| (B) ACIA will be determined by HHSC to be a percentage
that is estimated to result in payments for the hospital that are
equivalent to the amount described under subsection (g)(3)(A) of this
(2) HHSC will limit the percentage rate increases determined
pursuant to this subsection to no more than the levels that are supported
by the amount described in subsection (j)(3) of this section. Nothing
in this section may be construed to limit the authority of the state
to require the sponsoring governmental entities to transfer additional
funds to HHSC following the reconciliation process described in §353.1301(g)
of this subchapter, if the amount previously transferred is less than
the non-federal share of the amount expended by HHSC in the SDA for
(3) After determining the percentage of rate increase
using the process described in paragraphs (1) and (2) of this subsection,
HHSC will modify its contracts with the MCOs in the SDA to direct
the percentage rate increases.
(j) Non-federal share of CHIRP payments. The non-federal
share of all CHIRP payments is funded through IGTs from sponsoring
governmental entities. No state general revenue is available to support
(1) HHSC will communicate suggested IGT responsibilities
for the program period with all CHIRP hospitals at least 10 calendar
days prior to the IGT declaration of intent deadline. Suggested IGT
responsibilities will be based on the maximum dollars to be available
under the CHIRP program for the program period as determined by HHSC,
plus eight percent; and forecast member months for the program period
as determined by HHSC. HHSC will also communicate estimated revenues
each enrolled hospital could earn under CHIRP for the program period
with those estimates based on HHSC's suggested IGT responsibilities
and an assumption that all enrolled hospitals will meet 100 percent
of their quality metrics and maintain consistent utilization with
the prior year.
(2) Sponsoring governmental entities will determine
the amount of IGT they intend to transfer to HHSC for the entire program
period and provide a declaration of intent to HHSC no later than 21
business days before the first half of the IGT amount is transferred
(A) The declaration of intent is a form prescribed
by HHSC that includes the total amount of IGT the sponsoring governmental
entity intends to transfer to HHSC.
(B) The declaration of intent is certified to the best
knowledge and belief of a person legally authorized to sign for the
sponsoring governmental entity but does not bind the sponsoring governmental
entity to transfer IGT.
(3) HHSC will issue an IGT notification to specify
the date that IGT is requested to be transferred no fewer than 14
business days before IGT transfers are due. Sponsoring governmental
entities will transfer the first half of the IGT amount by a date
determined by HHSC, but no later than June 1. Sponsoring governmental
entities will transfer the second half of the IGT amount by a date
determined by HHSC, but no later than December 1. HHSC will publish
the IGT deadlines and all associated dates on its Internet website
no later than March 15 of each year.
(k) Effective date of rate increases. HHSC will direct
MCOs to increase rates under this section beginning the first day
of the program period that includes the increased capitation rates
paid by HHSC to each MCO pursuant to the contract between them.
(l) Changes in operation. If an enrolled hospital closes
voluntarily or ceases to provide hospital services in its facility,
the hospital must notify the HHSC Provider Finance Department by hand
delivery, United States (U.S.) mail, or special mail delivery within
10 business days of closing or ceasing to provide hospital services.
Notification is considered to have occurred when the HHSC Provider
Finance Department receives the notice.
(m) Reconciliation. HHSC will reconcile the amount
of the non-federal funds actually expended under this section during
the program period with the amount of funds transferred to HHSC by
the sponsoring governmental entities for that same period using the
methodology described in §353.1301(g) of this subchapter.
(n) Recoupment. Payments under this section may be
subject to recoupment as described in §353.1301(j) and §353.1301(k)
of this subchapter.