Balancing Incentive Program

What is the Balancing Incentive Program?

Federal law established the Balancing Incentive Program (BIP) which increases the Federal Medical Assistance Percentage to participating states through September 2015 in exchange for states making certain structural reforms to increase access to Medicaid community based long-term services and supports (LTSS).

These required structural reforms include

  • implementing a "no wrong door" eligibility and enrollment system;
  • developing core standardized assessment instruments; and
  • ensuring case management activities are conflict free.

The Texas Health and Human Services Commission (HHSC) and the Texas Department of Aging and Disability Services (DADS) submitted an application to the federal Centers for Medicare and Medicaid Services (CMS) to participate in the BIP (PDF format). On September 4, 2012, CMS approved the state's BIP application.

Texas must implement the required structural changes and achieve a 50 percent benchmark of Medicaid community-based LTSS expenditures by October 2015. Click here to access the BIP website. This website provides additional information about the BIP goals and requirements for states to receive BIP enhanced funding.

HHSC has delegated coordination of BIP activities to DADS. DADS held stakeholder meetings in 2012 to solicit public input on how to design the program. Click here for a list of all stakeholder recommendations DADS received (PDF format).

Balancing Incentive Program Workplan

The BIP workplan (PDF) outlines how DADS will implement the Balancing Incentive Program.