to reporting of Medicaid IDs.

The second packet is in development and will specify the transition year policies that should be effective no later than September 30, 2016.

Please note that a public hearing on these rules has been scheduled for April 11, 2016, at 9:30 a.m. at the Brown-Heatly Building, Public Hearing Room, located at 4900 North Lamar Boulevard, Austin, Texas 78751.   Craig and Katrina plan to be in attendance at the public hearing.  If your organization is unable to attend but have any specific concerns that you would like for us to  present at the meeting, please email using the subject line: DY6 Public Hearing Feedback. Craig and Katrina will take those concerns with them to Austin.

Additionally, as previously communicated, HHSC received from the federal Centers for Medicare and Medicaid Services (CMS) the attached letter. To support Texas’ extension request for the Uncompensated Care (UC) pool in the 1115 Transformation Waiver, the letter requests that HHSC submit an independent analysis by May 31, 2016 of the impact of the UC pool on overall UC in the state, Medicaid provider rates, Medicaid beneficiary access to services, and a number of other areas.

HHSC worked with CMS to extend the timeframe to August 2016. Given the tight deadline, HHSC is working with two existing contractors that have the subject matter expertise to complete the study. Health Management Associates (HMA) will complete the study, and Deloitte will be responsible for the actuarial portion of the project. HHSC had previously communicated their plan to work with a public university, however, the timeframes precluded the ability to reach an agreement.

HHSC continues to be optimistic about a waiver extension and will keep us apprised as they have more information.

Please let us know if you have any questions.


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Mar 31

SAVE THE DATE: RHP 2 Meeting-Friday, July 8, 2016

Dear RHP 2 Providers & Stakeholders:

We will hold a regional meeting on Friday, July 8, 2016, from 9:30 am-noon (CST) in the Caduceus Room on UTMB’s main campus located at 301 University Boulevard in Galveston.  We will publish the agenda prior to the meeting.

Please save the date.

Thank you,

Bobbie Guyton
Sr. Administrative Manager
Waiver Operations
UTMB Health
O 409.766.4045

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Mar 30

Region 2 – DY5 Cat 4 PPE Reports Update

Good afternoon,

Earlier today, HHSC sent out the EQRO reports for CY2014 that are needed for Category 4 reporting.  This was sent out via an encrypted message, so we wanted to encourage you to make sure that you could download the attachments; the Anchor office does not have access to the reports for your organization.

If you are a DSRIP provider and had any difficulties accessing the information, please alert HHSC at immediately.  Additionally, please note that HHSC sent out a follow-up email to let providers know that the Excel sheet with the column on eligibility to report in April is incorrect – you can follow the dates listed.  You can expect to receive a corrected Excel file from HHSC.

If you are a UC-only provider, the reports are provided so that you can certify that it is your data. If you had any difficulties accessing the information, please alert RAD at

Thank you,



Subject: DY5 Cat 4 PPE Reports Update

Good Morning Anchors,

The Category 4 PPE reports were sent to participating DSRIP and UC providers this morning. We’ve attached a summary of providers and which PPE reports they should expect to receive, just in case there are any questions. Some providers may not receive all three reports due to being a low volume provider with a lack of data. HHSC has notified those providers who will not be receiving any PPE reports. Also, DSRIP providers, who are not exempt from Category 4 reporting, should have received an excel file concerning reporting eligibility for DY5 Category 4 reporting domains.

Below please find the email that was sent to the providers. Please let us know if there are any questions or needed clarifications. Thanks so much!


Dear DSRIP/UC Provider,

Attached please find your facility’s report(s) from the Institute for Child Health Policy (ICHP), the Texas Medicaid External Quality Review Organization (EQRO). These reports are provided to you to meet requirements as a Delivery System Reform Incentive Payment (DSRIP) and/or Uncompensated Care (UC) participant in the Texas Healthcare and Quality Improvement 1115 Medicaid waiver for Category 4.

Please note that the data is Calendar Year 2014 for DY5. In general, hospitals will be receiving reports for Potentially Preventable Admissions (PPAs), Potentially Preventable Readmissions (PPRs), and Potentially Preventable Complications (PPCs) for Demonstration Year (DY) 5, but there may be some cases where there wasn’t enough data to create one or two of the reports. HHSC will be providing the RHP Anchors with a list of UC/DSRIP participants which will identify which reports providers should expect to receive.

