Reports and Presentations

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

Capitation Rate Setting Strategy Used to Cover Long-Term Services and Supports Provided to Recipients Under the STAR+PLUS Medicaid Managed Care Program Report - September 2022

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.

Medicaid Managed Care Provider Network Adequacy Report - December 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) - 2022

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

Feasibility of Creating an Online Portal for the Medicaid Waiver Interest List - January 2023

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.

Summary of Significant Audit Findings for Local Mental Health Authorities for Fiscal Year 2021

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.

Internal Audit Plan - Fiscal Year 2023 Revisions

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.

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

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

Funding Impacts of the Delivery System Reform Incentive Payment Program Transition - 2022

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.

Internal Audit Annual Report - Fiscal Year 2022

The Internal Audit Annual Report provides a summary of its 2022 activities which complies with the guidelines set forth by the State Auditor’s Office.

Dually Eligible Individuals Enrolled in Medicaid Managed Care Supplemental Report - 2022

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.