The extension request is for 5 years, which will allow the 1115 waiver authority to run through 2027. HHSC will review and modify current MMC measures to examine access to care, care coordination, quality, outcomes, and satisfaction, as applicable to the new populations and/or benefits. The plan includes milestones related to Health IT adoption and health information exchange (HIE), which will benefit stakeholders involved in and served by the 1115 waiver. The final, approved DY9-10 PFM and an accompanying file showing final provider DY9-10 valuations and Minimum Point Thresholds (MPTs) is also included below. All rights reserved. Adults who. The forms can only be reprinted upon request through the TIERS Correspondence functional area. For more information, read about theTexas Healthcare Transformation and Quality Improvement Program on the federal Medicaid website. The approval letter from CMS and the approved PFM are linked to below. In response to COVID-19, HHSC requires all health plans to extend the timeframes for the number of days members, legally authorized representatives or authorized representatives can request an appeal through Nov. 30, 2022: Effective July 1, 2021, health plans must enforce the normal, regular and established timeframes that members have to request for continuation of benefits. The report was submitted to CMS on Aug. 31, 2016, and is linked to below. Effective May 10, 2021, MDS assessments will no longer be extended. Copyright 2016-2022. States must maintain their Medicaid eligibility levels and enrollment procedures that were in effect as of January 1, 2020. Texas HHSC must take all necessary steps to transition these individuals to other programs for which they may be eligible, such as CHIP, Healthy Texas Women, and the ACA Health Insurance Marketplace, and to reduce the number of individuals who become uninsured following a Medicaid denial. Below please find links to the submitted cover letter, Extension Appendices, and Preliminary Evaluation Findings (Supplement A-Preliminary Draft Results). The 21 additional months also allows for the 86th Legislature to respond to any federal changes and sufficient time for Texas to develop a new 1115 Waiver proposal. The requested extension will allow Texas continued flexibility to pursue the goals of the existing 1115 waiver: expand risk-based managed care to new populations and services; support the development and maintenance of a coordinated care delivery system; improve outcomes while containing cost growth; and transition to quality-based payment systems across managed care and providers. 10/10/2022. Under the extension there will continue to be no beneficiary cost sharing. Children receiving HCBS services through the Medically Dependent Children Program (MDCP) 1915(c) waiver: these children and young adults will receive the full range of state plan acute care services and state plan LTSS as well as MDCP 1915(c) HCBS waiver services through STAR Kids. Childrens Dental. In the months leading up to the pandemic, SNAP and Medicaid timeliness was far lower than the norm. Texas will develop a new evaluation design for the extension period and plans to incorporate the following updates into the design to reflect recent or future changes to the THTQIP demonstration waiver. Poor planning or execution in Texas could trigger a mass disenrollment of eligible individuals from Medicaid. The Sign-Up Period at HealthCare.Gov Ends on January 15, How to Improve Texas Property Tax System Update, Consumer Protection in Private Health Care, Child and Adult Care Food Program (CACFP). The QDWI has even more stringent financial resources requirements. Then, beginning in April, states may resume disenrollment of Medicaid beneficiaries who have either been determined ineligible or who simply missed a required step in the renewal process and can be disenrolled with no actual eligibility determination (a procedural denial). The bill also provides important guardrails to determine how a state should resume Medicaid disenrollment. Members of the public throughout the State are provided this medium to have an opportunity to provide comments. To ensure members do not experience a gap in services due to the temporary suspension of face to face service coordination