Client Update

Enrollment Opens for CHIRP, TIPPS and RAPPS

HHSC has opened the enrollment window for State Fiscal Year 2023 of the Directed Payment Programs (CHIRP, TIPPS and RAPPS).  The portal to apply will only be open for 21 days and will close March 22, 2022 at 11:59 PM.  We have included links to the applications for your review so you can be prepared with the appropriate information. CHIRP Year 2 Application RAPPS Year 2 Application TIPPS Year 2 Application  However, if you would like for us to prepare the application on your behalf please contact Shonna Cannaday ([email protected]), Lauren Dudley ([email protected]) or Mandy Cox ([email protected] ).

A few things we would like to highlight:

    • No Intergovernmental Transfers (IGT) are requested at this time.
    • There will be an application fee of $8,500 for CHIRP for FY2023 for non-public entities.  This fee will not be due at the time of submission.  Pending CMS approval.

As a reminder:

CHIRP

  • Comprised of two components:
      • UHRIP   –
        • SDA Region calculation  – AVERAGE
        • Offsets for NAIP
      • Average Commercial Incentive Award (ACIA). Average Commercial Rate (ACR)
        •  Not average – Specific
  • Open to six classes of hospitals:  children’s, rural, state-owned that are not IMDs, urban, non-state owned IMDs, and state owned IMDs.
  • IGT is accumulated and based on each SDA

RAPPS

  • For RHC’s – hospital-based or free standing
  • Each SDA with at least one sponsoring governmental entity for the IGT
  • Minimum volume of 30 Medicaid MCO unique encounters in the prior fiscal year
  • Payment methodology:
    • Component 1 – Uniform dollar – 75 % of total program value.  Performance based
    • Component 2 – Percent rate increase for certain services.  Providers must report quality metrics – 25% of total program value.

TIPPS

  • Not for RHCs– RHCs are eligible for RAPPS
    • Physician can bill non-RHC services in a group and potentially qualify for TIPPS
  • Open to physician groups defined as
    • HRI – Medical Schools
    • IME – Teaching Interns & Residents
      • HRI & IME Physician practice groups must have a minimum volume of 30 Medicaid patients
    • Other –   Must serve 250 Medicaid managed care clients
  • There are three components to the program:
      1. Paid as a per-member-per month payment – HRIs and IMEs only are eligible
      2. Serves as a performance incentive payment – HRIs and IMEs only are eligible
      3. Serves as a rate enhancement for certain outpatient services – all physician practice groups are eligible

If you would like to discuss this in more detail, please let us know and we would be happy to schedule a call.

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