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Uncompensated Care Payments

 

Overview

Every private hospital that participates in the waiver must execute an affiliation agreement with the governmental entity that provides the Intergovernmental Transfer (IGT) for any type of payment (transition, Uncompensated Care (UC) or Delivery System Reform Incentive Payment (DSRIP)). Hospitals receiving transition payments already have the necessary affiliation agreements on file. Read more...

 

Methodology/Rules

The Waiver Payments to Hospitals and Waiver Payments for Physician Services rules are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 355, SubChapter J, Division 11.


The 1115 Waiver rules are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 354, SubChapter D.

 

Allocation Form

1115 Transformation Waiver IGT Allocation Confirmation Sheet: The waiver payment team has developed a new allocation confirmation spreadsheet for governmental entities to complete as a step in the payment process. Read more...

 

Hospital Affiliations

View Hospital Affiliations (.pdf), a comprehensive listing of each affiliation between a hospital or provider and a government entity. This will provide all information needed to complete the allocation form, such as the unique affiliation number, TIN number, TPI, account number, and region associated with the affiliation.

 

PAYMENT INFORMATION 

2015 (DY4) Uncompensated Care Expenditures

View the 2015 DY4 Uncompensated Care Expenditures (.pdf)

 

2014 (DY3) Uncompensated Care Expenditures

View the 2014 DY3 Uncompensated Care Expenditures (.pdf)

 

2013 (DY2) Uncompensated Care Expenditures

View the 2013 DY2 Uncompensated Care Expenditures (.pdf)

 

2013 (DY2) Uncompensated Care Payments Spreadsheet

The finalized 2013 Uncompensated Care (UC) Payment Spreadsheet displays the annualized payments, final payments and calculations for payment reductions to remain within the aggregate limit (maximum funding) for the first year of the waiver.

View the 2013 DY 2 Uncompensated Care Payment Calculation Spreadsheet (.zip)

View the 2013 Final DY 2 UC Payment Amount by Affiliation Spreadsheet (.xls)

ADDITIONAL INFORMATION

Providers that have a payment recoupment will be notified separately by HHSC regarding the process for recouping amounts owed.


View the Final 2012 UC IGTs (.pdf)


Waiver Payment Forms for UC/DSRIP Providers


Guidelines for Participating in Transformation Waiver Payments (.pdf)

 

Contacts

Note: Rate Analysis staff can assist you with questions concerning only payment rates for the specified services. They are not able to answer other types of questions, such as the status of payment for services rendered or questions involving eligibility for care services.


If you have questions regarding Hospitals - Inpatient and Outpatient Hospital Services payment rates, please call the appropriate person on the Contacts List.


If you have questions regarding Hospitals program/policy issues, please call the TMHP Contact Center at 1-800-925-9126.

 

Send email to Rate Analysis

 

Updated: August 19, 2016