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.

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.

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.

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.

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.

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).