Category Archive: Upcoming Deadlines

Feb 15

DSRIP DY7/8 PFM Discussion – Region 2

RHP 2,

Please find today’s DSRIP DY 7/8 PFM Discussion Webinar slides attached as well as the PFM document the feedback must address. The HHSC PFM feedback survey link is https://www.surveymonkey.com/r/MMBZ6P7 and can be found on the HHSC Medicaid 1115 Waiver website at https://hhs.texas.gov/laws-regulations/policies-rules/waivers/medicaid-1115-waiver as well as all other applicable documents and updates that are currently available for review. The survey must be completed by COB on 02/28/2017 (2 weeks from now)  for the feedback to be considered by HHSC.

Please feel free to reach out to our office with any questions you may have.

Thank you,
Andrew T. Herndon, MHA, CSSGB
Senior Management Analyst
Waiver Operations
Office of the President
UTMB Health
301 University Blvd. Galveston, TX 77555-0985
Office: 409-766-4044 Cell: 979-204-8526
Fax: 409-747-0896 atherndo@utmb.edu

 

Permanent link to this article: https://blogs.utmb.edu/1115/2017/02/15/dsrip-dy78-pfm-discussion-region-2/

Jan 25

1/20/17 Anchor Update

Please see the email below that was received from HHSC.

  • HHSC confirmed the October DY5 metric payment dates.
  • HHSC also confirmed the date for final determination on any outstanding NMIs from October reporting.
  • Please review the Category 3 Reporting Summary and Goal Calculator file (the second file available in the Category 3 section at https://hhs.texas.gov/laws-regulations/policies-rules/waivers/medicaid-1115-waiver/1115-medicaid-waiver-tools-guidelines-regional-healthcare-partnership-participants) to confirm that the information matches your records. If you have determined that you need to make a correction to any of your previously reported Category 3 information, please check this file for eligibility.
  • If you are eligible to correct a Category 3 metric and plan to do so, the template (Category 3 Interim Corrections Template DY6 R1) is due back to HHSC on or before Sunday, February 19th; the template can be found at the link above (third file available in the Category 3 section). If you have any questions regarding the Category 3 correction process, please contact Susan Seidensticker (smseiden@utmb.edu), Jennifer Woodard (jnwoodar@utmb.edu) or Andrew Herndon (atherndo@utmb.edu) on our team for assistance.

    A few update for you this week:October DY5 Reporting Dates

    • January 19, 2017 – October reporting DY5 DSRIP payments for transferring hospitals and the top 14 IGT entities were processed.
    • January 31, 2017 – Remaining DSRIP payments (DY4 payments for all providers and DY5 payments for remaining providers that were not paid on January 19) will be processed.  Note that there are separate transactions for each payment for each DY.
    • February 24, 2017 – HHSC and CMS will approve or deny the additional information submitted in response to HHSC’s “Needs More Information” (NMI) requests from October reporting.

    Category 3 Summary Documents Category 3 Summary Workbook and Goal Calculator is being updated, as well as the Category 3 RHP Summary. These should be posted on the waiver website by Monday, January 23rd. The updated workbooks should reflect Category 3 data as submitted through the October DY5 reporting process, as well as MSLC updates sent to HHSC by January 17th. These summary documents do not reflect any data submitted through the NMI review process.

    Category 3 Interim Corrections HHSC has also sent the Category 3 DY6 R1 Interim Corrections template for web posting and it should be available by Monday. Most P4P outcomes that have submitted at least one year of performance are eligible to submit a correction in the interim correction period. Category 3 DY6 R1 Interim Correction eligibility is indicated in the Category 3 summary documents as well as the Interim Correction Template. Interim corrections if needed should be submitted to the waiver mailbox by February 19th.

    Just a reminder to please provide feedback on the questions for the Sustainability Milestone template that are posted on the Waiver website. HHSC would appreciate feedback via the waiver mailbox by the end of January.

     

Permanent link to this article: https://blogs.utmb.edu/1115/2017/01/25/12017-anchor-update/

Dec 20

Important 1115 Waiver (DSRIP) Updates

Please see the main notes of interest recently received from HHSC bulleted below, as well as the RHP2 Waiver Office holiday schedule*. Additional information is attached related to financial and reporting information. If you have any questions or comments, please feel free to reach out to me personally.

