An official State of Texas website.
HHSC has received federal approval of a waiver that allows the state to expand Medicaid managed care while preserving hospital funding, provides incentive payments for health care improvements and directs more funding to hospitals that serve large numbers of uninsured patients.
Recent Updates
- On June 11, 2025, at 9 a.m., HHSC will hold a hybrid public forum with both virtual and in person options, to present updates on the Texas Healthcare Transformation and Quality Improvement Program 1115 demonstration. The public forum will be held in conjunction with the quarterly Medical Care Advisory Committee (MCAC) meeting and will be held at the Texas Health and Human Services Commission, John H. Winters Building, Public Hearing Room 125, First Floor, 701 West 51st Street, Austin, Texas 78751. The agenda, including instructions for attending and providing oral or written comments in person or virtually, will be posted on this website once confirmed.
- Read the most recent 1115 annual report, Demonstration year 13 (Oct. 2023-Sept. 2024) (PDF)
- On September 24, 2024, the Centers for Medicare & Medicaid Services (CMS) approved the following items for the Texas Healthcare Transformation and Quality Improvement Program (THTQIP) 1115 demonstration:
- The Public Health Provider – Charity Care Program pool limits for DY 13 – DY 17,
- Technical corrections and clarifications to the Attachment H Protocol and the Uncompensated Care cost report tool,
- A technical correction to the Special Terms and Conditions (STCs) to reflect the extension of continuous postpartum Medicaid coverage in Texas to 12 months, and
- An update to Attachment Q, Delivery System Reform Incentive Payment Transition Plan, to reflect counties that currently participate in the Texas Dual-Eligibles Integrated Care Demonstration Project.
Read the updated STCs and attachments.
- On May 14, 2024, at 9 a.m., HHSC held a hybrid public forum with both virtual and in person options, to present updates on the Texas Healthcare Transformation and Quality Improvement Program 1115 demonstration. The public forum was held in conjunction with the quarterly Medical Care Advisory Committee (MCAC) meeting and was held at the Texas Health and Human Services Commission, John H. Winters Building, Public Hearing Room 125, First Floor, 701 West 51st Street, Austin, Texas 78751.
- On June 8, 2023, at 9 a.m., HHSC held a hybrid public forum with both virtual and in person options, to present updates on the Texas Healthcare Transformation and Quality Improvement Program 1115 demonstration. The public forum was held in conjunction with the quarterly Medical Care Advisory Committee (MCAC) meeting and was held at the Texas Health and Human Services Commission, John H. Winters Building, Public Hearing Room 125, First Floor, 701 West 51st Street, Austin, Texas 78751.
- On June 8, 2022, CMS issued technical corrections to the Special Terms and Conditions to Texas’ section 1115 Texas Healthcare Transformation and Quality Improvement Program (THTQIP) waiver. Read the STC Technical Corrections.
- On Aug. 2, 2022, CMS approved the Interim Evaluation Report for the 1115 Evaluation Design Plan associated with the demonstration approval period between Jan. 1, 2018 and Sept. 30, 2022. Read the approved Interim Evaluation Report.
- On May 26, 2022, CMS approved the 1115 Evaluation Design Plan for the demonstration extension authorized through September 2030. Read the approved 1115 Evaluation Design Plan.
- On June 9, 2022, at 10 a.m., HHSC held a hybrid public forum with both virtual and in person options, to present updates on the Texas Healthcare Transformation and Quality Improvement Program 1115 demonstration.
- On July 14, 2021, at 9:30 a.m. HHSC held a virtual-only public forum to present updates on the Texas Healthcare Transformation and Quality Improvement Program 1115 waiver extension that was approved on Jan. 15, 2021.
- On June 21, 2021, at 1 p.m. HHSC held a virtual-only public forum to present updates on the Texas Healthcare Transformation and Quality Improvement Program 1115 waiver and receive public comments.
- On Jan. 15, 2021, HHSC received Federal approval for the Texas Healthcare Transformation and Quality Improvement 1115 Demonstration Waiver (PDF).
- HHSC has posted the 1115 waiver Special Terms and Conditions, “Fast Track” application template, and Extension Appendices for public comment on the 1115 Waiver Renewal page.