The Rural Access to Primary and Preventive Services program is one of four directed payment programs (DPPs) HHSC submitted to the Centers for Medicare and Medicaid Services (CMS) for approval as part of the Delivery System Reform Incentive Payment Transition Plan. CMS approved RAPPS for state fiscal year (SFY) 2022 (Year [Y]1) on March 25, 2022. CMS approved RAPPS for SFY 2023 (Y2) on August 1, 2022.
Background
RAPPS is a DPP for rural health clinics (RHCs) that incentivizes the provision of primary and preventive services to individuals enrolled in the STAR, STAR+PLUS, and STAR Kids Medicaid managed care programs.
The program includes two components:
- Component 1 provides a uniform dollar increase in the form of prospective, monthly payments to all participating RHCs. The amount of the increase varies by RHC class.
- Component 2 is a uniform percent rate increase for certain services to incentivize preventive care and services to manage individuals' chronic conditions.
Proposed SFY 2024 (Y3) Measures and Requirements
The proposed quality requirements and measures are submitted to CMS for annual program review and approval. The final quality measures and reporting requirements will be posted following CMS’ approval.
- Proposed Y3 Requirements (PDF) (2/23/2023)
- Proposed Y3 Measure Specifications (Excel) (2/23/2023)
- Proposed Y3 Measure Specifications FAQs (Excel) (2/23/2023)
- Stakeholder Feedback for Y3 (PDF) (2/23/2023)
SFY 2023 (Y2) Measures, Requirements, and Evaluation
- Y2 Requirements (PDF) (1/10/2022)
- Y2 Measure Specifications (Excel) (9/23/2022)
- Y2 Measure Specifications FAQs (Excel) (9/23/2022)
- Stakeholder Feedback for Y2 (PDF) (3/1/2022)
SFY 2022 (Y1) Measures, Requirements, and Evaluation
- Y1 Requirements (PDF) (3/1/2022)
- Y1 Measure Specifications (Excel) (8/9/2022)
- Y1 Measure Specifications FAQs (Excel) (8/9/2022)
- Stakeholder Feedback for Y1 Proposals (PDF) (3/13/2021)
- Y1 Provider-Reported Data (Excel) (10/27/2022)
Rules
Contact Information
- Visit the HHSC Provider Finance Department website for more enrollment, eligibility and payment information for RAPPS.
- For eligibility and financial questions, email PFD_Hospitals@hhsc.state.tx.us.
- For questions on RAPPS quality requirements and reporting, email DPPQuality@hhs.texas.gov.