visits for COVID-19, HHSC is extending Intellectual Disability/Related Condition (ID/RC) assessments and individual plans of care (IPC) through Dec. 30, 2020. Read more information about the waiver. HHSC will provide more information if there are changes. Benefits Form H1010-R, Your Texas Works Benefits: Renewal Form Before sharing sensitive information, make sure youre on an official government site. You feel sick with fever, cough, or difficulty breathing, and have been in close contact with a person known to have COVID-19. No prior authorization will be required on the COVID-19 lab test by Medicaid and CHIP health plans or by traditional Medicaid. In the months leading up to the pandemic, SNAP and Medicaid timeliness was far lower than the norm. Ensure individuals who are no longer eligible are successfully transitioned to other coverage such as CHIP and the Affordable Care Act (ACA) Health Insurance Marketplace, or to the Healthy Texas Women program. HHSC must also ensure that individuals who are no longer eligible for Medicaid are successfully transitioned to other coverage options. The Texas Health and Human Services Commission (HHSC) is extending these flexibilities through January 31, 2022, because it includes teleservices that are being analyzed in alignment with House Bill 4. Through a collaborative process, a waiver agreement was reached between CMS and Texas effective January 15, 2021. Expenditures Related to Managed Care Organization (MCO) Enrollment and Disenrollment. STAR is the primary managed care program providing acute care services to low-income families, children, pregnant women, adoption assistance and permanency care assistance, and former foster care children. Beneficiaries can go through the renewal process by phone, fax, email or in person if they wish. The extension years better align the DSRIP transition timeline with the overall goals to create a sustainable, integrated managed care program. HHSC is allowing STAR+PLUS health plans to use the existing process for requesting upgrades to STAR+PLUS Home and Community Based Services (HCBS) for members who exited a NF on or after March 18, 2020, due to concerns about COVID-19 or in accordance with local orders during the early stages of the public health emergency, without HCBS in place. Number of days members, legally authorized representatives or authorized representatives have to request a fair hearing. Further, the ongoing health risks associated with the pandemic make it of the utmost importance that Texas take the necessary steps to avoid massive coverage losses in 2022. Waiver Renewal | Texas Health and Human Services How To Renew Medicaid Benefits - MedicAidTalk.net Today, Texas serves over four million Texans through Medicaid and CHIP programs, and 95% are covered under the Medicaid managed care model. 1115 Transformation Waiver: Extension Application Public Hearing on June 2, 2021 at 10:00 am on the campus of UT Southwestern Medical Center, T. Boone Pickens Building, Auditorium, 6001 Forest Park Road, Dallas, Texas 75235. For more information, see the Medicaid and CHIP Teleservices webpage or contact your health plan or program. The following are temporary expenditure authorities that will expire 60 days after the conclusion of the Secretarys Public Health Emergency, and are effective March 1, 2020: Expenditure authority for inpatient hospital stays related to COVID-19 (i.e. When unable to administratively renew a persons Medicaid, HHSC must provide adequate time a minimum of 30 days for clients to return requested information and should accept reasonable explanations of inconsistencies or to allow for self-attestation of certain eligibility criteria for which documentation may be difficult for individuals to obtain. For example, Utah suspended renewals for its Childrens Health Insurance Program (CHIP) at the beginning of the pandemic, and when renewals resumed, an unprecedented 41% of children in the CHIP program lost coverage, the vast majority (around 89%) because of a procedural issue, not because the state determined they were no longer eligible. