With Medicare and Medicaid providing more than half of most hospitals’ patient revenue, any changes to these government-sponsored programs have a significant impact on hospitals. In a Medicare or Medicaid fee-for-service model, payment rates to hospitals are administratively set instead of negotiated between providers and payers. Medicare and Medicaid both also feature supplemental payment opportunities, which boost low hospital base payments in these programs, which typically do not cover enrollees’ costs of care.
The Texas Legislature sets the Medicaid program budget for each biennium, and the Texas Health and Human Services Commission (HHSC) administers the base and supplemental payment programs that reimburse hospital care for low-income and uninsured Texans. THA works with the Texas Legislature on legislation that affects health care financing and helps shape the regulatory environment through involvement with specific Medicaid advisory committees, HHSC and the Texas Department of State Health Services.
In Medicare, the amount and manner of payments are governed by acts of Congress and the Centers for Medicare and Medicaid Services (CMS). THA engages the Texas congressional delegation on key Medicare issues and takes part in public comment opportunities put forth by CMS to safeguard hospitals’ Medicare payments.
Resources
Medicare Resources
u003culu003ern tu003cliu003eu003ca href=”https://www.tha.org/wp-content/uploads/2023/09/THA-340B-CMS-letter-090723.pdf” target=”_blank” rel=”noopener”u003eLetter to CMS re: 340Bu003c/au003e (9/7/23) | THAu003c/liu003ern tu003cliu003eu003ca href=”https://www.tha.org/wp-content/uploads/2022/09/THA-MA-RFI-Response-Final.pdf”u003eComments Responding to CMS Request for Information on Medicare Advantageu003c/au003e (8/30/2022) | THAu003c/liu003ern tu003cliu003eu003ca href=”https://www.aha.org/system/files/media/file/2021/07/cms-issues-hospital-outpatient-asc-proposed-rule-including-modifications-to-price-transparency-rule-bulletin-7-20-21.pdf” target=”_blank” rel=”noopener”u003eSpecial Bulletin: CMS Issues Hospital Outpatient/ASC Proposed Rule, Modifications to Price Transparency Ruleu003c/au003e (7/20/21) | AHAu003c/liu003ern tu003cliu003eu003ca href=”https://public-inspection.federalregister.gov/2021-15496.pdf” target=”_blank” rel=”noopener”u003eCY 2022 Proposed Hospital OPPS Ruleu003c/au003e (7/19/21) | CMSu003c/liu003ern tu003cliu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/CMS_Comment_Letter-IPPS_Proposed-June-2021.pdf” target=”_blank” rel=”noopener”u003eTHA Comments on CMS’ FY 2022 Proposed Hospital Inpatient Prospective Payment System Ruleu003c/au003e (June 28, 2021)u003c/liu003ernu003c/ulu003e
Medicaid Resources
General/Directed Payment Programs
u003culu003ern tu003cliu003eu003ca href=”https://www.tha.org/wp-content/uploads/2023/07/THA-Comment-Letter-EAPG-Proposed-Rules-FINAL.pdf” target=”_blank” rel=”noopener”u003eTHA Comments on Proposed Rule 23R026u003c/au003e (7/24/2023) | THAu003c/liu003ern tu003cliu003eu003ca href=”https://www.tha.org/news-publications/ceo-messages/dpp-approval-the-first-step-in-securing-texas-safety-net/”u003eDPP Approval: The First Step in Securing Texas’ Safety Netu003c/au003e (4/20/2022) | THAu003c/liu003ern tu003cliu003eu003ca href=”https://www.tha.org/alert/information-alert-tha-issues-new-details-on-dpp-payments/”u003eInformation Alert: THA Issues Latest Information on DPP Paymentsu003c/au003e (4/6/2022) | THAu003c/liu003ern tu003cliu003eu003ca href=”https://www.tha.org/alert/information-alert-cms-approves-texas-proposed-directed-payment-programs-for-state-fiscal-year-2022/”u003eInformation