Reports and Presentations

A study to assess the impact of revising the capitation rate setting strategy used to cover long-term care services and supports provided to members enrolled in the STAR+PLUS Medicaid managed care program, from a strategy based on the setting in which services are provided to a strategy based on a blended rate across settings.

This report provides information about Medicaid managed care provider network contract requirements and HHSC efforts to monitor Medicaid managed care provider networks.

The Texas Medicaid and CHIP Reference Guide, also called the Pink Book, provides an overview of the Texas Medicaid and CHIP programs.

The Texas Health and Human Services Commission (HHSC) assessed the feasibility of creating an online portal for individuals to both request and check placement on a Medicaid waiver program interest list. Through this study, HHSC determined the most cost-effective automated method for determining the level of need of an individual seeking services.

Texas Health and Safety Code, Section 534.068(f) requires HHSC to submit a report to the legislature that includes a summary of the significant findings identified during a review of fiscal audit activities.

This report provides updates on the improvement process for reducing the time it takes for nursing facility providers undergoing a change of ownership (CHOW) to receive payment for services to Medicaid clients.

This third biennial submission of the Pediatric Tele-Connectivity Resource Program for Rural Texas (Pedi Tele-Conn Program) report includes updated and new information (since the December 2020 report) on grants awarded to nonurban healthcare facilities to implement telemedicine services that connect these facilities to pediatric specialists and pediatric subspecialists who provide telemedicine services. The report discusses the outcome of 2020-21 biennium grants program projects, responses to the 2022-23 biennium grants program request for applications (RFA), and program implementation challenges and lessons learned.

The Internal Audit Plan is a list of the scheduled audits to be conducted in FY23 based on a business risk assessment focused on identifying and evaluating risks related to each major HHS activity and input from management. This addendum summarizes revisions made to the Internal Audit Plan for fiscal year 2023.

This report provides findings and recommendations from the 2022 Utilization Review of the STAR+PLUS Managed Care program.

This report summarizes the transition of directed payment programs from the Delivery System Reform Incentive Payment (DSRIP) program. It also lists five recommendations for financial stability throughout the DSRIP transition.