Uncompensated Care (UC)

Announcements:

Providers,
All "UC-only" hospitals must comply with the Category 4 and Learning Collaborative requirements set out in Title 1 Part 15 Chapter 354 Subchapter D (relating to Texas Healthcare Transformation and Quality Improvement Program). Please note that both certifications are now contained in one workbook that is attached.
For Category 4 reporting, providers should have received their PPE (Potentially Preventable Events) reports several months ago. If you received and reviewed these reports, please complete all of the yellow fields and select "Yes" in cell D11 of the "Category 4 Certification" tab. Also attached is a list of rural providers who are exempt from Category 4 reporting, but must still meet the Learning Collaborative requirement. If you are one of these rural facilities, please complete and sign all of the yellow fields in the Category 4 certification tab but select "Yes" in cell D9. Once you have completed the certification, please print the tab, sign, scan and save as a .pdf, and submit to HHSC with the naming convention of TPI_HospitalName_Cat4Cert.
All UC-Only hospitals must comply with the Learning Collaborative requirement, including the small rural hospitals that are exempt from Category 4 reporting requirements. Providers must have attended or viewed a recording of a Learning Collaborative during the DY 4 UC program year, which was from October 1, 2014 to September 30, 2015, to meet this requirement. If you attended or viewed a Learning Collaborative during the DY 4 program year, please complete all of the yellow fields in the "Learning Collaborative" tab. Once you have completed the certification, please print the tab, sign, scan and save as a .pdf, and submit to HHSC with the naming convention of TPI_HospitalName_LearnColCert.
All providers need to submit these certifications to the UC Tools mailbox no later than COB, Friday, December 11, 2015. If you are a DSRIP hospital and have been erroneously deemed a UC-only hospital (see attachment), please reply to this email and let HHSC know. If you have any questions, please email the UC Tools mailbox at uctools@hhsc.state.tx.us.

Thank You,
Mance Fine
Rate Analyst
Texas Health and Human Services Commission


Providers, Government Entities, and Anchors:
Please read this entire message carefully and make note of the information provided below that failure by IGT entities and providers to submit the required forms may result in a delayed payment for the providers.
HHSC is providing notice to IGT for the DY4 Advance UC Payment.

Dates pertinent to this payment:
  • 10/6/15: Last day to submit your IGT into TexNet
  • 10/7/15: IGT Settlement date
  • 10/16/15: Pay Transferring Hospitals, i.e. Large public hospitals, as defined in 1 Tex. Admin. Code §355.8201(b)(14)
  • 10/30/15: Pay all other UC Providers- Public entities will be paid as soon as possible after October 16th, with the private entities also being paid as soon as possible but no later than October 30th
Attached are the following documents:
The amount that needs to be submitted into TexNet is in Column AK. Please ensure you select the applicable UC bucket in TexNet when you enter your IGT. It is imperative that you send a screen shot/PDF copy of the confirmation/trace sheet from TexNet or an email with the confirmation number and IGT amount if the TexNet is submitted over the phone, to RAD_UC_Payments@hhsc.state.tx.us. Please include two contacts and their phone numbers and email addresses, should HHSC have any questions regarding the TexNet received.
Government Entities that are IGT'ing for multiple providers may submit one lump sum IGT for their affiliates. All IGTs, even for entities submitting IGT for themselves, must complete the attached allocation form. If a Trace Sheet is received without an IGT allocation form HHSC will allocate the IGT received in accordance with 1 Tex. Admin. Code §355.8201(h)(ii). In the absence of the notification described in 1 Tex. Admin. Code §355.8201(h)(i), each hospital owned by or affiliated with the governmental entity will receive a portion of its payment amount for that period, based on the hospital's percentage of the total payment amounts for all hospitals owned by or affiliated with that governmental entity.
In accordance with 1 Tex. Admin. Code §355.8201(h)(ii)(C), if a government entity transfers more than the maximum IGT amount that can be provided for that hospital, and that hospital is affiliated with multiple governmental entities, then HHSC will calculate the amount of IGT funds necessary to fund the hospital's payment and HHSC will issue a pro-rata refund to the governmental entity/entities identified by HHSC. HHSC will determine the pro-rata refund, not the government entity/entities or their representative(s).
If you have questions regarding the UC payment process, please send an email to RAD_UC_Payments@hhsc.state.tx.us.

HHSC Hospital Rate Analysis
Texas Health and Human Services Commission

A letter from CMS formally removes the UC deferral issued in September 2014. The letter notes that CMS plans to work with Texas to do further analysis related to its concerns around private hospital IGT financing arrangements. As outlined in the letter, if CMS determines that any of the financing arrangements violate federal law and/or any regulations, they expect that Texas would make necessary adjustments by December 2015.


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