Alert: CMS Approves Three DPPsu003c/au003e (3/25/2022) | THAu003c/liu003ern tu003cliu003eu003ca href=”https://www.tha.org/news-publications/ceo-messages/critical-funding-remains-in-limbo-as-pandemic-wears-on/”u003eCritical Funding Remains in Limbo as Pandemic Wears Onu003c/au003e (2/17/2022) | THAu003c/liu003ern tu003cliu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/2022-Crisis-Within-Pandemic.pdf” target=”_blank” rel=”noopener”u003eWithholding Hospital Funds Hurts Patientsu003c/au003e (2/7/22) | THAu003c/liu003ern tu003cliu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/Texas-HDC-1115-Letter-1.24.2022.pdf” target=”_blank” rel=”noopener”u003eTexas House Members Submit Letters to CMS on 1115 Waiveru003c/au003e (1/24/22)u003c/liu003ern tu003cliu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/Letter-to-CongressmanGonzalez-re-Healthcare-Coverage-Gap.pdf” target=”_blank” rel=”noopener”u003eJoint Letter to Congressman Gonzalez RE: Healthcare Coverage Gapu003c/au003e (1/20/22)u003c/liu003ern tu003cliu003eu003ca href=”https://www.tha.org/Portals/0/files/HCA/THA-Response-to-Sen-Cruz-on-BBB.pdf” target=”_blank” rel=”noopener”u003eTHA Response to Sen. Cruz on Build Back Better Provisionsu003c/au003e (1/13/22)u003c/liu003ern tu003cliu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/SDC-letter-to-HHS-and-CMS-FINAL-2021.12.08.pdf” target=”_blank” rel=”noopener”u003eTexas Senate Members Issue Letter on Medicaid Funding and 1115 Waiveru003c/au003e (12/8/21)u003c/liu003ern tu003cliu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/THA-BBB-Medicaid-Letter-Final.pdf” target=”_blank” rel=”noopener”u003eTHA Letter on Build Back Better Provisions u0026amp; Waiver Negotiationsu003c/au003e (12/1/21)u003c/liu003ern tu003cliu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/Ltr-to-Texas-Congressional-Delegation-on-BBB-Cuts.pdf”u003eMulti-association Letter Against Certain BBB Provisionsu003c/au003e (11/5/21)u003c/liu003ern tu003cliu003eu003ca href=”https://www.hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/provider-portal/medicaid-supp-pay/txhhs-letter-to-cms-09-07-2021.pdf”u003eTexas Accepts Offer for FY 22 DSRIP, UHRIP, QIPP; Commits to Work on DPPsu003c/au003e (9/7/21) | HHSCu003c/liu003ern tu003cliu003eu003ca href=”https://www.hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/provider-portal/medicaid-supp-pay/attachment-c-mandatory-payments-administrative-expenditures.pdf” target=”_blank” rel=”noopener”u003eAttachment C – State Report of Mandatory Payments u0026amp; Administrative Expenditures FFY 21 Q3u003c/au003e (8/25/21) | HHSCu003c/liu003ern tu003cliu003eu003ca href=”https://www.hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/provider-portal/medicaid-supp-pay/attachment-b-texas-monitoring-plan-timelines.pdf” target=”_blank” rel=”noopener”u003eAttachment B – Oversight u0026amp; Monitoring Plan for Local Funds Used in Texas Medicaidu003c/au003e (8/25/21) | HHSCu003c/liu003ern tu003cliu003eu003ca href=”https://www.hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/provider-portal/medicaid-supp-pay/attachment-a-chirp-analysis.xlsx” target=”_blank” rel=”noopener”u003eAttachment A – CHIRP Analysisu003c/au003e (8/25/21) | HHSCu003c/liu003ern tu003cliu003eu003ca href=”https://www.hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/provider-portal/medicaid-supp-pay/texas-cms-meeting-with-texas-response-08-25-2021.pdf” target=”_blank” rel=”noopener”u003eDiscussion Document With State Responses Re: Requested DPP