DSRIP Reporting

For hospitals participating in DSRIP, please use the attached report(s) for informational purposes and for reporting on DSRIP Category 4 Domains 1 (PPAs), 2 (PPRs), and 3 (PPCs) during the April DY5 or October DY5 reporting period. HHSC will be posting the April DY5 Reporting Companion Document soon, which will provide additional information on reporting Category 4 for DSRIP. This document will be posted on our Tools and Guidelines page, which can be found here:

In addition to the PPE reports, we are also attaching an excel file that identifies the April DY5 reporting eligibility for each reporting domain based on the documented measurement period.

For questions related to reporting Category 4 for DSRIP, please email the Transformation Waiver mailbox at

UC Reporting

For hospitals participating in UC, please use the attached report(s) for informational purposes and to certify that your facility has received the data for your hospital and that you agree that the data is for your hospital. You are not required to submit the data back to HHSC, as we already have the information. If your hospital is exempt from reporting Category 4, you can notify RAD during the certification process. DY5 Category 4 certifications will be sent by HHSC Rate Analysis to UC-only hospitals in June, 2016.

Please submit your certification forms or any questions concerning reporting Category 4, please contact RAD at

Exempt Hospitals

Please note that certain hospitals are exempt from Category 4 (refer to paragraph 11.f.) as specified in the Program Funding and Mechanics (PFM) protocol ( In these cases, ICHP may have provided data for your hospital and HHSC is distributing the report(s) for informational purposes only.

If your facility is no longer participating in DSRIP or UC, these report(s) are for informational purposes only and no action is needed.

Thank you!

HHSC Transformation Waiver Team


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Mar 22

HHSC Webinar on DSRIP April DY5 Reporting – April 6, 2016, 10-11:30AM

Good afternoon Region 2!

HHSC has announced that the April DY5 reporting webinar will be held on Wednesday, April 6th from 10:00-11:30.

Dial-in/Log-in information is as follows:

Topic:                    April DY5 Reporting
Date:                     Wednesday April 6, 2016
Time:                    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: 732 344 534
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.

Additionally, you should have received an invitation to the Region 2 Anchor Office supplemental reporting webinar on Tuesday, April 12th from 10:00-11:30. Our team offers this as an opportunity to ask any questions that may remain after the HHSC session.


  1. General Reporting
  2. QPI Reporting
  3. Category 3 Reporting
  4. Category 4 Reporting
  5. Question and Answer Period

Call-In:                               877.226.9790
Access Code:                   3020674

Meeting Number:               8772269790
Code:                                 3020674

As always, the Anchor team is available during Reporting to assist in resolving your concerns.  Please feel free to contact us and we’ll do our best to help.

Susan Seidensticker, BSIE, MSHAI, CPHQ, CSSBB, PMP
Director, Waiver Quality Operations
University of Texas Medical Branch (UTMB)

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Mar 21

Category 3 Summary Workbook Update

Good afternoon Region 2,

HHSC has released the attached document that reflects the Category 3 values as they currently have them recorded. As referenced in the email below, each provider is being asked to review each of their Category 3s and report any discrepancies to the HHSC Waiver mailbox ( by COB next Wednesday, March 30th.

Susan Seidensticker, BSIE, MSHAI, CPHQ, CSSBB, PMP
Director, Waiver Quality Operations
University of Texas Medical Branch (UTMB)


Anchors and Providers,

Category 3 Summary Workbook:

Attached please find an updated Category 3 Outcome Summary Workbook. The attached workbook will be posted to the waiver website next week. This update includes changes from DY4 R1 NMI responses, approved Interim Corrections, completed MSLC reviews, baseline PFPM submissions, and technical assistance conducted since January. The updated Category 3 Outcome Summary Workbook also contains DY5 R1 reporting and correction eligibility for all outcomes.

Providers should review project selection and reporting history for accuracy as this is the information that will be used to populate the April DY5 reporting template. Please send an email to the waiver mailbox if inaccuracies are identified in the following fields:

  • IT Selection & Subsets
  • Milestone Structure
  • DY4/DY5 Goals
  • Measurement Periods
  • Reporting Eligibility
  • Percent of Goal Achieved

Please send any needed corrections to the waiver mailbox by Wednesday, March 30th.

April DY5 Reporting Template Corrections:

In October DY4, the Category 3 reporting template was only able to accommodate corrections to outcomes that were reporting achievement of DY4 milestones. In April DY5, the Category 3 Reporting Template will be able to accommodate corrections for both outcomes reporting for achievement and those providing a status update. P4P outcomes that have not yet reported performance will be able to make corrections to the reported baseline numerator and denominator through the reporting template. P4R outcomes will be able to make corrections to all prior reporting history. After the April DY5 reporting period, HHSC will have another Category 3 Interim Correction period for outcomes that have already reported performance, and are not eligible to submit corrections through the April DY5 Category 3 Reporting Template.

