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TITLE 1ADMINISTRATION
PART 15TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 355REIMBURSEMENT RATES
SUBCHAPTER JPURCHASED HEALTH SERVICES
DIVISION 11TEXAS HEALTHCARE TRANSFORMATION AND QUALITY IMPROVEMENT PROGRAM REIMBURSEMENT
RULE §355.8200Retained Funds for the Uncompensated Care Program

(a) Introduction. Texas Healthcare Transformation and Quality Improvement Program under §1115(a), Medicaid demonstration waiver payments available under this division help to defray the uncompensated cost of charity care provided by eligible hospitals and physician practices on or after October 1, 2019. Participation in the Texas Healthcare Transformation and Quality Improvement Program is subject to an application fee.

(b) Definition. A non-public provider, when the term is used in this section, is defined as a provider who is owned by any entity other than a unit of local, state, or federal government.

(c) Applicability. The requirement to submit an application fee applies to all non-public providers in the state.

(d) Application Fee. An application fee will be required with the submission of the application described in §355.8212(c)(2) of this subchapter.

  (1) The application fee will be determined annually based upon an estimate of the amount equal to the estimated costs necessary to administer the program and will be posted on the Texas Health and Human Services Commission Provider Finance Department website.

  (2) Payment is due at the time of the submission of the application. If no payment is received with the application, an account receivable will be established. HHSC will offset the next applicable payment to the provider against the account receivable until the obligation to the state is discharged.

  (3) Payment must be made in the manner determined by HHSC and in compliance with payment instructions that will be posted on the HHSC Provider Finance Department website.

(e) Uses of the Funds and Limitations.

  (1) The total amount received from the application fee may not exceed $8,000,000 annually when combined with any other funds retained under the authority of Texas Government Code §531.021135.

  (2) HHSC will spend money retained under this section to assist in paying the costs necessary to administer the program for which the money is received. HHSC will not use the money to pay any type of administrative cost that was funded with general revenue before June 1, 2019.


Source Note: The provisions of this §355.8200 adopted to be effective November 28, 2021, 46 TexReg 7871

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