Waiver Renewal

  • HHSC is planning on submitting a request to CMS in the new year for an additional 21 month extension. The current extension takes us through December 31, 2017. The additional extension would take us through September 30, 2019. This will allow time for transition to the new presidential administration, and an additional Texas legislative session in spring 2019. The request would be to continue level funding for both DSRIP and UC consistent with the current 15-month extension.
  • This does not change the plans for the draft Program Funding and Mechanics (PFM) protocol in development, with a draft planned for January 2017 for stakeholder feedback. HHSC has a PFM approved for DY 6, which ends on September 30, 2017. The PFM in development for DY 7 will be developed to accommodate a DY 8, with future updates as needed.
  • Stakeholder input will occur for the draft PFM, including a webinar in February 2017.
  • In last week’s anchor notes, we said that the DY7 program rules would be proposed in February to be effective in August 2017.  We want to clarify that the HHSC internal timeline is to have rules drafted in February.  The actual date that the rules will be proposed in the Texas Register will likely be in May 2017 with an effective date in September 2017.

January 2017 Payments

  • Attached is the project level approved DSRIP amounts. The bolded columns are for the total approved amounts for each DY. Note that these are the approved DSRIP amounts while actual DSRIP payments will be based on IGT transferred.
  • As noted previously, below are the estimated payment dates:
    • January 19, 2017 – October reporting DY5 DSRIP payments processed for transferring hospitals and top 14 IGT Entities. Note that this date was previously January 13th.
    • January 31, 2017 – October reporting DY4 DSRIP payments processed for all providers and DY5 DSRIP payments processed for remaining providers that were not paid on January 19, 2016. Note that there are separate transactions for each payment for each DY.

DY6 Monitoring IGT

*As a reminder, the Anchor Office will be closed the week of December 26, 2016 for UTMB’s Winter Break. Normal operations will resume on Monday, January 2, 2017 at 8 a.m.; however, during the break, Waiver Office management will be periodically checking both e-mail and voice mail. I invite you to contact me via cell if you need anything urgently. My cell is 281-806-0347. Please do not hesitate to do so if needed.

Craig S. Kovacevich, MA
Associate Vice President
Waiver Operations & Community Health Plans
Office of the President
The University of Texas Medical Branch at Galveston
Region 2, 1115 Medicaid Waiver
University of Texas Medical Branch
301 University Blvd., Galveston, TX 77555-0985
P 409.766.4047 M 281.806.0347
F 409.747.0896 E cskovace@utmb.edu

Permanent link to this article: https://blogs.utmb.edu/1115/2016/12/20/important-1115-waiver-dsrip-updates/

Sep 19

1115 Waiver Anchor Update from September 16, 2016

Good afternoon Region 2,

Thank you again to all that attended the RHP 2 Behavioral Learning Collaborative event in Galveston last week.  The notes from that meeting should be available on our website (http://www.utmb.edu/1115) by the end of the week.

Attached please find the notes from Friday’s Anchor call with HHSC and we have added a couple of other updates below.  Please review the notes carefully for information on reporting, Category 3, compliance audits, and Waiver renewal.

October DY5 Reporting

  • Anchors, Providers, and IGT entities should now have access to the Project Reporting Summary under the “Reports” function on their home page’s menu bar.  The attached guide to the new Project Reporting Summary also includes information on the Uploaded Files Summary.  This information will also be included in the updated version of the DSRIP Online Reporting System User Guide for October DY5.  If you have any questions about the reports, please contact the Waiver mailbox at TXHealthcareTransformation@hhsc.state.tx.us.
  • In preparation for October DY5 reporting, we had previously asked that you alert our office of any changes needed to the access list for the online reporting tool.  Those changes need to be sent to Bobbie Guyton (bjguyton@utmb.edu) by COB on Monday, September 26th.  Thank you to those that have already responded.
  • The tentative date for the October DY5 Reporting Webinar is October 5th at 10:00 AM.  We will provide the call-in and log-in information to DSRIP providers when it is available.
  • The Category 3 DY5 Stretch Activity Reporting Coversheet is attached again (previously part of the 8/26 Anchor Notes) for those who will be reporting on this activity during October reporting.  If you have questions about the content needed for this, please contact Jennifer Woodard (jnwoodar@utmb.edu) or Susan Seidensticker (smseiden@utmb.edu).  All projects that have a DY6 stretch activity selection must have that information back to Jennifer ASAP in order to meet the Anchor submission deadline of September 30th.
  • As a reminder, all providers will be submitting one Category 3 template into the online reporting tool; this must include a scanned copy of the certification signature page.

