Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 354 - MEDICAID HEALTH SERVICES
Subchapter D - TEXAS HEALTHCARE TRANSFORMATION AND QUALITY IMPROVEMENT PROGRAM
Division 2 - REGIONAL HEALTHCARE PARTNERSHIPS
Section 354.1611 - Organization

Universal Citation: 1 TX Admin Code ยง 354.1611

Current through Reg. 49, No. 38; September 20, 2024

(a) Each Regional Healthcare Partnership (RHP) has geographic boundaries as prescribed by HHSC.

(b) An RHP is composed of one anchor and other participants, which may include IGT entities, performers, and other regional stakeholders. A single entity may act in multiple roles.

(c) An IGT entity may participate in more than one RHP contingent upon HHSC approval.

(d) A performer may only participate in DSRIP in the RHP where it is physically located. However, a physician group practice affiliated with an academic health science center, major cancer hospital, or children's hospital may participate in DSRIP in another region if it receives a DSRIP allocation from that region.

(e) Only providers participating in an RHP are eligible to receive a UC payment, although exceptions may be approved by CMS on a case by case basis.

(f) Each RHP is categorized into a tier as follows:

(1) Tier 1 consists of any RHP that contains at least 15% of the state's total population under 200% of the federal poverty level as determined by the 2006-2010 American Community Survey for Texas.

(2) Tier 2 consists of any RHP that contains at least 7% and less than 15% of the state's total population under 200% of the federal poverty level as determined by the 2006-2010 American Community Survey for Texas.

(3) Tier 3 consists of any RHP that contains at least 3% and less than 7% of the state's total population under 200% of the federal poverty level as determined by the 2006-2010 American Community Survey for Texas.

(4) Tier 4 consists of any RHP that:
(A) contains less than 3% of the state's total population under 200% of the federal poverty level as determined by the 2006-2010 American Community Survey for Texas;

(B) does not have a public hospital; or

(C) has one or more public hospitals that, when combined, provide less than 1% of the region's uncompensated care.

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