Good afternoon RHP 2:
As a friendly reminder, please note that the last day to transfer UC IGT funds into TexNet is tomorrow, September 8th with a settlement date of September 9th. Please remember to submit the allocation form along with your trace sheet to HHSC Rate Analysis.
Craig S. Kovacevich, MA
Associate Vice President,
Waiver Operations &
Community Health Plans
1115 Medicaid Waiver – RHP 2
UTMB HealthCare Systems
UTMB Community Health Plans
UC Providers, Government Entities, and Anchors,
Attached to this email you will find a workbook titled “Final-2015 DY 5 UC Payment Calculation that contains the DY5 UC payment with the haircut applied. The applicable tab for the IGT amounts, with the haircut, is titled “IGT Commitments 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 K. 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 Commitments by Affiliation” tab, the provider either (a) exceeded their UC limit paid in the DY5 Advance UC Payment (see the “Recoupments” tab), or (b) the IGT source did not commit to funding the Final DY5 UC Payment (see the “Not Participating” 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. Please note affiliation numbers for public non-state providers may have been changed by HHSC to ensure the UC Payments are processed under the same affiliation number as previous payments.
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 DY5 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 DY5 UC payment based on the court decision.
Below are the pertinent dates associated with the DY5 UC payment:
- September 8 Last date to transfer funds into TexNet
- September 9 DY5 UC IGT Settlement Date
- September 30 Latest DY5 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. In addition, you must submit the attached IGT Allocation form with the trace sheet. Please do not submit separate emails for the trace sheet and IGT Allocation form. 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. The IGT entity must complete the 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)(2)(B)(ii). In the absence of the notification described in 1 Tex. Admin. Code §355.8201(h)(2)(B)(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)(2)(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. Please note our phones have had technical issues for a number of days and HHSC is currently working on resolving this matter. We ask that all communication regarding this payment be submitted to the resource mailbox, as it is our only reliable form of communication, at this time. We apologize for any inconvenience this may cause.
HHSC Hospital Rate Analysis
Texas Health and Human Services Commission
P.O. Box 149030, Mail Code H-400
4900 N. Lamar Blvd.
Austin, TX 78714-9030