(a) Introduction. The Texas Healthcare Transformation
and Quality Improvement Program §1115(a) Medicaid demonstration
waiver provides for Delivery System Reform Incentive Payment (DSRIP)
program payments to eligible performers. In order to ensure that such
payments are made properly, the Health and Human Services Commission
(HHSC) will contract with one or more independent entities to monitor
the DSRIP program. This section describes the method by which HHSC
will gain the source of the non-federal share of payments to reimburse
the independent entity for its administrative expenses. For purposes
of this section, the definitions in §354.1729 of this title (relating
to Definitions) apply, except where otherwise indicated.
(b) Funding for DSRIP program monitoring. HHSC will
allocate an intergovernmental transfer (IGT) amount to each DSRIP
IGT entity to fund DSRIP monitoring activities.
(1) HHSC will determine the amount of the IGT allocation
in each demonstration year (DY) for each IGT entity. The amount of
the IGT allocation for each IGT entity will be calculated using the
following formula: IGT Allocation = (AffiliatedValue divided by DYValue)
multiplied by TotalIGT, where:
(A) "AffiliatedValue" is the portion of the value for
which the IGT entity agreed to fund the non-federal share for all
DSRIP performers that the IGT entity is affiliated with for a particular
DY;
(B) "DYValue" is the value for all DSRIP performers
in the state for the same DY as used in subparagraph (A) of this paragraph;
and
(C) "TotalIGT" is the total amount of IGT necessary
for monitoring activities in a DY, as determined by HHSC, which may
not be greater than $5 million.
(2) The values utilized in paragraph (1) of this subsection
are the official values as of January 1 of the calendar year in which
the calculation occurs.
(3) The full IGT allocation for monitoring will be
requested the first time an IGT entity provides an IGT for a DY.
(4) An IGT entity may choose to either provide the
IGT allocation from an IGT intended to fund a DSRIP payment or in
addition to an IGT to fund a DSRIP payment.
(c) Return of unused IGTs. The balance of any allocation
not used to fund monitoring activities will be returned to the IGT
entities. The amount returned is calculated on a pro rata basis in
accordance with the amount of such entities' IGTs intended to fund
the DSRIP monitoring program for the DY for which the refund is made.
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