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. In September 2021 the Urban Institute estimated that 1.3 million Texas enrolled in Medicaid at the end of 2021 would be ineligible and, therefore, disenrolled in 2022 when the continuous coverage provisions ended. for processing Supplemental Nutrition Assistance Program (SNAP) and Medicaid applications within federally-required timeframes was consistently above 90%. Safety net providers, already reeling from pandemic-related disruptions and demands, would face increased uncompensated care. Texas Incentives for Physicians and Professional Services. The Uncompensated Charity Care pool will first be re-sized in DY11 to take effect in DY12 (FY2023). Cost Sharing The extension does not make any changes to eligibility requirements. Forms | Texas Health and Human Services Beneficiary Groups, Eligibility Requirements, and Benefits Significant changes in care delivery due to COVID-19 may prevent Delivery System Reform Incentive Payment (DSRIP) program providers from achieving Category B goals for Medicaid and Low-Income or Uninsured (MLIU) Patient Population by Provider (PPP), improving Category C measures (pay-for-performance measures) of health care quality, and earning related incentive payments. H0090-I. Your provider agency and MCO service coordinator must support you in developing those plans. Notice of Admission, Departure, Readmission or Death of an Applicant/Recipient of Supplemental Security Income and/or Medical Assistance Only in a State Institution. People who are concerned that they might have COVID-19 should contact their healthcare provider via phone before going to a clinic or hospital to prevent spread in healthcare facilities. Evaluation Design Medicaid Supplemental Payment & Directed Payment Programs, Texas Healthcare Transformation and Quality Improvement Program on the federal Medicaid website, Texas Healthcare Transformation and Quality Improvement 1115 Demonstration Waiver, 1115 Transformation Waiver Extension Cover Letter (PDF), 1115 Transformation Waiver Extension Appendices (PDF), 1115 Transformation Waiver Preliminary Evaluation Findings (Supplement A-Preliminary Draft Results) (PDF), Updated THTQIP 1115 Extension Special Terms and Conditions Technical Corrections (PDF), Updated THTQIP 1115 Extension Special Terms and Conditions (PDF), Updated THTQIP 1115 Expenditure Authorities Extension (PDF), Updated THTQIP 1115 Waiver List Extension (PDF), Attachment A Demonstration Deliverables (PDF), Attachment B Quarterly and Annual Report Template (PDF), Attachment C HCBS Service Definitions (PDF), Attachment F Fair Hearing Procedures (PDF), Attachment G HCBS Participant Safeguards (PDF), Attachment H Waiver Renewal UC Claiming Protocol (PDF), Attachment I Regional Healthcare Partnership Planning Protocol (PDF), Attachment K Administrative Cost Claiming Protocol (PDF), Attachment L Independent Consumer Support Plan (PDF), Attachment M Historical Demonstration of Information (PDF), Attachment N Health IT Strategic Plan (PDF), Attachment O Developing the Evaluation Design (PDF), Attachment P Preparing the Evaluation Report (PDF), Attachment Q DSRIP Sustainability Plan (PDF), Attachment R Texas DSRIP Measure Bundle Protocol Demonstration Years 7 10 (PDF), Attachment T PHP CCP Payment Protocol (PDF), Attachment U Estimated Without Waiver Per Member Per Month Expenditures MEG Trend (PDF), Attachment VCOVID-19 Amendment Evaluation Design (PDF), TAMU Preliminary Evaluation Findings (PDF), To participate virtually, members of the public must register here, Members of the public must register for the meeting here, CMS webpage for the Texas Healthcare Transformation and Quality Improvement Program, Texas THTQIP 1115 Extension Standard Terms and Conditions (PDF), Section 1115 Fast Track Extension Application (PDF), Click here to register for the public hearing, Click here for public comment registration, Attachment J FINAL PFM DY9-10 COVID-19 Changes (PDF), Summary of Stakeholder Feedback on Proposed DY9-10 PFM Changes (PDF), Category C Estimated Average Achievement Values by Measure or Bundle (Excel), Attachment J PFM DY9-10 Cat B and C COVID-19 Changes (PDF), Category C Estimated Average Achievement Values by Measure Class (Excel), Summary of Stakeholder Feedback on the initial draft DY7-10 MBP (PDF), Final DY9-10 PFM with Changes for Provisional Approvals (PDF), Summary of DY9-10 PFM Requirements (Excel), Final Provider DY9-10 Valuations