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The CHART Model is a funding opportunity from the Centers for Medicare and Medicaid Services. The CHART Model is a voluntary opportunity for rural communities to test health care transformation supported by payment reform.
Topics: Medicaid Business Resources
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Information on how to file Medicaid fee-for-service and managed care complaints and appeals.
Topics: Health, Medicaid Business Resources
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Texas Medicaid and CHIP provider resources include information on provider enrollment and re-enrollment, rate analysis, the CHIP Perinatal program, physician-administered drugs and communications resources.
Topics: Medicaid Business Resources
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Directed payment programs must be evaluated to show that the payment arrangement is advancing the goals of the Texas Managed Care Quality Strategy.
Topics: Medicaid Business Resources
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The QIPP is a state directed payment program (DPP) for Texas nursing facilities serving residents enrolled in the STAR+PLUS Medicaid managed care program. Providers earn payments for meeting participation and performance requirements across four components.
Topics: Medicaid Business Resources, Long-term Care Providers
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This End of Continuous Medicaid Coverage Ambassador Toolkit is available to help members, providers, health plans, and advocates prepare for the end of continuous Medicaid coverage.
Topics: Health, Medicaid Business Resources
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Instructions and resources for Provider Appeals to HHSC Medical and UR Appeals.
Topics: Health, Medicaid Business Resources
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The Texas Incentives for Physicians and Professional Services program is one of four directed payment programs HHSC has submitted for CMS approval as part of the Delivery System Reform Incentive Payment Transition Plan.
Topics: Medicaid Business Resources, Financial
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The Rural Access to Primary and Preventive Services program is one of four directed payment programs HHSC has submitted for CMS approval as part of the Delivery System Reform Incentive Payment Transition Plan.
Topics: Medicaid Business Resources, Financial, Data
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The Directed Payment Program for Behavioral Health Services is one of four directed payment programs HHSC has submitted for CMS approval as part of the Delivery System Reform Incentive Payment Transition Plan.
Topics: Medicaid Business Resources, Behavioral Health Services Providers, Financial, Data
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The Comprehensive Hospital Increased Reimbursement Program is one of four directed payment programs HHSC has submitted for CMS approval as part of the Delivery System Reform Incentive Payment Transition Plan.
Topics: Medicaid Business Resources, Financial, Data
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Directed Payment Programs are designed to help Medicaid managed care programs achieve delivery system and payment reform and performance improvement.
Topics: Medicaid Business Resources, Financial
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HHSC created the Rural Hospital Services Strategic Plan to improve health care access and outcomes in rural communities.
Topics: Medicaid Business Resources, COVID-19, Licensing and Credentialing
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Information about Supplemental Payment Programs for Texas Medicaid Providers.
Topics: Medicaid Business Resources
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Uniform Hospital Rate Increase Program is a statewide program that provides for increased Medicaid payment for inpatient and outpatient services. Texas Medicaid MCOs receive additional funding through their monthly capitation rate from HHSC and are directed to increase payment rates for certain hospitals.
Topics: Medicaid Business Resources