Compliance

  • MSLC has a deadline of September 30th to complete the current Round 2 reviews for Categories 1 and 2, as well as the Round 1 of Category 3 reviews. MSLC has alerted HHSC that there are some delays with selected providers that may cause certain metrics in review to not be completed by that deadline.  If your organization is one that experienced such a delay, you may be asked to work with MSLC during the October reporting period.

DY6 Participation Templates

  • HHSC is reviewing the NMI responses and is scheduled to have their feedback returned to the Anchors on October 3rd.

HHSC Waiver Website

  • The new HHSC website launched September 1st, and the new address for the main waiver website page is https://hhs.texas.gov/laws-regulations/policies-and-rules/medicaid-1115-waiver , although there is a re-direct to this link if you use the previous waiver website address.  However, links we have sent out in the past for documents on the waiver website will no longer work.
  • The RHP 2 Anchor team understands (and share!) your frustration that many links are currently inaccessible on the waiver website, and that more recent updates have not made it over to the new site.  HHSC is working to get information back up there and accessible as soon as possible.  If there is something specific you need access to, please let us know and we’ll work to resolve the concern(s).

Thanks,

 

Craig S. Kovacevich, MA
Associate Vice President,
Waiver Operations &
Community Health Plans
UTMB Health
409.766.4047 (Office)
cskovace@utmb.edu

Representing:
1115 Medicaid Waiver – RHP 2
UTMB HealthCare Systems
UTMB Community Health Plans

Permanent link to this article: https://blogs.utmb.edu/1115/2016/09/19/1115-waiver-anchor-update-from-september-16-2016/

Sep 09

9/9/16 Anchor Update

Good afternoon Region 2,

Please see the email below that HHSC sent out today; we encourage you to pay special attention to the highlighted items, as well as the PDF attachment that describes the new functionality within the online reporting tool.

We look forward to seeing many of you at the Behavioral Learning Collaborative event that will be held in Galveston on Thursday afternoon; if you have questions regarding that please email me back directly.

 

Susan Seidensticker, BSIE, MSHAI, CPHQ, CSSBB, PMP
Director, Waiver Quality Operations
University of Texas Medical Branch (UTMB)
409-766-4041
smseiden@utmb.edu

 

*********************************************************************

Anchors –

A few brief updates this week:

DY6

  • HHSC continues to work to finalize the second set of DSRIP rules for adoption. HHSC anticipates that the adopted rules will be published in the Texas Register in October 2016, and we will notify anchors when they are published.

DSRIP Reporting

  • Anchors, Providers, and IGT entities should now have access to the Project Reporting Summary under the “Reports” function on their home page’s menu bar. Attached please find a brief guide to the new Project Reporting Summary, as well as the Uploaded Files Summary. This information will be included in the updated version of the DSRIP Online Reporting System User Guide for October DY5. If you have any questions about the reports, please contact the Waiver mailbox at TXHealthcareTransformation@hhsc.state.tx.us.
  • In preparation for October DY5 reporting, HHSC plans on sending out our semi-annual user/contact update on Monday, September 12th to help ensure providers have up-to-date access to the reporting system. The updates will be due back to HHSC on Wednesday, September 28th. Additional instructions will be provided in Monday’s email.

Upcoming Category 3 Due Dates

  • Category 3 Alternate Achievement Request for DY6: (for those eligible and choosing to submit): September 9th (TODAY!) or September 11th if an extension has been requested. To be sent to HHSC by Anchors.
  • Category 3 Interim Corrections: These were due earlier in the summer, but the absolute deadline for any outstanding requests is September 14th. To be sent to HHSC by provider.
  • Category 3 Stretch Activity Selections for DY6: September 30th, to be sent to HHSC by Anchor.