and MPTs (Excel), Summary of Stakeholder Feedback on the first draft DY9-10 PFM (PDF), Summary of Proposed Changes to the DY9-10 PFM (PDF), Proposed Changes to the DY9-10 PFM Webinar, DY9-10 PFM Webinar Frequently Asked Questions (Excel), Attachment R - Measure Bundle Protocol (PDF), Attachment J - Program Funding and Mechanics Protocol (PDF), Accessible Version of Summary of DY7-8 Requirements (PDF), CMS Approval Letter for DSRIP Protocols (PDF), Revised Draft DY7-8 Measure Bundle Protocol (PDF) (8/4/17), Summary of Stakeholder Feedback on first Draft DY7-8 Measure Bundle Protocol (PDF) (8/4/17), Revised Draft Value Based Purchasing Roadmap (PDF) (8/4/17), Draft DY7-8 Measure Bundle Protocol (PDF) (6/22/17), Presentation for 6/20/17 Webinar on Draft DY7-8 Protocols (PDF) (6/22/17), Draft Category C Measure Specifications (PDF) (6/22/17), Draft Category C Measures (Excel) (6/22/17), Draft Value Based Purchasing Roadmap (PDF) (6/22/17), Revised Draft DSRIP DY7-8 PFM (PDF) (updated 8/4/17 to reflect changes in the DY7-8 Measure Bundle Protocol), Summary of Proposed DY7-8 Requirements (PDF) (5/17/17), Accessible version of Summary of Proposed DY7-8 Requirements (PDF) (5/17/17), Summary of Stakeholder Feedback on the First Draft DY7-8 PFM (PDF) (5/17/17), Budget Neutrality Summary (Excel) (12/21/17), Letter to CMS Requesting an Additional 21 Months (PDF), Letter to CMS on Waiver Negotiations - Oct. 6, 2016 (PDF), HHSC Letter to CMS about 1115 Waiver Extension (PDF), Texas Waiver Extension Approval Letter (PDF), Request for 15-Month Extension of the Texas 1115 Waiver (PDF), Addendum to RHP Planning Protocol for DY6A (PDF), CMS Approval Letter for the DY6 PFM Protocol (PDF), Updated Transformational Extension Protocol (Menu) with Best Practices/Models (PDF), Texas DSRIP Transition Year (DY6) Proposal Submitted to CMS (PDF), Summary of the Transformational Extension Protocol (Menu) for Replacement (PDF), DSRIP Extension Planning and Protocols Webinar (PDF), 1115 Waiver Extension Request Stakeholder Feedback (Excel), 1115 Transformation Waiver Extension Application (PDF), 1115 Transformation Waiver Interim Evaluation Report (PDF), Attachment A - Texas DSRIP Projects (PDF), Attachment B - Quality Monitoring Reports and Deliverables (PDF), Attachment C - Performance Indicator Dashboards and Pay-for-Quality Measures (PDF), Attachment D - 1115 Waiver Extension Budget Neutrality Calculations (PDF), Summary of Comments from Public Meetings on 1115 Waiver Extension (PDF), Waiver Renewal - Discussion of Key DSRIP Issues (PDF). Due to these application processing issues, Texas HHSC took the rare step of pushing SNAP renewals out 6 months. Mail Form H0025 when the client does not have a face-to-face interview or the client reports a change of address by telephone or by mail. Learn more about the July 2021 Extension Application below. State and federal government websites often end in .gov. It also means that states will continue to receive enhanced . School Health and Related Services (SHARS) are provided to students with a disability to ensure individuals benefit from special education programs. HHSC has encouraged health plans to use this option when responding to COVID-19. HHSC sought feedback on the 1115 Waiver Fast Track extension proposal posted below and submitted the proposal to CMS (see the CMS webpage for the Texas Healthcare Transformation and Quality Improvement Program). Medical and / or functional needs are assessed according to level of care (LOC) criteria published by the State in State rules. Expenditures Related to COVID-19 Response. Before sharing sensitive information, make sure youre on an official government site. TIERS mails Form H1010-R, which is pre-populated with basic client information. Annual aggregate expenditures under the 1115 extension are expected to increase consistent with historical state trends. You or your LAR should: Provider agencies are required to have back-up and emergency plans in place, which include if an in-home care provider cannot work because they are sick. On July 14, 2021, Texas submitted to CMS its request to extend and to amend the Texas Healthcare Transformation Quality Improvement Program waiver under section 1115 of the Social Security Act. Financial Management Services