Category: Uncategorized

Oct 18

RHP 2 DSRIP: 10/13/17 Anchor Notes

Good afternoon Region 2,

Below please find the notes from the Anchor call that HHSC conducted on Friday.
Anchor Notes
MPT Instructions
Calculator for MPT
DSRIP Draft Category C Measure Specifications

The following items are of special interest:

October Reporting:
• All RHP 2 performing providers who are reporting in the DY6 October cycle should have received an email from HHSC entitled “October DY6 DSRIP Reporting and Hurricane Harvey Reporting Exceptions”, which included a large (5MB) excel template.
o If you did not receive this email and are eligible to report now, please let the Anchor team know and we’ll get the template over to you.
o If your organization chooses to utilize HHSC’s offer of provisional approval of metrics due to the storm, that template is to be completed and submitted back to HHSC via the mailbox ( by Tuesday, October 31st – this file is not to be uploaded into the online reporting tool.
o The template shows at the individual metric level what accommodations may be available.
o If you are not requesting to use the provisional approvals, no action is necessary.
o As a courtesy, if you choose to submit the template to request the provisional approvals, please copy me ( so that our office has a record of the request as well.
• Reminder: HHSC’s cut-off dates for questions are as follows:
o Category 1, 2 and 4: Wednesday, October 25th
o Category 3: Friday, October 20th
• Please see page 2 of the Anchor notes regarding formatting issues in the Sustainability template needed to complete your M-4.1 deliverables. HHSC has uploaded the corrected template to the online reporting tool (it will say Version 2 at the top), though they did not change the revision date in the bulletin board list of available files. If you have downloaded the template already and are not seeing any issues, you are free to continue to use that one.
• Please also see page 2 of the Anchor notes regarding a glitch in the Category 3 template. Some providers in the state have been getting errors in the calculated achievement percentage when they populated the numerator and denominator. As of now, HHSC has not uploaded the corrected template. If you have already started and your calculations appear correct, you are free to continue to utilize the version of the template you currently are using. HHSC has said that they will attempt to notify directly those providers who appear to be impacted by this error.

Compliance Monitoring:
• Notifications on new Category 1, 2 and 3 efforts for compliance review by Myers & Stauffer LC (MSLC) will be issued shortly. MSLC is aware that providers are not to be asked to deliver any compliance-related responses until the DY6 October reporting cycle closes.

Waiver Renewal:
• HHSC stated that the negotiations with CMS are ongoing.
• The feedback window regarding Category C now closes on Monday, November 6th. The links (one for the introduction, 23 for the hospital and physician practice, one for local health departments and one for community mental health centers) are in the attached email.
• HHSC has added a Minimum Point Threshold calculator to the online tool; that Excel file and its accompanying PDF are attached for your convenience.

Susan Seidensticker, BSIE, MSHAI, CPHQ, CSSBB, PMP
Director, Waiver Quality Operations
University of Texas Medical Branch (UTMB)
Shearn Moody, 9th Floor

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Dec 03

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

Dear RHP 2 Providers & Stakeholders:

We will hold a regional meeting on Friday, January 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,


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Oct 28

Stakeholder Feedback

Good afternoon RHP 2:

Please note that HHSC has posted a link to a survey for stakeholder feedback on protocol level proposals for the 1115 Transformation Waiver Extension Application as described during the September 30, 2015 webinar, along with a document showing stakeholder comments already received on the proposed extension elements.  (If you have already responded to a previous survey or provided feedback at one of the public meetings, it is not necessary to make additional comments).  More information can be found on the waiver website’s Waiver Renewal page.

Thank you,


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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 and participate in the survey which closes on November 26, 2014. 

To access the survey, click on the following link:  Once you have completed the survey, click the “submit” button at the end of the survey to submit your responses.  Again, the survey will be available until November 26, 2014

On behalf of HHSC and the Region 2 Waiver Office, thank you in advance for your participation.



Texas’ 1115 demonstration waiver, the Healthcare Transformation and Quality Improvement Program, is a 5-year waiver that goes through September 30, 2016. It includes Texas’ two major Medicaid managed care programs (STAR and STAR+PLUS), children’s dental managed care, an Uncompensated Care (UC) Pool and a Delivery System Reform Incentive Payment (DSRIP) Pool. In order for Texas to continue these Medicaid managed care programs, UC, and DSRIP, Texas must submit a renewal or extension request no later than September 30, 2015.  This survey is specific to DSRIP.

HHSC seeks input from Texas Medicaid stakeholders, including both current Regional Healthcare Partnership (RHP) participants and other interested entities, on the future of the DSRIP program as Texas begins to pull together the renewal/extension (hereafter referred to renewal) request.  HHSC will use this information to help inform an initial plan for the waiver renewal request.

