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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 3RHP PLAN CONTENTS AND APPROVAL
RULE §354.1623RHP Plan Modifications and the Addition of Three-Year DSRIP Projects

(a) A performer may submit an RHP plan modification request to HHSC to modify elements of an existing DSRIP project prospectively, including changes to milestones and metrics.

  (1) The final opportunity to submit a plan modification request for the fourth demonstration year will coincide with the end of the mid-point assessment described in §354.1624 OF THIS DIVISION (relating to the Independent Assessment of DSRIP Projects). A performer will have an opportunity to initiate a plan modification for the fourth and fifth demonstration years by August 2014. Any plan modifications after August 2014 will be initiated by either HHSC or the independent assessor as part of the mid-point assessment.

  (2) A performer may submit a plan modification request during the fourth demonstration year for changes during the fifth demonstration year only for changes to Category 3 outcomes and three-year DSRIP projects.

(b) If an RHP does not utilize its entire allocation for the second demonstration year, the remaining allocation can be utilized by HHSC for state initiatives. These initiatives must be accomplished through the DSRIP program.

(c) If an RHP does not utilize its entire allocation for the third, fourth, and fifth demonstration year, that RHP may propose three-year DSRIP projects. Each RHP must submit a list of all DSRIP projects from which the three-year DSRIP projects are selected.

  (1) Each three-year DSRIP project on the list must be chosen from a subset of the RHP Planning Protocol as determined by HHSC.

  (2) Each three-year DSRIP project on the list must include at least one implementation milestone in the third demonstration year.

  (3) An RHP must prioritize the three-year DSRIP projects based on regional needs except that the listed projects must alternate by affiliated IGT entity.

  (4) Each three-year DSRIP project must identify, and have written confirmation, of the IGT source.

  (5) Each three-year DSRIP project must demonstrate significant benefit to the Medicaid and indigent populations.

  (6) An RHP must hold a public meeting to consider the list of three-year DSRIP projects prior to submitting the list to HHSC. When submitting the list to HHSC, the RHP must also submit:

    (A) a description of the processes used to engage potential performers, public stakeholders, and consumers;

    (B) a description of the regional approach for evaluating and prioritizing DSRIP projects; and

    (C) a list of DSRIP projects that were considered by the RHP but not included on the list, regardless of whether or not those DSRIP projects had an identified source of IGT.


Source Note: The provisions of this §354.1623 adopted to be effective September 30, 2014, 39 TexReg 7570

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