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.

This report presents findings from a large-scale study on the impacts of coronavirus disease 2019 (COVID-19) on vulnerable populations in Texas during the first year of the pandemic.

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 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 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.

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.

This presentation covers HHSC's Information Technology (IT) Modernization plan, an overview of the Medicaid program, the Medicaid Management Information Systems (MMIS) modernization project, and compliance with state regulations related to IT projects.