Texas Administrative Code

Texas Administrative Code

TITLE 1	ADMINISTRATION
PART 15	TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 355	REIMBURSEMENT RATES
SUBCHAPTER J	PURCHASED HEALTH SERVICES
DIVISION 11	TEXAS HEALTHCARE TRANSFORMATION AND QUALITY IMPROVEMENT PROGRAM REIMBURSEMENT
RULE §355.8201	Waiver Payments to Hospitals for Uncompensated Care

(C) After the first pass allocation, HHSC will cap non-state providers at their final remaining UCC. A second pass allocation will occur in the event non-state providers were paid over their final remaining UCC after the weight in subsection (k)(2)(A) of this section was applied. HHSC will calculate the second pass by dividing the final remaining UCC calculated in the reconciliation described in subsection (i) of this section by the total remaining UCCs for all non-state providers after accounting for first pass payments. HHSC will multiply the quotient by the total amount of funds in excess of total UCCs for non-state providers capped at their total UCC.

(l) Penalty for failure to complete Category 4 reporting requirements for Regional Healthcare Partnerships. Hospitals must comply with all Category 4 reporting requirements set out in Chapter 354 of this title, Subchapter D (relating to Texas Healthcare Transformation and Quality Improvement Program). If a hospital fails to complete required Category 4 reporting measures by the last quarter of a demonstration year:

(1) the hospital will forfeit its uncompensated-care payments for that quarter; or

(2) the hospital may request from HHSC a six-month extension from the end of the demonstration year to report any outstanding Category 4 measures.

(A) The fourth-quarter payment will be made upon completion of the outstanding required Category 4 measure reports within the six-month period.

(B) A hospital may receive only one six-month extension to complete required Category 4 reporting for each demonstration year.

Source Note: The provisions of this §355.8201 adopted to be effective July 1, 2012, 37 TexReg 4581; amended to be effective June 13, 2013, 38 TexReg 3526; amended to be effective June 12, 2014, 39 TexReg 4419; amended to be effective September 1, 2014, 39 TexReg 6407; amended to be effective May 3, 2015, 40 TexReg 2259; amended to be effective November 26, 2018, 43 TexReg 7519; amended to be effective March 17, 2020, 45 TexReg 1849; amended to be effective July 15, 2020, 45 TexReg 4738; amended to be effective December 31, 2020, 45 TexReg 9408