Waiver Website

  • The new HHSC website launched September 1st, and the new address for the main waiver website page is https://hhs.texas.gov/laws-regulations/policies-and-rules/medicaid-1115-waiver, although there is a re-direct to this link if you use the previous waiver website address.  However, links we have sent out in the past for documents on the waiver website will no longer work.
  • We understand (and share!) your frustration that many links are currently inaccessible on the waiver website, and that more recent updates (such as the SLC presentations and Cat 3 Alternate Achievement Request template) did not make it over to the new site. We are working with our Web services to get information back up there and accessible as soon as possible.  Thank you and your providers for your patience!

Please let us know if you have any questions. Thank you all so much for helping make our 2016 Statewide Learning Collaborative summit such a great success.  Have a great weekend!

 

Healthcare Transformation Waiver Operations
Medicaid/CHIP
Texas Health and Human Services Commission

Permanent link to this article: https://blogs.utmb.edu/1115/2016/09/09/9916-anchor-update/

Sep 07

DY5 UC IGT Notification

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
UTMB Health
409.766.4047 (Office)
cskovace@utmb.edu

Representing:
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.

Thank you,

HHSC Hospital Rate Analysis
Texas Health and Human Services Commission
P.O. Box 149030, Mail Code H-400
Brown-Heatly Building
4900 N. Lamar Blvd.
Austin, TX 78714-9030

Permanent link to this article: https://blogs.utmb.edu/1115/2016/09/07/dy5-uc-igt-notification/

Aug 22

8/19/16 Anchor Update

Good afternoon Region 2:

Below please find the Anchor Updates from HHSC, including two documents related to Category 3 operations in DY6 as well as the newly released Statewide Learning Collaborative (SLC) agenda.

Please note the deadline noted by HHSC for the Alternate Achievement Request Form, in order to adhere to their deadline, we asked that you forward those to us by close of business on Tuesday, September 6th.  Regarding the deadline for Stretch Activity Selections, our office will contact those providers that need to respond to this.

In addition, please see the letter from HHSC to CMS to begin discussions on the longer term extension of the Medicaid 1115 Demonstration Waiver.  Thanks.

 

Craig S. Kovacevich, MA
Associate Vice President,
Waiver Operations &
Community Health Plans
UTMB Health
409.766.4047 (Office)
cskovace@utmb.edu

Representing:

1115 Medicaid Waiver – RHP 2
UTMB HealthCare Systems
UTMB Community Health Plans

 

*********************************************************

Dear Anchors,

Here are a few updates for you this week:

Category 3

Alternate Achievement Requests for DY6

  • The Alternate Achievement Request Form for DY6 has been posted to the waiver website (http://www.hhsc.state.tx.us/1115-Waiver-Guideline.shtml, under the Category 3 section halfway down the page) . Providers with a currently approved alternate achievement request must submit an updated request for DY6 goals. Providers with a P4P QISMC outcome with a baseline below the MPL may also submit an alternate achievement request to change DY6 goals to a 12.5% gap closure towards perfect, similar to a P4P IOS outcome. HHSC will take into account achievement reported as of April DY5 when reviewing these request.
  • The form will indicate eligibility to submit an alternate achievement request based on the above criteria. If a provider believes an outcome should be eligible, but is not showing as eligible in the form, please contact HHSC. One form should be completed for each alternate achievement request.
  • Alternate Achievement Requests should be submitted by Anchors to HHSC by September 9th, along with responses to HHSC comments regarding the DY6 Participation Form.

Stretch Activity Selections for DY6

  • The Stretch Activity DY6 Selection template is attached. This template should be completed by Anchors as it is organized at an RHP level. HHSC is extending the submission deadline for the Stretch Activity Selection Template to September 30th, pending submission of the RHP Planning Protocol updates for DY6. The deadline is being extended so that providers will have a chance to review the PFPM and Stretch Activity menu in the RHP Planning Protocol as submitted to CMS prior to making final selections. Prior to submission to CMS, HHSC has updated the Draft Category 3 operational details document with the detailed PFPM and Stretch Activity menus.