Agencies (FMSAs) can help you make CDS budget revisions as needed. The program is designed to defray costs associated with care, including behavioral health, immunizations, chronic disease prevention and other preventive services for the uninsured. Expenditures Related to the Uncompensated Care Pool. For example, Utah suspended renewals for its Childrens Health Insurance Program (CHIP) at the beginning of the pandemic, and when renewals resumed, an, not because the state determined they were no longer eligible. The extension request includes a request to create Public Health Provider-Charity Care Program. Click here for instructions on opening this form. SSI-Related Eligibles. For an individual to be eligible for HCBS services, the State must have determined that the individuals cost to provide services is equal to or less than 202 percent of the cost of the level of care in a nursing facility. What if I have questions about Texas Medicaid and CHIP renewal? Temporary Change on Living in Same Home Prohibitions. Midland, TX 79711-4700. Beginning Aug.1, 2021 pharmacies will no longer provide early refills. The State will deliver services authorized under the MDCP section 1915(c) waiver through the STAR Kids managed care model for those individuals not in state conservatorship. Health plans are currently identifying and informing eligible members of the option to upgrade, and conducting the STAR+PLUS HCBS Program assessment for program eligibility. To evaluate specific answers, refer to policies in the Texas Works Handbook. The agreement will take the program through December 2017 and will maintain its current funding. On Jan. 15, 2021, HHSC received Federal approval for the Texas Healthcare Transformation and Quality Improvement 1115 Demonstration Waiver. Proposed DPPs for state fiscal year 2022 include CHIRP, TIPPS Program, RAPPS Program, Directed Payment Program for BHS, QIPP for Nursing Facilities, and an Ambulance Services Directed Payment Program. To avoid further overloading Texas eligibility and enrollment systems, HHSC should follow federal guidance and limit the number of renewals they attempt in any given month after the Medicaid continuous coverage provision is lifted. Texas is requesting that in response to the public health emergency, CMS allow a one-time adjustment to budget neutrality to account for impacts of COVID-19 on enrollment and expenditures. To obtain a copy of the waiver attachments, ask questions, obtain additional information, obtain a hard copy of the waiver extension, or submit comments regarding this proposed extension application individuals may contact Amanda Sablan by U.S. mail Texas Health and Human Services Commission Attention: Amanda Sablan, Waiver Coordinator, Policy Development Support, PO Box 13247, Mail Code H-600, Austin, Texas 78711-3247, telephone 512-487-3446, fax Attention: Amanda Sablan, Waiver Coordinator, at 512-206-3975, or email at: TX_Medicaid_Waivers@hhsc.state.tx.us until December 27, 2020. All rights reserved. Renew Your Medicaid or CHIP Coverage | Medicaid Copyright 2016-2022. Expenditures made under contracts that do not meet the requirements in section 1903(m) of the Act specified below. A subsequent rebasing exercise to without waiver PMPMs is included effective FFY 2028 using FFY 2026 expenditures. The extension request is for approximately 10 years, which will allow the 1115 waiver authority to run through 2030. Form H1010-R is sent with Form H1830-R during the month before the last month of certification. Those children in state conservatorship who are eligible for the MDCP section 1915(c) waiver will receive those services through the STAR Health managed care program under the 1915(a) authority, rather than under the 1115 authority, and through contract with the STAR Health managed care organization. HHSC has updated the draft DSRIP PFM that describes proposed requirements for DSRIP participation in DY 7-8. Your health plan can cover teleservices, including in your home. i. This group consists of persons age 21 and older, who meet the nursing facility level of care (LOC), who qualify as members of the 217-Like HCBS Group, and who need and are receiving HCBS as an alternative to nursing facility care. 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