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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 2REGIONAL HEALTHCARE PARTNERSHIPS
RULE §354.1612Anchors

(a) Only one entity in a Regional Healthcare Partnership (RHP) may be an anchor.

(b) An entity may be an anchor if it meets the following criteria:

  (1) The anchor must be a governmental entity.

  (2) If an RHP includes a public hospital, the anchor must be a public hospital, except as described in paragraph (3) of this subsection.

  (3) If an RHP does not include a public hospital, or if no public hospital wants to be an anchor, the anchor must be:

    (A) a hospital district;

    (B) a hospital authority;

    (C) a county; or

    (D) a state university with an academic health science center.

  (4) If a region cannot agree on an anchor, HHSC will designate the anchor. HHSC will base its decision on criteria such as ability to financially support necessary administrative activities, prior relationships with other participants in the region, and history of participating in community and regional activities outside of the waiver.

(c) An anchor must:

  (1) serve as the single point of contact with HHSC for the RHP, except as specified in rule;

  (2) facilitate transparent and inclusive meetings among participants to discuss RHP activities;

  (3) coordinate RHP activities to help ensure that participants properly address both the needs of the region and the requirements placed upon the RHP;

  (4) develop the RHP needs assessment included in the RHP plan;

  (5) compile and submit the RHP plan to HHSC, as prescribed by HHSC;

  (6) prepare and submit an annual progress report on behalf of the RHP, in accordance with HHSC requirements;

  (7) ensure that all confidential information obtained through its role as an anchor remains confidential as required by state and federal laws and regulations;

  (8) ensure that all waiver information provided to it in its capacity as anchor is distributed to the RHP participants;

  (9) post the most recent approved RHP plan and any proposed RHP plan modifications to the RHP website; and

  (10) meet all other requirements as specified in the Program Funding and Mechanics Protocol.

(d) An anchor must not:

  (1) request reimbursement from a Medicaid provider for the discharge of the anchor's responsibilities, although an anchor and other governmental entities within the RHP may agree to share such costs;

  (2) delegate decision-making responsibilities concerning the interpretation of the waiver, HHSC policy, or actions or decisions that involve the exercise of discretion or judgment;

  (3) require any IGT entity to fund any project;

  (4) require any participant to act as a performer in any DSRIP project; or

  (5) prevent or in any way prohibit the development of a DSRIP project between an IGT entity and a performer.

(e) An anchor may delegate ministerial functions such as data collection and reporting. Any entity to which ministerial functions are delegated under this subchapter must comply with the roles, responsibilities, and limitations of an anchor.

(f) In addition to any reimbursement received under §354.1634(e) of this subchapter (relating to Waiver Pool Allocation), an anchor may be reimbursed for the cost of its administrative duties conducted on behalf of the RHP. The anchor must provide an intergovernmental transfer to HHSC for the purpose of obtaining federal matching funds in accordance with the Administrative Cost Claiming Protocol so that it can be reimbursed for such costs. An anchor may not recover more than the anchor's actual costs.


Source Note: The provisions of this §354.1612 adopted to be effective October 31, 2012, 37 TexReg 8453; amended to be effective September 30, 2014, 39 TexReg 7570

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