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 7 - DSRIP PROGRAM DEMONSTRATION YEARS 7-8
Section 354.1711 - Category B Requirements for Performers

(a) A performer must provide the following information in the RHP plan update for its RHP to be eligible for its RHP plan update submission funds for DY7 and its Category B valuation for DY7 and DY8:

(b) HHSC will use the information provided by a performer in accordance with subsection (a) of this section to calculate the performer's:

(c) A performer's total PPP baseline is equal to the average of its total PPP for DY5 and its total PPP for DY6 with the exception described in subsection (e) of this section.

(d) A performer's MLIU PPP baseline is equal to the average of its MLIU PPP for DY5 and its MLIU PPP for DY6 with the exception described in subsection (e) of this section.

(e) If a performer demonstrates good cause, the performer may request in the RHP plan update that:

(f) A performer's MLIU PPP to total PPP ratio baseline is equal to the performer's MLIU PPP baseline, as calculated in subsection (d) or (e) of this section, divided by the total PPP baseline, as calculated in subsection (c) or (e) of this section.

(g) A performer's MLIU PPP goal per DY for DY7 and DY8 is equal to its MLIU PPP baseline, as calculated in subsection (d) or (e) of this section.

(h) A performer's allowable MLIU PPP goal variation per DY for DY7 and DY8 is calculated with consideration of the performer's:

(i) A performer will have a MLIU PPP milestone for each DY. The valuation of the MLIU PPP milestone for a DY is 100 percent of the performer's Category B valuation for the DY.

(j) A performer must report the following to be eligible for payment of its MLIU PPP milestone for a DY:

(k) A performer must report the information in subsection (j) of this section during the second reporting period of the DY it is reporting to be eligible for payment of the MLIU PPP milestone for the DY, with the exception that a performer may request to carry forward reporting of its MLIU PPP milestone to the first reporting period of the DY immediately following the DY it is reporting; however, if approved, the measurement period would not change.