Modificationsu003c/au003e (8/25/21) | HHSCu003c/liu003ern tu003cliu003eu003ca href=”https://www.hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/provider-portal/medicaid-supp-pay/texas-cms-meeting-08-20-2021.pdf” target=”_blank” rel=”noopener”u003eDiscussion Document Re: Requested DPP Modificationsu003c/au003e (8/20/21) | CMSu003c/liu003ern tu003cliu003eu003ca href=”https://www.hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/provider-portal/medicaid-supp-pay/20210816-letter-mr-tsai.pdf” target=”_blank” rel=”noopener”u003eResponse to CMS Regarding DPPsu003c/au003e (8/16/21) | HHSCu003c/liu003ern tu003cliu003eu003ca href=”https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/tx-healthcare-transformation-cms-ltr-state-08132021.pdf” target=”_blank” rel=”noopener”u003eLetter Disapproving Proposed Directed Payment Programsu003c/au003e (8/13/21) | CMSu003c/liu003ern tu003cliu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/THA-HARP-Comments-final.pdf” target=”_blank” rel=”noopener”u003eComments on Proposed Hospital Augmented Reimbursement Program Rulesu003c/au003e (8/6/21) | THAu003c/liu003ern tu003cliu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/09-01-2021-prospective-reimbursement-rural-hospitals-in-medicaid.pdf” target=”_blank” rel=”noopener”u003eProposed Rural Hospital Medicaid Inpatient Rate Increaseu003c/au003e (7/8/21) | HHSCu003c/liu003ern tu003cliu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/09-01-2021-adj-pmnt-rates-outpatient-srvcs.pdf” target=”_blank” rel=”noopener”u003eProposed Rural Hospital Medicaid Outpatient Rate Increaseu003c/au003e (7/8/21) | HHSCu003c/liu003ern tu003cliu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/FFS_Program_with_Private_and_State_Hospitals_Option-3-For_Workgroup_5.7.2021.xlsx?ver=2021-05-19-184838-470″u003ePreliminary Modeling by Hospital – Hospital Augmented Reimbursement Programu003c/au003e (5/19/21) | HHSCu003c/liu003ern tu003cliu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/FFS_Program_with_Private_and_State_Hospitals_Tableau-For%20Workgroup_5.7.2021.pdf?ver=2021-05-19-184850-760″u003eSummary of Preliminary Modeling for Hospital Augmented Reimbursement Programu003c/au003e (5/19/21) | HHSCu003c/liu003ern tu003cliu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/HTW_Eligiblity_Changes_Questions_for_HHSC_and_Responses_TWHC-Meeting-041621.pdf?ver=2021-04-29-142310-563″u003eHealthy Texas Women Eligibility Changes Qu0026amp;Au003c/au003e (April 28, 2021) | HHSCu003c/liu003ern tu003cliu003eu003ca href=”https://hhs.texas.gov/sites/default/files/documents/laws-regulations/policies-rules/Waivers/medicaid-1115-waiver/measure-specifications-chirp-tipps-rapps-dpp-bhs.xlsm”u003eSFY 2022 Quality Measure Specifications for CHIRP, TIPPS, RAPPS, BHSu003c/au003e (March 18, 2021)u003c/liu003ernu003c/ulu003e
Comprehensive Hospital Increased Reimbursement Program
u003culu003eu003cliu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/2023-CHIRP-Application.pdf” target=”_blank” rel=”noopener” data-mce-href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/2023-CHIRP-Application.pdf”u003e2023 CHIRP Applicationu003c/au003eu0026nbsp;(PDF) (March 2, 2022) | HHSCu003c/liu003eu003cliu003eu003ca href=”https://rad.hhs.texas.gov/sites/rad/files/documents/pfc/2021/03-04-2021-chirp-modeling.pdf” target=”_blank” rel=”noopener” data-mce-href=”https://rad.hhs.texas.gov/sites/rad/files/documents/pfc/2021/03-04-2021-chirp-modeling.pdf”u003eUpdated CHIRP Modelingu003c/au003eu0026nbsp;(PDF) (March 4, 2021) | HHSCu003c/liu003eu003cliu003eu003ca