Reports and Presentations

This report provides preliminary findings from the 2019 utilization review of the Managed Care STAR+PLUS review.

This annual report builds on the previous annual report, submitted in January 2019, which provided outcomes related to transitioning children and young adults enrolled in the Medically Dependent Children Program (MDCP) into the STAR Kids capitated managed care program.

This second report describes HHSC Value-Based Care Strategy Background, Managed Care Value-Based Payments Programs, The 1115 Healthcare Transformation Waiver, specifically the Delivery System Reform Incentive Payment Program, The Directed-Payment Programs, Trends in Key Quality Measures, HIV Viral Suppression and the number of individuals who relocated to a community setting.

HHSC is committed to improving the quality of life for individuals with intellectual disabilities who reside at the SSLCs. This report highlights ongoing efforts as of August 2019 to achieve targeted improvements in services and supports provided to enhance compliance with the DOJ settlement agreement.

The report includes the prescription drug rebate outstanding principal and interest amounts, age of receivables, annual collection rates, billed amounts, dollar value of pricing and utilization adjustments, and dollars collected. This report includes a separate prescription drug rebate collection report for each managed care and fee-for-service rebate program.

Texas Government Code Section 531.0999 added by Senate Bill (S.B.) 578, 85th Legislature, Regular Session, 2017, requires the Health and Human Services Commission (HHSC) to develop a comprehensive action plan to increase access to and availability of professional health services to prevent veteran suicides in Texas.

The 2019 Rider 207 report details the agency’s latest data on the direct care workforce and related topics, provides status updates on strategies that were mentioned in the 2018 report, and discusses additional potential strategies that were not mentioned in the 2018 report.

Provides information on the State Opioid Response grant received from SAMHSA and the implementation and goals of these funds through the Texas Targeted Opioid Response program.

The report summarizes the exchange of information between agencies to support continuity of care services for individuals with mental illness involved in the criminal justice system; and supplement local post-booking jail diversion activities.

The report provides an evaluation of Medicaid funding initiatives for rural inpatient and outpatient hospital services, including the percentage of estimated allowable hospital cost reimbursed by payments for services provided to managed care clients; the percentage of wrongful denials; the average wait time for final payment; and any remedies taken to improve compliance of vendors.