Category 3 Interim Corrections and PFPM Baselines

  • HHSC has completed reviews of Category 3 Interim corrections that were submitted to HHSC by August 11th . We will be notifying providers of approval or any needed follow up the week of the 22nd.
  • HHSC has also completed reviews of PFPM Baseline templates hat were submitted August 15th. We will be notifying providers of approval or any needed follow-up the week of the 22nd.

DY6 DSRIP Rule Set #2

  • Just a reminder that the public comment period for the second set of DY6 DSRIP rules, which closely mirror the DY6 Program Funding and Mechanics (PFM) protocol language, ends August 29, 2016.   These rules were published as proposed in the July 29, 2016, issue of the Texas Register, and are available here – http://www.sos.state.tx.us/texreg/pdf/backview/0729/0729prop.pdf.
  • Please note that the public hearing date listed in the initial Texas Register posting is inaccurate.  The public hearing on these rules will be held on August 26, 2016, at 9:00 AM at HHSC, Brown Heatly Building, Public Hearing Room, 4900 N. Lamar Blvd., Austin, TX.   The public hearing will be webcast.

2016 Statewide Learning Collaborative

  • The Statewide Learning Collaborative is right around the corner!  Thank you to all of the anchors for facilitating reservations for all of your providers.  Attached is the final agenda!
  • HHSC has arranged for the Statewide Learning Collaborative Summit to be available for viewing on-line, in real time, in order to allow all interested individuals to watch the proceedings.  To access the Summit via webcast on August 30th and/or 31st , please click on the Summit Webcast link: https://player2.streamspot.com/?playerId=92a4a38d. The webcast will only stream the sessions that are occurring in the Grand Ballroom.  A test stream will be available on August 22 – 24 each day between the hours of 8:00AM and 10:00PM at the same link (https://player2.streamspot.com/?playerId=92a4a38d) in order for viewers to troubleshoot any firewall issues prior to the Summit.  If issues are encountered during the test stream, we recommend facilities wanting to watch the Summit open up the ability to offer streaming through their firewall and test again to make sure it is working. When you access this site during the test period or the Summit hours, please press play to begin watching on-going sessions. If at any time a participant leaves the webcast and returns later, you will need to click on the same link and press play to re-join. During the webcast, participants may submit questions through an online chat function. Questions will be answered after the Summit concludes.
  • We will send the SLC agenda and livestream link to our provider distribution list and post on the website, but feel free to also share with your providers.

As always, thanks for all of your help.  We will follow-up early next week on the questions you sent in response to my inquiry (although the Cat 3 questions are likely answered above), and please let us know if you have additional questions.  We hope you have a great weekend.

 

Healthcare Transformation Waiver Operations
Medicaid/CHIP
Texas Health and Human Services Commission

 

 

Permanent link to this article: https://blogs.utmb.edu/1115/2016/08/22/81916-anchor-update/

Aug 22

RHP 2 Announcement/Reminder – Immediate Action Required DY5 UC IGT Commitment Notification

Dear RHP 2 Providers (Related to Uncompensated Care):

Just a quick reminder that IGT commitment forms are due today, Friday August 19, 2016 by 5 PM CT.

Below, I have noted the updated dates that HHSC shared with us and providers yesterday. Please note there have been changes for both TexNet entries and settlements.

If you have any questions please do not hesitate to contact HHSC Rate Analysis or the RHP 2 Anchor Office.

