Reports and Presentations

Note: These files are in PDF format unless otherwise noted.

December 30, 2022

Capitation Rate Setting Strategy Used to Cover Long-Term Services and Supports Provided to Recipients Under the STAR+PLUS Medicaid Managed Care Program Report

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.

December 28, 2022

Report on Medicaid Managed Care Provider Network Adequacy FY 2022

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

Texas Medicaid and CHIP Reference Guide, Fourteenth Edition (Pink Book)

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

December 27, 2022

Medicaid Waiver Interest List Feasibility Study Legislative Report FY 2022

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.

December 16, 2022

Rural Texas Pediatric Tele-Connectivity Resource Program FY 2022 Report

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.

November 14, 2022

Utilization Review in STAR+PLUS Managed Care Report for Fiscal Year 2022

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

November 10, 2022

Funding Impacts of the Delivery System Reform Incentive Payment Program Transition

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.

November 2, 2022

Office of the State Long-term Care Ombudsman: Ombudsman Annual Report SFY 2021-2022

This report is issued to inform the public of the work of the State Long-Term Care Ombudsman Program on behalf of residents of nursing facilities and assisted living facilities. The report includes information and findings relating to the problems and concerns of residents and recommendations to solve the problems, resolve the concerns, and improve the quality of the residents’ care and lives.

October 4, 2022

Study on Dually Eligible Individuals Enrolled in Medicaid Managed Care Supplemental Legislative Report

The supplemental report builds on the information provided in the September 2022 Dually Eligible Individuals Enrolled in Medicaid Managed Care report and provides HHSC’s findings regarding the cost-effectiveness of transitioning Medicaid-only services for dually eligible people into Medicaid managed care and requiring cost-sharing for those services, considerations of the costs associated with the operational and systematic changes needed to implement the transition and a recommendation as to whether the transition and cost-sharing should be implemented.

May 23, 2022

Quarterly IJ Summary Report October 2021 – December 2021

The following report presents information regarding all tags cited at the Immediate Jeopardy (IJ) level during licensing and certification surveys and complaint or incident investigations performed in nursing facilities during the fourth quarter of 2021 (10/01/2021 – 12/31/2021).