href=”https://rad.hhs.texas.gov/sites/rad/files/documents/pfc/2021/03-04-2021-chirp-modeling.xlsx” target=”_blank” rel=”noopener” data-mce-href=”https://rad.hhs.texas.gov/sites/rad/files/documents/pfc/2021/03-04-2021-chirp-modeling.xlsx”u003eUpdated CHIRP Modelingu003c/au003eu0026nbsp;(Excel) (March 4, 2021) | HHSCu003c/liu003eu003cliu003eu003ca href=”https://rad.hhs.texas.gov/sites/rad/files/documents/pfc/2021/03-04-2021-chirp-summary-visual.pdf” target=”_blank” rel=”noopener” data-mce-href=”https://rad.hhs.texas.gov/sites/rad/files/documents/pfc/2021/03-04-2021-chirp-summary-visual.pdf”u003eSummary Visualizations of CHIRP Modelingu003c/au003eu0026nbsp;(March 4, 2021) | HHSCu003c/liu003eu003cliu003eu003ca href=”https://rad.hhs.texas.gov/sites/rad/files/documents/pfc/2021/2021-chirp-rules.pdf” target=”_blank” rel=”noopener” data-mce-href=”https://rad.hhs.texas.gov/sites/rad/files/documents/pfc/2021/2021-chirp-rules.pdf”u003eFinal CHIRP Rulesu003c/au003eu0026nbsp;(March 4, 2021) | HHSCu003c/liu003eu003cliu003eu003ca href=”https://rad.hhs.texas.gov/sites/rad/files/documents/pfc/2021/2021-chirp-preamble.pdf” target=”_blank” rel=”noopener” data-mce-href=”https://rad.hhs.texas.gov/sites/rad/files/documents/pfc/2021/2021-chirp-preamble.pdf”u003eFinal CHIRP Rules Adoption Preambleu003c/au003eu0026nbsp;(March 4, 2021) | HHSCu003c/liu003eu003cliu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/CHIRP_Quality-Letter-v2_final.pdf?ver=2021-02-04-163344-897″ target=”_blank” rel=”noopener” data-mce-href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/CHIRP_Quality-Letter-v2_final.pdf?ver=2021-02-04-163344-897″u003eComments to HHSC on Proposed CHIRP Quality Measuresu003c/au003eu0026nbsp;(Feb. 2, 2021) | THAu003c/liu003eu003cliu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/CHIRP_Letter_to_HHSC-020121.pdf?ver=2021-02-02-230643-143″ target=”_blank” rel=”noopener” data-mce-href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/CHIRP_Letter_to_HHSC-020121.pdf?ver=2021-02-02-230643-143″u003eComments to HHSC on Proposed CHIRP Ruleu003c/au003eu0026nbsp;(Feb. 1, 2021) | THAu003c/liu003eu003cliu003eu003ca href=”https://forms.office.com/Pages/ResponsePage.aspx?id=Mnf5m7mCm0mxaqk-jr1TayYaYjiGHoxPtz5OGwZEEYJUNERQRzNLWEFSSlNHQzdENE1VRVkwNDc4WS4u” target=”_blank” rel=”noopener” data-mce-href=”https://forms.office.com/Pages/ResponsePage.aspx?id=Mnf5m7mCm0mxaqk-jr1TayYaYjiGHoxPtz5OGwZEEYJUNERQRzNLWEFSSlNHQzdENE1VRVkwNDc4WS4u”u003eCHIRP Proposed Measures Surveyu003c/au003eu0026nbsp;(Jan 12, 2021) | HHSCu003c/liu003eu003cliu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/CHIRP_DPP_Specs_20210112.xlsx?ver=2021-01-14-170817-387″ data-mce-href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/CHIRP_DPP_Specs_20210112.xlsx?ver=2021-01-14-170817-387″u003eCHIRP Directed Payment Program Specificationsu003c/au003eu0026nbsp;(Jan. 12, 2021) | HHSCu003c/liu003eu003cliu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/CHIRP_Requirements_20210112.pdf?ver=2021-01-14-170922-897″ target=”_blank” rel=”noopener” data-mce-href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/CHIRP_Requirements_20210112.pdf?ver=2021-01-14-170922-897″u003eCHIRP Requirementsu003c/au003eu0026nbsp;(Jan. 12, 2021) | HHSCu003c/liu003eu003cliu003eu003ca href=”https://www.sos.state.tx.us/texreg/pdf/backview/0101/0101prop.pdf” target=”_blank” rel=”noopener” data-mce-href=”https://www.sos.state.tx.us/texreg/pdf/backview/0101/0101prop.pdf”u003eHHSC Proposed Rules for CHIRP (§353.1305 – 353.1307)u003c/au003eu0026nbsp;(Jan. 1, 2021)u003c/liu003eu003c/ulu003e