Thanks for all your hard work and have a great weekend.

Medicaid/CHIP Transformation Waiver Operations
Texas Health & Human Services Commission


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Mar 04

3/4/16 Anchor update

Good afternoon Region 2,

HHSC has released a new Anchor update; please see the e-mail below and take special notice of the items highlighted in red.

Thank you,



Anchors –

Thank you for your survey responses and emails to the waiver mailbox about the Transition Year/DY6 proposals.  We continue to go through them and are developing an FAQ that we plan to have available later this month.


  • October DY4 NMI Review Results were distributed on Friday, February 26 to providers who received NMIs during the October DY4 Initial Review. Due to technical difficulties with software upgrades, we had to resend some emails on Thursday, March 3rd.
  • HHSC sent an Active Users Report to each region to collect any changes to user status or contact information to ensure that providers and their IGT entities have access to the reporting system for April DY5. This update is due back to the waiver team on Wednesday, March 23rd. After this deadline, changes must be submitted using an RHP Contact Change Form to the waiver mailbox.
  • Preparations for April DY5 reporting are underway, including updating the Companion and developing a new Category 3 reporting template.  If we have any reporting webinars it will likely be to go through the new Cat 3 template, but we will let you know soon.

Category 3 Update

  • Partial Payment: We’ve received a number of questions in the waiver box asking about carryforward for outcomes that reported partial achievement in DY4. HHSC is attaching an example from previous reporting webinars that clarifies partial payment calculations. As a reminder, reporting partial achievement of a Category 3 DY4 milestone does not change your Category 3 measurement periods. Unlike QPI, Category 3 measurement periods are not extended if a goal is not fully achieved during the measurement year. The Performance Year 1 measurement period is the twelve months immediately following baseline. Performance Year 1 is associated with DY4 achievement milestones. The Performance Year 2 measurement period is the 12 months immediately following Performance Year 1.  Performance Year 2 is associated with DY5 achievement milestones and DY4 milestones carried forward due to partial achievement.
  • Stretch Activities: Providers will report Stretch Activity milestones in October DY5. For Stretch Activity 3 (Program Evaluation), HHSC will be providing a template to summarize your final report for reporting purposes. The template will be similar to a cover page. This template will be available prior to the October reporting period.
  • Interim Corrections: HHSC has started review of Interim Corrections submitted in February and will notify providers of approval or any needed follow up by March 11th.
  • PFPM Baseline Submissions: HHSC has started review of Population Focused Priority Measure baselines submitted in February and will notify providers of approval or any needed follow up by March 11th.
  • Category 3 Summary Workbook Update: HHSC will be updating the Category 3 Summary Workbook currently posted to the waiver website. The current target date is March 14th. This update will include any changes made through the NMI reporting period, baseline TA for baselines reported in October DY4, approved interim corrections, approved PFPM baselines, and baselines under review by MSLC that have been reported to HHSC. This update will also include April DY5 reporting eligibility. HHSC will send anchors a regional Category 3 summary of selection and reporting details included in the Category 3 Summary Workbook.


Statewide Events Calendar


March 2016
RHP Date Topic Contact
19 3/23 RHP 19 Learning Collaborative Rebecca McCain
8 & 17 3/24 RHP 8 & 17 Joint Learning Collaborative Jennifer LoGalbo
16 3/29 RHP 16 Learning CollaborativeTo register: RHP 16 LC Kathy Lee
April 2016
RHP Date Topic Contact
4 4/14 RHP 4 Learning CollaborativeTo register: RHP 4 LC Jonny Hipp
May 2016
RHP Date Topic Contact
12 5/4 RHP 12 Learning Collaborative Sandra James
August 2016
RHP Date Topic Contact
HHSC 8/30-31 2016 Statewide Learning Collaborative Transformation Waiver
September 2016
RHP Date Topic Contact
2 9/15 RHP 2 Behavioral Health Learning Collaborative Susan Seidensticker

We will likely cancel the Anchor call scheduled for March 18th since it is during Spring Break for a lot of folks, but we will plan to schedule a call sometime during the week of March 28th to continue our waiver extension discussion and share any updates we have by then. If you have any questions in the meantime, please let us know.  Have a great weekend!


Healthcare Transformation Waiver Operations
Texas Health and Human Services Commission


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Mar 04

RHP 2: Metric Report

Good morning Region 2,

HHSC has provided the attached metric report for your review.  This is updated through the October DY4 NMI period; if the contents do not match what you have in your records, please contact the HHSC mailbox ( immediately and copy Susan Seidensticker ( on that correspondence.

Thank you,


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