August 19th                  IGT Commitments Due
August 25th                  UC IGT Notification
September 8th             Last Day to Enter into TexNet
September 9th             IGT Settlement Date
September 30th               Latest Date for DY5 UC Payments

 

Craig S. Kovacevich, MA

Associate Vice President
Waiver Operations & Community Health Plans
Office of the President
The University of Texas Medical Branch at Galveston

Representing

UTMB Multi-Share, UTMB ChoiceONE Select and UTMB HealthCare Systems
Region 2, 1115 Medicaid Waiver
University of Texas Medical Branch
301 University Blvd., Galveston, TX 77555-0985
P 409.766.4047
F 409.747.0896
E cskovace@utmb.edu

 

****************************************************************************************

Subject: Immediate Action Required DY5 UC IGT Commitment Notification

Anchors:

The purpose of this e-mail is to provide demonstration year 5 (DY 5) uncompensated care (UC) and intergovernmental transfer (IGT) data to all UC providers for the UC payment to be processed in September 2016.  The attached file contains the maximum UC payment for this round of the DY 5 payment, the maximum IGT commitment for each provider and a request for the final IGT commitment from providers.  This is not the final DY 5 UC payment.  There will be a final DY 5 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 5 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 5 UC payment based on the court decision.

At this point, eligible providers and/or their government entities are asked to view the “IGT Commitments by TPI” tab of the attached workbook, locate their hospital and its associated “Maximum IGT (Commitment Cannot Exceed this Amount)” in Column E and complete the IGT commitment form by entering the IGT amount they are committing for the September 2016 DY 5 UC payment.  The commitment form must be returned to HHSC at RAD_UC_Payments@hhsc.state.tx.us by close of business on August 19, 2016.

Please determine the IGT amount you wish to commit up to the limit contained in Column E.  While you may commit to IGT the maximum amount in Column E, 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 DY 5 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 DY 5 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 DY 5 UC payment:

  • August 19                                  DY 5 UC IGT Commitment Due
  • August 25                                  DY 5 UC IGT Notification sent to industry
  • August 30                                  Last date to transfer funds into TexNet
  • September 1                             DY 5 UC IGT Settlement Date
  • September 12                           DY 5 Transferring Entities (Big 6) Payment Date
  • September 30                           Latest DY 5 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 August 25, 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
Texas Health and Human Services Commission
P.O. Box 149030, Mail Code H-400
Brown-Heatly Building
4900 N. Lamar Blvd.
Austin, TX 78714-9030

Permanent link to this article: https://blogs.utmb.edu/1115/2016/08/22/rhp-2-announcementreminder-immediate-action-required-dy5-uc-igt-commitment-notification/

Jul 22

Important DY 5 UC Deadlines and Timeline

All:

Please see the information below for HHSC.  Also, please advise Bobbie Guyton (bjguyton@utmb.edu) by  close of business on Wednesday, July 27th if your TPI changed between DY4 and DY5.  Thanks.

 

Craig S. Kovacevich, MA
Associate Vice President,
Waiver Operations &
Community Health Plans
UTMB Health
409.766.4047 (Office)
cskovace@utmb.edu

Representing:
1115 Medicaid Waiver – RHP 2
UTMB HealthCare Systems
UTMB Community Health Plans

 

***********************************************************

UC Providers,

HHSC will be making the final DY 5 Uncompensated Care (UC) payments to all eligible hospitals in September 2016. There are several important upcoming deadlines which pertain to UC payments that providers should be aware of in the table below. Please note that if your TPI has changed between DY 4 to DY 5 you will need to update it with the anchor of your RHP and the Transformation Waiver Team.

DY 5 UC PAYMENT CALENDAR
EVENT DATE
Deadline for UC-Only Hospitals to Submit Cat 4 /Learning Collaborative Certifications July 28, 2016
Deadline to Update TPI’s in RHP Plan July 29, 2016
Deadline to Submit New/Revised Affiliation Agreements July 29, 2016
IGT Commitment Amounts Sent to Industry by HHSC August 16, 2016
IGT Commitment Responses Due to HHSC August 19, 2016
UC IGT Notification by HHSC August 25, 2016
Last day to Enter IGT in TexNet August 30, 2016
IGT Settlement Date September 1, 2016
UC Transferring Hospitals Paid by HHSC September 12, 2016
State Owned Hospitals Submit Vouchers September 19, 2016
State Owned Hospitals Paid by HHSC September 23, 2016
UC Non-Transferring Hospitals Paid by HHSC September 30, 2016

If you have questions, please send them to the appropriate mailbox to ensure an accurate and prompt response:

Item Mailbox
  • Payments
  • IGT Commitments
  • UC Payment Calculations
  • Cat 4/Learning Collaborative Certification submissions
  • UC Participation or Eligibility
uctools@hhsc.state.tx.us.
  • TexNet Enrollment
  • Affiliation Agreement Status Questions and Submissions
  • Bank Account Updates
  • Other Payment Questions
RAD_UC_Payments@hhsc.state.tx.us
  • RHP Updates
  • TPI Updates
TXHealthcareTransformation@hhsc.state.tx.us.

