HHSC has announced its intent to develop a Fee-for-Service supplemental payment for publicly owned and operated hospitals. They plan to initiate rulemaking this spring with a proposed effective date for the program of October 1, 2021.
The ACR data request through the CHIRP application is also used for this program. It is important to get this data submitted by April 5.
While the FFS model shows a $25-27 million gain for Rural Public Hospitals the overall CHIRP impact (both programs) is a $176 million loss.
We will keep you updated as new information is released.
HHSC is releasing modeling of potential options to create a new fee-for-service (FFS) supplemental payment program for certain hospital services. HHSC intends to create this program to continue the financial transition for providers who have historically participated in the Delivery System Reform Incentive Payment program. We continue to work on solutions to preserve the financial resources many of our hospitals depend on to provide access and quality care to Medicaid clients and the uninsured.
The FFS program would be created, subject to approval by the Centers for Medicare and Medicaid Services (CMS), through the Medicaid state plan. State plan programs and services do not impact 1115 Waiver budget neutrality. The initial program design includes publicly-owned and -operated hospitals only. Options considered by HHSC include payments up to the Medicare upper payment limit (UPL), up to the estimate of what an average commercial payer would have paid (a.k.a. the average commercial reimbursement (ACR) UPL), or the greater of the Medicare UPL or ACR UPL.
HHSC plans to initiate rulemaking this spring with a proposed effective date for the program of October 1, 2021. A copy of the model can be found here.