In submitting your responses, please consider the following:


  • DSRIP is a substantial federal investment – Texas needs to demonstrate the value of the investment.
  • The need to continue to strengthen care coordination among providers across the continuum of care.
  • Outcomes measurement is important – consider some funding for shared outcomes at the RHP and/or State level?
  • Sustainability going forward – how to take what’s being learned through DSRIP, sustain/disseminate/replicate best practices, and embed these practices into everyday Medicaid business?
  • Texas is at the forefront of DSRIP renewal (California is a year ahead of Texas) – so think what the next phase of DSRIP could look like to build on what we’ve learned so far.

To access the survey, click on the following link:  Once you have completed the survey, click the “Submit” button at the end of the survey to submit your responses.  The survey will be available until 11/26/2014.


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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]

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Oct 22

UPDATE: Talking Points from HHSC on CMS UC Deferral Letter

Good Afternoon Region 2:

In an effort of full transparency, I am sharing with RHP 2 Performing Providers (and those stakeholders who have requested such communication) the following update from HHSC regarding the ongoing Uncompensated Care (UC) review.  As previously announced, CMS has stated it will “defer” federal funds for Uncompensated (UC) payments for private hospitals that are in certain funding arrangements that CMS believes may be unallowable uses of provider-related donations.  More details can be found on the HHSC website and in the letter I published for RHP 2 on Tuesday, October 7, 2014 (

The information below from HHSC was shared with anchors and other parties on Friday, October 17, 2014 in advance of a UC update call hosted by Ms. Pam McDonald, Director, HHSC Rate Analysis and other key HHSC staff members from both Rate Analysis and the 1115 Waiver team.  This, once again, supplements prior information covered in my above-mentioned communication from Tuesday, October 7, 2014 as well as any prior communication from the State on/before Friday, October 17, 2014.  
At this point, we have not learned of any impact to DY3 October Reporting due to the ongoing UC issue.  As such, Performing Providers should continue their plans to submit their reporting tool to HHSC on/before the (extended) deadline of Wednesday, November 5, 2014 at 11:59 p.m.

As we learn more, we will share with our regional providers and interested stakeholders.  If you have additional questions or require further assistance, please contact me personally at: or 409.766.4047.
Thanks you,


Uncompensated Care (UC) Deferral Issue – Talking Points

 HHSC Hosted Call:

Friday, October 17, 2014, 1:00 PM CST


  1. Removal of 8 private hospitals and 1 public hospital from the deferral list and reduction of deferral by $11.7M FF.


Baylor Medical Center at Waxahachie
Scott & White Hospital – Llano
Scott & White Healthcare- Round Rock
CHCA Bayshore LP dba Bayshore Medical Center
Christus Health ARK-LA-TEX dba Christus St. Michae
CHRISTUS St. Catherine Hospital
Christus Health Gulf Coast dba Christus St. John H
Christus Health Southeast Texas dba Christus St. E
Lavaca Medical Center


  1. HHSC meeting this week with attorneys/consultant representing many of the entities involved with the 501s, discussion of strategy, agreement to share information, etc.  Strategy could include:
  2. Prove there were no donations
  3. Provide documentation proving everything was disclosed to and recognized by CMS in 2008
  4. Equity/Access-to-care argument
  5. Face-to-face meeting with Cindy Mann
  6. Contacts from Texas Legislative delegation, state legislators with ties to the Obama administration, etc.


  1. Individual meetings/calls with various impacted entities to gather info requested by CMS.


  1. Working on request to CMS for:
  2. Identities of individuals representing to CMS that public entities would not provide IGTs for private entities if private entity had not provided payment to public entity or 501 and notes of these statements.
  3. Explanation of how HHSC can adequately address CMS’s concern that entities were not forthcoming with documents.  What documents or evidence must HHSC obtain from providers if those providers have no relationship with the questioned 501 or no documents exist?
  4. List of documentation HHSC must provide to ensure that waiver supplemental payments continue without future threat of deferral or disallowance.


  1. HHSC staff briefing with HHSC leadership next week to present strategy for feedback and approval.




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Oct 13

RHP 2 Conference Call-HHSC Updates-Monday, October 13

RHP 2 Providers and Stakeholders:

If possible, plan to join us for a brief conference call on Monday, October 13, 2014 at 1:00 pm (details below).  We will cover updates received from HHSC’s anchor call today.

 Date:                    Monday, October 13, 2014

Time:                    1:00-1:30 pm

Dial:                      1.877.226.9790

Access Code:      3020674

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Oct 02

1115 Waiver – RHP 2 Providers Invited to Join Ebola Outbreak Presentation

Part of UTMB’s commitment as anchor of RHP 2 is to coordinate efforts to share information regionally; therefore, please see the announcement on a very important and timely presentation regarding the Ebola outbreak.  I apologize for the short notice, but if you are able to join us Friday, October 3, 2014, Dr. Tom Ksiazek will be presenting live in the Main Auditorium of Levin Hall, located at 10th and Market Street in Galveston.  UTMB also plans to stream the presentation live and record it for YouTube viewing.