 

Thank You,

 

Rate Analyst
Texas Health and Human Services Commission

 

Permanent link to this article: https://blogs.utmb.edu/1115/2016/07/22/important-dy-5-uc-deadlines-and-timeline/

Jul 11

7/8/16 Anchor Update

Good morning,

Thank you to everyone who joined us for the Regional Meeting in Galveston; we hope it was beneficial for your ongoing DSRIP efforts.

Please see the brief Anchor update that was issued by HHSC late on Friday, as well as the attachments.  The draft DY6 Core Components questions are now open for review and feedback (due to HHSC by July 22nd); we ask that you copy Jennifer Woodard (jnwoodar@utmb.edu) and/or myself (smseiden@utmb.edu) if you decide to submit feedback.

Also attached is the list of registrants currently showing for the Statewide Learning Collaborative, which will be August 30 & 31 in Austin.  We do have providers looking for additional spots so for those organizations who will not be sending anyone to Austin, please let Bobbie Guyton (bjguyton@utmb.edu) in our office now ASAP.  HHSC has set a registration deadline of August 8th.

A separate email will be coming from me shortly with the Category 3 information referenced below.

 

Susan Seidensticker, BSIE, MSHAI, CPHQ, CSSBB, PMP
Director, Waiver Quality Operations
University of Texas Medical Branch (UTMB)
409-766-4041
smseiden@utmb.edu

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Dear Anchors,

Here are a few updates:

DY6

  • The attached draft questions for core component reporting milestone reporting were posted yesterday on the waiver website for provider feedback. Please submit any questions or feedback regarding these draft questions to TXHealthcareTransformation@hhsc.state.tx.us by July 22, 2016, and include the subject line: “Core Component Milestone Reporting Question Feedback.”
  • We posted an updated DSRIP Participation Template yesterday, which corrects an issue with calculating IGT for Category 3 outcomes on theDY6 IGT Information  If you have already completed the previous template, the updated template does not need to be used because the change does not impact provider entries.

Statewide Learning Collaborative Summit

  • Please see the attached list of registrants for the 2016 Statewide Learning Collaborative.  The list is organized by RHP and performing provider, including details for the total number of slots allocated per provider (i.e., TPI) as well as the number and name of registrants as of June 28, 2016. As previously described, performing providers that cross regional lines have been assigned to a single RHP in the attached file and were allocated slots based on the total number of projects affiliated with the provider’s TPI.  We have included a reference in the file to guide these providers to the RHP they are assigned to for the purposes of registration.
  • Please work with your regional providers that have not yet registered for the event, noting the deadline to register of August 8th. After this date, HHSC will be redistributing any remaining slots.  HHSC staff will continue to confirm panelist presenters and identify opportunities for additional slots for these individuals.
  • Below is the link to the registration page to share with your providers:

To be guaranteed a spot at the conference, designated individuals must register at https://2016slcsummit.eventbrite.com by Monday, August 8th. The registration passcode is HHSC2016.  Upon completing registration, registrants will receive an e-mail confirming their registration.

Category 3

  • An updated Category 3 Summary Workbook & Goal Calculator and the Category 3 Interim Correction Template for DY5 R2 should be posted this afternoon on the waiver website.  We will send those links to providers and anchors when they are posted, along with some additional guidance for Cat 3 in DY6.
  • The updated Category 3 RHP Summary will be available next week.

As always, please let us know if you have any questions. Have a great weekend!

 

Healthcare Transformation Waiver Operations
Medicaid/CHIP
Texas Health and Human Services Commission

Permanent link to this article: https://blogs.utmb.edu/1115/2016/07/11/7816-anchor-update/

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