(a) To be eligible for the MLIU QPI milestone payment,
beginning in the transition year, performers must report for each
DSRIP project the MLIU individuals served or encounters provided at
the individual or encounter level as opposed to the percentage of
total QPI.
(b) There are limited exceptions to this requirement.
Performers may request an exception to this requirement by a date
to be determined by HHSC. DSRIP projects eligible for an exception
include:
(1) a DSRIP project for which the performer did not
assess the DSRIP project participants' health insurance coverage or
financial status prior to September 30, 2015, and instead used a proxy
to estimate the MLIU population served in their October DY4 QPI Reporting
Template, and:
(A) utilizes an intervention site that is a school,
non-medical social service office (i.e., shelter), or community health
fair;
(B) is in Project Area 1.6 (Enhance Urgent Medical
Advice), 2.6 (Implement Evidence-based Health Promotion), or 2.7 (Implement
Evidence-based Disease Prevention Programs); or
(C) the performer is a Local Health Department that
does not bill Medicaid for the types of services provided through
the DSRIP project; or
(2) any other DSRIP project that HHSC determines has
a strong justification for an exception.
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