Texas Incentives for Physician and Professional Services Program
u003culu003eu003cliu003eu003ca href=”https://rad.hhs.texas.gov/sites/rad/files/documents/pfc/2021/03-09-2021-tipps-modeling.xlsx” target=”_blank” rel=”noopener” data-mce-href=”https://rad.hhs.texas.gov/sites/rad/files/documents/pfc/2021/03-09-2021-tipps-modeling.xlsx”u003eUpdated TIPPS Modelingu003c/au003eu0026nbsp;(Excel) (March 9, 2021) | HHSCu003c/liu003eu003cliu003eu003ca href=”https://rad.hhs.texas.gov/sites/rad/files/documents/pfc/2021/2021-tipps-preamble.pdf” target=”_blank” rel=”noopener” data-mce-href=”https://rad.hhs.texas.gov/sites/rad/files/documents/pfc/2021/2021-tipps-preamble.pdf”u003eFinal TIPPS Rulesu003c/au003eu0026nbsp;Adoption Preamble (March 9, 2021) | HHSCu003c/liu003eu003cliu003eu003ca href=”https://rad.hhs.texas.gov/sites/rad/files/documents/pfc/2021/2021-tipps-rules.pdf” target=”_blank” rel=”noopener” data-mce-href=”https://rad.hhs.texas.gov/sites/rad/files/documents/pfc/2021/2021-tipps-rules.pdf”u003eFinal TIPPS Rulesu003c/au003eu0026nbsp;(March 9, 2021) | HHSCu003c/liu003eu003cliu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/TIPPS_Letter_to_HHSC_1-25-21-updated.pdf?ver=2021-01-26-163348-763″ target=”_blank” rel=”noopener” data-mce-href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/TIPPS_Letter_to_HHSC_1-25-21-updated.pdf?ver=2021-01-26-163348-763″u003eComments to HHSC on Proposed TIPPS Programu003c/au003eu0026nbsp;(Jan. 25, 2021) | THAu003c/liu003eu003c/ulu003e
Rural Access to Primary and Preventative Services Program
u003culu003eu003cliu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/THA_RAPPS_Comment_Letter-final_021221.pdf?ver=2021-02-16-142245-620″ target=”_blank” rel=”noopener” data-mce-href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/THA_RAPPS_Comment_Letter-final_021221.pdf?ver=2021-02-16-142245-620″u003eComments to HHSC on Rural Access to Primary and Preventive Servicesu003c/au003eu0026nbsp;(Feb. 12, 2021) | THAu003c/liu003eu003c/ulu003e
Disproportionate Share Hospital Payments u0026 Uncompensated Care
u003culu003eu003cliu003eu003ca href=”https://www.tha.org/wp-content/uploads/2023/06/THA-UC-Resizing-Comments-to-CMS-6.5.23.pdf” target=”_blank” rel=”noopener” data-mce-href=”https://www.tha.org/wp-content/uploads/2023/06/THA-UC-Resizing-Comments-to-CMS-6.5.23.pdf”u003eComments on Modification to Second Reassessment of Uncompensated Care Pool Programu003c/au003e (6/12/23) | THAu003c/liu003eu003cliu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/THA-HHSC_DSH_Reimbursement_Rule_Letter.pdf?ver=2021-05-17-181720-993″ target=”_blank” rel=”noopener” data-mce-href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/THA-HHSC_DSH_Reimbursement_Rule_Letter.pdf?ver=2021-05-17-181720-993″u003eComments on Proposed DSH Reimbursement Methodology Ruleu003c/au003eu0026nbsp;(5/17/21) | THAu003c/liu003eu003cliu003eu003ca href=”https://www.sos.state.tx.us/texreg/archive/April162021/Proposed%20Rules/1.ADMINISTRATION.html#18″ target=”_blank” rel=”noopener” data-mce-href=”https://www.sos.state.tx.us/texreg/archive/April162021/Proposed%20Rules/1.ADMINISTRATION.html#18″u003eProposed Medicaid DSH Reimbursement Methodology Ruleu003c/au003eu0026nbsp;(4/16/21) | HHSCu003c/liu003eu003c/ulu003e
Medicaid DSH Payment Cuts
The Texas Hospital Association is asking Congress to address Medicaid disproportionate share hospital (DSH) cuts to help protect patient care. THA has calculated the number of DSH hospitals and reduction amounts for each of the 38 U.S. House districts for FY 2024. More information is available here.
