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(A)To qualify for a payment from Component Two, a
NF must meet at least the initial quarterly goal of 1.7 percent improvement
from the baseline, with subsequent quarterly goals increasing to a
maximum of seven percent by the end of the eligibility period. For
example, to qualify for a payment from Component Two for a quality
metric for the second quarter of the eligibility period, the NF must
meet at least the second quarter goal of 3.4 percent improvement from
the baseline.
(B)To qualify for a payment from Component Three,
a NF must meet at least the initial quarterly goal of 5.0 percent
improvement from the baseline with subsequent quarterly goals increasing
to a maximum of 20 percent by the end of the eligibility period. For
example, to qualify for a payment from Component Three for a quality
metric for the second quarter of the eligibility period, the NF must
meet at least the second quarter goal of 10.0 percent improvement
from the baseline. A NF that qualifies for a payment from Component
Three for a metric automatically qualifies for a payment from Component
Two for the same metric.
(C)A NF that exceeds the benchmark for a metric qualifies
for a payment from both Component Two and Component Three for that
metric. A NF that exceeds the benchmark may decline in performance
and still qualify for a payment from both Component Two and Component
Three as long as the NF continues to exceed the benchmark for the
metric.
(j)Changes of ownership.
(1)If an enrolled NF changes ownership during the
eligibility period to private ownership, the NF under the new ownership
must meet the private NF eligibility requirements described in this
section in order to continue QIPP participation during the eligibility
period.
(2)If a non-state government-owned NF changes ownership
during the eligibility period to another non-state governmental entity,
the NF under the new ownership must meet the non-state government-owned
eligibility requirements described in this section in order to continue
QIPP participation during the eligibility period.
(k)Recoupment. Payments under this section may be
subject to recoupment as described in §353.1301(k) of this subchapter.
The agency certifies that legal counsel has reviewed
the proposal and found it to be within the state agency's legal authority
to adopt.
Filed with the Office
of the Secretary of State on January 9, 2017
TRD-201700103 Karen Ray
Chief Counsel
Texas Health and Human Services Commission
Earliest possible date of adoption: February 19, 2017
For further information, please
call: (512) 424-6900
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