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TITLE 1ADMINISTRATION
PART 15TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 354MEDICAID HEALTH SERVICES
SUBCHAPTER DTEXAS HEALTHCARE TRANSFORMATION AND QUALITY IMPROVEMENT PROGRAM
DIVISION 8DSRIP PROGRAM DEMONSTRATION YEARS 9-10
RULE §354.1737RHP Plan Update for DY9-10

(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

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