Medicaid 1115 Waiver
The Centers for Medicare & Medicaid Services has renewed Texas’ Medicaid 1115 Waiver through September 2030. The waiver authorizes the state to operate Medicaid managed care and sets budgetary limits for several key supplemental payment programs, including state directed payment programs and Texas’ uncompensated care pool.
Although the waiver itself received 10-year approval, payment programs within the waiver must be reapproved or resized periodically. THA continues its advocacy with state and congressional leaders to preserve the state’s health care safety net.
Texas hospitals urge CMS to continue working with the state to achieve the following outcomes:
- Preserve a budget neutrality determination that permits sufficient safety-net hospital funding.
- Sustain a strong hospital uncompensated care pool.
- Reinforce the behavioral heath safety net.
- Recognize the waiver as a building block to comprehensive health care coverage.
10-Year Extension (DYs 10-19/Jan 2021 – Sept. 2030)
u003ctable class=”table”u003eu003ccolgroupu003e u003ccol /u003eu003c/colgroupu003ernu003ctbodyu003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/wp-content/uploads/2022/05/Human-Services-1115-Waiver-Hearing-May-2022-THA-Written-Testimony.pdf” target=”_blank” rel=”noopener”u003eTHA Written Testimony on 1115 Waiver, DPP Approvalsu003c/au003e (5/5/22)u003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/alert/information-alert-texas-medicaid-1115-waiver-extension-reinstated/”u003eInformation Alert: CMS Reinstates Texas’ 1115 Waiver Extensionu003c/au003e (4/22/2022) | THAu003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/tx-healthcare-transformation-cms-ltr-state-04222022.pdf” target=”_blank” rel=”noopener”u003eCMS Reinstates Texas’ 1115 Waiver Extensionu003c/au003e (4/22/22) | CMSu003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/MedicareMedicaid/THA-BBB-Medicaid-Letter-Final.pdf” target=”_blank” rel=”noopener”u003eTHA Update to Texas Congressional Delegation on Medicaid Supplemental Payments and 1115 Waiveru003c/au003e (12/1/2021)u003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/Congressional-Delegation-Update-11.30.21.pdf” target=”_blank” rel=”noopener”u003eCHAT Update to Texas Congressional Delegation on Children’s Hospital Fundingu003c/au003e (11/30/2021)u003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/tx-healthcare-transformation-cms-ltr-state-11152021.pdf” target=”_blank” rel=”noopener”u003eCMS Letter to Texas on DPP Next Steps, Outstanding Issuesu003c/au003e (11/15/2021)u003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/THOT-EC-Letter-to-CMS-Director-Tsai-2021-11-05-152624.pdf” target=”_blank” rel=”noopener”u003eTeaching Hospitals of Texas Letter to CMS on 1115-Related Waiver Requestsu003c/au003e (11/5/2021)u003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/Congressional-Delegation-Update-October-30-2021.pdf” target=”_blank” rel=”noopener”u003eCHAT Request to Texas Congressional Delegation Regarding DSH and UC Fundingu003c/au003e (10/30/2021)u003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/Congressional-Delegation-Update-October-28-2021.pdf” target=”_blank” rel=”noopener”u003eCHAT Update to Texas Congressional Delegation on Waiver Negotiationsu003c/au003e (10/28/2021)u003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/Tsai-Waiver-and-DPP-Letter-October-26-2021.pdf” target=”_blank” rel=”noopener”u003eCHAT Comment Letter on Status of 1115 Waiver and Directed Payment Programsu003c/au003e (10/26/2021)u003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/CMS-letter-Multi-Hospital_DSRIP-SDP-102521.pdf”u003eMulti-Association Letter to CMS Regarding Continuation of DSRIP, UHRIP and QIPP Programs u003c/au003e(10/25/2021)u003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/CMS_letter-DSRIP-SDP-Approval-final-10.1.21.pdf” target=”_blank” rel=”noopener”u003eTexas Hospitals Urge CMS to Approve Temporary Payment Programs for Current Fiscal Yearu003c/au003e (10/1/2021)u003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/provider-portal/medicaid-supp-pay/txhhs-letter-to-cms-09-07-2021.pdf”u003eTexas Accepts Offer for FY 22 DSRIP, UHRIP, QIPP; Commits to Work on DPPsu003c/au003e (9/7/2021) | HHSCu003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/1115-Waiver-Support-Letters.pdf” target=”_blank” rel=”noopener”u003eTexas Essential Healthcare Partnerships Letter to CMS on 1115 Waiver Extensionu003c/au003e (8/30/2021)u003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/THOT-comments-CMS-on-1115-Waiver_Final-082521.pdf” target=”_blank” rel=”noopener”u003eTeaching Hospitals of Texas Comment Letter to CMS on 1115 Waiver Extensionu003c/au003e (8/25/2021)u003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/THA-Federal-Waiver-Comment-Letter-FINAL.pdf” target=”_blank” rel=”noopener”u003eFederal Comments on Texas’ 1115 Waiver Extension Applicationu003c/au003e (8/25/2021)u003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Public-Policy/Advocacy-Communications/Action-and-Information-Alerts/Action-Alert-Provide-Federal-Public-Comment-on-Texas-Waiver-Extension-Application-Use-THAs-Template”u003eAction Alert: Provide Federal Public Comment on Texas Waiver Extension Application; Use THA’s Templateu003c/au003e (8/17/2021)u003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/federal-template-comment-letter-final.docx”u003eTemplate Letter for Public Comment on CMS’ Waiver Extension Applicationu003c/au003e (8/16/2021) | THAu003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/Texas-DPP-Joint-Letter-to-CMS-FINAL.pdf” target=”_blank” rel=”noopener”u003eMulti Association Letter to CMS on Waiver and DPP Approvalu003c/au003e (7/26/2021)u003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/July-14-DPP-Support-letter-to-CMS_Final.pdf” target=”_blank” rel=”noopener”u003eTeaching Hospitals of Texas Letter to CMS on Texas’ Directed Payment Programsu003c/au003e (7/14/2021)u003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.hhs.texas.gov/sites/default/files/documents/laws-regulations/policies-rules/1115-waiver/waiver-renewal/governors-cover-letter-1115-waiver.pdf” target=”_blank” rel=”noopener”u003eWaiver Extension Application Cover Letteru003c/au003e (7/14/2021) | HHSCu003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.hhs.texas.gov/sites/default/files/documents/laws-regulations/policies-rules/1115-waiver/waiver-renewal/demonstration-extension-application-section-1115a-appendices-a-e.pdf” target=”_blank” rel=”noopener”u003eWaiver Extension Application Appendicesu003c/au003e (7/14/2021) | HHSCu003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.hhs.texas.gov/sites/default/files/documents/laws-regulations/policies-rules/1115-waiver/waiver-renewal/evaluation-1115-texas-demonstration-waiver.pdf” target=”_blank” rel=”noopener”u003eWaiver Extension Application Preliminary Findings (Supplement A – Preliminary Draft Results)u003c/au003e (7/14/2021) | HHSCu003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/THA-1115_Waiver_comment-final.pdf?ver=2021-06-24-180440-307″ target=”_blank” rel=”noopener”u003eComments on HHSC’s Medicaid 1115 Waiver Extension Applicationu003c/au003e (6/24/2021) | THAu003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Public-Policy/Advocacy-Communications/Action-and-Information-Alerts/Action-Alert-Provide-Public-Comment-on-Texas-Waiver-Extension-Application-Use-THAs-Template”u003eAction Alert: Provide Public Comment on Texas Waiver Extension Application; Use THA’s Templateu003c/au003e (6/3/2021) | THAu003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/template_comment_letter_final.docx?ver=2021-06-03-172205-943″u003eTemplate Letter for Public Comment on HHSC’s Waiver Extension Applicationu003c/au003e (6/3/2021) | THAu003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/GGA_Letter_Waiver_Extension_Priorities_5-12-21.pdf?ver=2021-05-12-205913-270″ target=”_blank” rel=”noopener”u003eMulti Association Letter on Hospital Priorities for Potential Waiver Extension Negotiationu003c/au003e (5/12/2021)u003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/1115_Renegotiation_and_Coverage_Letter.pdf?ver=2021-04-29-143513-927″u003eU.S. House Democrats Letter to CMS, HHS on Waiver Rescissionu003c/au003e (4/27/2021)u003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/Republican_ltr_to_hhs_re_tx_1115_waiver_rescission.pdf?ver=2021-04-29-143533-320″u003eU.S. House Republicans Letter to HHS on Waiver Rescissionu003c/au003e (4/27/2021)u003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/Coverage/coverage_support_letter_final.pdf?ver=2021-04-21-220526-713″ target=”_blank” rel=”noopener”u003eLetter to State Leaders – Hospitals Support the Waiver and Coverage Expansionu003c/au003e (4/21/2021) | THAu003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/1115_Waiver_Rescinded_FINAL-042221.pdf?ver=2021-04-22-231052-850″u003eWhitepaper: Losing Texas’ Waiver Extension Destabilizes the Health Care Safety Netu003c/au003e (4/21/2021) | THAu003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/tx-healthcare-transformation-ca.pdf” target=”_blank” rel=”noopener”u003eLetter Rescinding 10-Year Extension of Texas’ 1115 Waiveru003c/au003e (4/16/2021) | CMSu003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Public-Policy/Advocacy-Communications/Action-and-Information-Alerts/Information-Alert-CMS-Rescinds-10-Year-Extension-of-Texas-Medicaid-1115-Waiver” target=”_blank” rel=”noopener”u003eInformation Alert: CMS Rescinds 10-Year Extension of Texas’ Medicaid 1115 Waiveru003c/au003e (4/16/2021) | THAu0026amp;u003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Public-Policy/Newsroom/THA-Statement-on-Medicaid-Waiver-Action” target=”_blank” rel=”noopener”u003eStatement on CMS Rescinding 10-Year Waiver Extension u003c/au003e(4/16/2021) | THAu003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/Medicaid_1115_Waiver_Is_a_Building_Block_to_Health_Care_Coverage.pdf?ver=2021-02-23-155829-347″ target=”_blank” rel=”noopener”u003eWhite Paper: 1115 Waiver Is a Building Block to Health Care Coverageu003c/au003e (Feb. 12, 2021) | THAu003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/Thank_You_to_GGA_2-8-21.pdf?ver=2021-02-09-145148-787″ target=”_blank” rel=”noopener”u003eMulti Association Thank you Letter to Gov. Abbott u003c/au003e(Feb. 8, 2021)u003c/tdu003ernu003c/tru003ernu003ctru003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/Thank_You_to_CEY_2-8-21.pdf?ver=2021-02-09-145140-217″ target=”_blank” rel=”noopener”u003eMulti Association Thank You Letter to Commissioner Youngu003c/au003e (Feb. 8, 2021)u003c/tdu003ernu003c/tru003ernu003ctr valign=”top”u003ernu003ctdu003eu003ca href=”https://www.tha.org/Public-Policy/Advocacy-Communications/Action-and-Information-Alerts/Information-Alert-CMS-Approves-10-Year-Extension-of-Texas-Medicaid-1115-Waiver” target=”_blank” rel=”noopener”u003eInformation Alert: Summary of 10-Year Waiver Extensionu003c/au003e (Jan. 21, 2021) | THAu003c/tdu003ernu003c/tru003ernu003ctr valign=”top”u003ernu003ctdu003eu003ca href=”https://www.tha.org/Portals/0/files/Issues/waiver/1115_Waiver_Extension_Presentation_1-19-2021.pdf?ver=2021-01-20-160815-530″ target=”_blank” rel=”noopener”u003e1115 Waiver Extension Presentationu003c/au003e (Jan. 20, 2021) | HHSCu003c/tdu003ernu003c/tru003ernu003ctr valign=”top”u003ernu003ctdu003eu003ca href=”https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/tx-healthcare-transformation-ca.pdf” target=”_blank” rel=”noopener”u003eLetter Approving 10-Year Waiver for Texasu003c/au003e (Jan. 15, 2021) | CMSu003c/tdu003ernu003c/tru003ernu003c/tbodyu003ernu003c/tableu003e
Supporting Web pages
Visit THA’s supporting Web pages for additional information on certain Medicaid and Medicare issues as well as hospital financing.
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According to Texas Government Code 305.027, portions of this material may be considered “legislative advertising.” Authorization for its publication is made by Jennifer Banda, J.D., Texas Hospital Association, 1108 Lavaca, Suite 700, Austin, TX 78701-2180.