Texas Administrative Code (Last Updated: February 21,2024) |
TITLE 1. ADMINISTRATION |
PART 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION |
CHAPTER 354. MEDICAID HEALTH SERVICES |
SUBCHAPTER D. TEXAS HEALTHCARE TRANSFORMATION AND QUALITY IMPROVEMENT PROGRAM |
DIVISION 8. DSRIP PROGRAM DEMONSTRATION YEARS 9-10 |
SECTION 354.1737. RHP Plan Update for DY9-10
Latest version.
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(a) A performer may receive DSRIP only if HHSC has approved the RHP plan update for DY9-10 for the performer's RHP. (b) An RHP plan update for DY9-10 must: (1) meet the requirements listed in the Program Funding and Mechanics Protocol and the Measure Bundle Protocol; (2) update the RHP's community needs assessment, if needed; (3) include a list of IGT entities, performers, and other stakeholders involved in the development of the RHP plan update; (4) include signed certifications from the performer's leadership and the performer's affiliated IGT entities that all the information contained within the RHP plan update for DY9-10 is true and accurate; (5) describe the processes used to engage stakeholders including the public meetings held; (6) include the total amount of estimated DSRIP funding to be used by demonstration year (DY); (7) include for each performer: (A) an updated definition of the performer's system, if needed; (B) any updates to the performer's DY7-8 Category A core activities for DY9-10; (C) updates to the performer's Category B total Patient Population by Provider (PPP) or MLIU PPP for DYs 5-8, if needed; (D) the forecasted number of Medicaid individuals served in DY9-10 and the forecasted number of LIU individuals served in DY9-10 based on the number of MLIU individuals served in DY7-8; (E) if the performer is a hospital or physician practice: (i) the performer's selected Category C Measure Bundles and measures for DY9-10; (ii) the performer's requests for allowable changes to its selected Category C Measure Bundles and measures, as described in §354.1753(a)(1)(E) of this division (relating to Category C Requirements for Performers), the Program Funding and Mechanics Protocol and Measure Bundle Protocol; and (iii) the related strategies associated with each of the performer's Category C Measure Bundles for DY9-10. (F) if the performer is a community mental health center or local health department: (i) the performer's selected Category C measures for DY9-10; (ii) the performer's requests for allowable changes to its selected Category C measures, as described in §354.1753(b)(1)(E) and §354.1753(c)(1)(F) of this division, the Program Funding and Mechanics Protocol and Measure Bundle Protocol; and (iii) the related strategies associated with each of the performer's Category C measures for DY9-10. (G) the performer's Category D Statewide Reporting Measure Bundle; (H) the performer's DSRIP valuation amounts; and (I) the performer's sources of non-federal funds by category and DY; and (8) include a narrative explaining the performer's rationale for its Category C Measure Bundle and measure selections for DY9-10. Source Note: The provisions of this §354.1737 adopted to be effective November 12, 2019, 44 TexReg 6854; amended to be effective December 2, 2020, 45 TexReg 8514