HHSC 1115 Wavier and Stakeholder Meeting
During the September 23 HHSC Stakeholder meeting the 1115 Wavier along with other items were taken up. It was noted during the meeting that the TIERS rollout was completed the previous week and progress was made in the Medicaid Managed Care Expansion. 4 out of the 8 bidding MCO’s won an award for South Texas. In regards to the dental service carve-in, HHSC is working on a better policy for orthodontics since it appears to be over utilized.
In regards to the 1115 Waiver, HHSC and CMS were still working out the last details at that time but anticipated completion by the end of the month. It was noted that metrics will be developed after the waiver is 100% approved. HHSC will transition under the waiver program for a one year period, and the payments will be divided into two sub-pools: 1) Uncompensated care pool and 2) Delivery System Reform Incentive Payments (DSRIP) that will support coordinated care and quality improvements through regional health care partnerships (RHPs) and incentive payments to transfer hospital care delivery systems.
Also, on September 15, the House Committee on County Affairs, under the direction of Chairman Garnet Coleman, met for invited testimony on Texas Healthcare Transformation and Quality Improvement Program Medicaid 1115 Waiver. Chairman Coleman, who stated his support for the waiver and the program, clarified his committee has jurisdiction over county dollars, which are the “primary funder” of the program and the waiver.
Billy Millwee, associate commissioner for Medicaid and CHIP, said the waiver will be a profound change. He presented an overview of Medicaid and waivers: Presentation to House County Affairs Committee on Texas Healthcare Transformation and Quality Improvement Program 1115 Waiver – September 2011. Millwee stated the 1115 Waiver from CMS will allow Texas to preserve the IGT system that the UPL program runs on currently, with the ability to double the federal match from $15B to $30B if local funds are identified. Regional Health Care Partnerships will connect private hospitals to public hospitals or counties to increase state match for IGT. The intent is also to have a more transparent process to see how UPL funds are dispersed and spent. There will be a 12- month transition period with CMS to create financial stability.
A complete hearing report for all HillCo clients is available on the HillCo Client Communication and Resource website: http://login.hillcopartners.com/
