Medicaid 1115 Waiver

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 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.