To view the Ebola lecture online, please use the following links:

 Apple QuickTime Viewers:

 Windows Media Viewers:

 If technical assistance is required, please call 409.747.9037.

Additionally, if any providers in the region have specific questions regarding the Ebola crisis, the Office of Waiver Operations will happily facilitate a discussion with one of UTMB’s experts on the topic.  We are very fortunate in RHP 2 to have some of the world’s leading researchers and experts who are most willing to serve as a resource with our regional providers.  If you have questions, please let me know: or 409.766.4047. 




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Sep 29

9/26/14 Anchor Call Notes and Pre-test/Post-test Guidance

Dear Region 2 Performing Providers & Stakeholders:

Attached are the [anchor call notes] from Friday, September 26, 2014.  As John noted during the call, regarding the October reporting template, Anchors will be able to view what providers in their region report in the new automated reporting system.  He also confirmed after the call that Anchors will also be able to open any attached documentation files.

Also attached, please find the [guidance for utilizing pre-and post-testing] to report scores for survey tools in OD-10 and OD-11, mentioned in the anchor notes.
Thanks, Craig

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Sep 08

1115 Waiver: IMPORTANT INFORMATION for Region 2 Providers & Stakeholders

Greetings from Galveston Island and the Region 2 Anchor Office team!

This message contains a number of important updates so please review carefully,  and let me or a member of my staff know if we can answer any questions for you.  Many of you have received more specific, targeted messages if you have a DSRIP project in Region 2 that has been identified as requiring a mid-point assessment.  However, in compliance HHSC’s request and our duty as Anchor, I am share the following messages and attachments broadly with all performing providers and stakeholders who have asked to be part of our general 1115 Waiver distribution list.


HHSC shared the list of projects for Region 2 that have been selected for mid-point assessment review late yesterday evening.  Please review this [attached] document carefully to see which projects you have on the list.  If you plan to attend the Statewide Learning Collaborative (SLC) event this week in Austin, please attend one of the breakout sessions dedicated to mid-point assessment (more information on the SLC below).  Projects for the mid-point assessment were selected based on the following criteria per HHSC’s notification to our office:

  • Projects with the following options: 1.10, 2.4, 2.5, and 2.8 and “other”
  • Projects identified by HHSC during approval, plan modification  and reporting reviews
  • Projects selected via random sampling

HHSC will send formal mid-point assessment notification letters shortly after the SLC to providers with identified projects.  This letter will provide additional information, including specific dates and deadlines relating to the mid-point assessment process.  The project list and limited information is being shared in advance of the SLC, so providers can plan to participate in the breakout session in person or via conference option.  For those providers who will be participating in the SLC via webinar, the mid-point assessment breakout session will not be streamed during the webinar; however, it will be recorded and the link will be posted on the HHSC website at a later date.  If providers who are not travelling to Austin prefer to listen to the presentation prior to it being posted on the HHSC website, a conference option for the Tuesday afternoon session (September 9, 2014 from 3:45-5:00 pm) will be made available to those who e-mail the waiver mailbox and request access in advance.  I strongly suggest you e-mail and request audio access as soon as possible today at:


The SLC is being held in Austin this week, and the formal agenda that HHSC released late last week is [attached].  It is exciting to see that RHP 2 will be well represented and that we have regional partners and Region 2 Waiver Office staff scheduled to present on a sampling of the collaborative efforts and innovative projects and opportunities that are happening here within our 16-counties due to the 1115 Waiver.  For those who are unable to attend the SLC in person, information at the bottom of this message provides detailed instructions on how to view various sessions live/real-time (via web streaming.) 

*Please Note:  If you are a UC-only hospital who has not yet attended a Region 2 Learning Collaborative event in DY 3 or who is not planning to join us in Galveston at UTMB’s Open Gates Center this coming Friday, September 12, 2014, for the behavioral health collaborative/cohort workgroup, you should plan to participate in the SLC via web streaming in order to meet your collaboration requirement.  Specific break-out sessions are noted on the attached SLC agenda. 

Katrina Lambrecht and I will be attending the SLC in Austin this week on behalf of the Region 2 Waiver Office, and we are extremely proud and honored for the opportunity to personally showcase the great work that the regional partners have done so far with the common goal of transforming healthcare in the 16-counties that make up our region.  We both look forward to seeing many of you there in person, and to hosting the Region 2 provider reception and dinner tomorrow evening, Tuesday, September 9, 2014, for those providers and regional stakeholders who will be in Austin attending the SLC in person.

In addition, [attached] are the anchor notes from the call on Friday, September 5th. 

Thank you again,

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