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Waiver Update - DY7-8
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Waiver Update - DY7-8
Feb
09
RHP Plan Update Template has been sent via email. All documents are also posted on the DSRIP Online Reporting System bulletin board.
HHSC is updating many documents; please see the bulletin board for the latest version.
The Cat C Measure Specs (excel file), the Cat C Specifications FAQ, and the 2. Cat C Measure Specs – Hospitals and Physician Practice were all updated.
Please download from the DSRIP Online Reporting System bulletin board. I have not attached as the files are too large.
Please review the Companion Document prior to submitting questions to HHSC.
Category B:
Anchors requested clarification on how outpatient clinics such as labs, X-ray, physical therapy, etc., should be included in the provider’s system definition. As previously suggested by HHSC,
these types of clinics may be included as optional components.
This will be reflected in the next update of the Category B FAQs (not yet available).
Category C
The second round of FAQ on the Measure Specifications were sent earlier this week. They have also been posted on the DSRIP Online Reporting System bulletin board.
HHSC continues to review questions regarding Measure Specifications and
plan to update the FAQ every other week through the end of March.
Providers may submit new questions to the waiver mailbox, but please check the posted FAQs and the measure specifications (especially the Introduction) before sending additional questions.
Due to the volume of specifications questions received, HHSC may refer some providers back to their anchor for assistance, depending on the type of question asked.
Attached is the goal calculator for DY7-8.
The goal calculator allows providers to calculate DY7 and DY8 achievement goals for the standard payer-type for P4P Category C measures.
The goal calculator does not currently allow for goal calculation for grandfathered LHD measures.
HHSC has corrected a mistake in the Cat C FAQ posted on Monday related to the use of the ANSA/CANS by CMHCs to collect data for certain measures. The FAQ posted to the waiver bulletin board has been updated, and the revised response is also posted below.
Question: Can CMHCs use data from the ANSA or CANS for measures M1-261 Assessment for Substance Abuse Problems of Psychiatric Patients, M1-262 Assessment of Risk to Self/Others, and M1-263 Assessment for Psychosocial Issues of Psychiatric Patients? Can CMHCs use the data that is already being captured by the CANS/ANSA assessment tool as it is already required to be used to assess ALL of our mental health clients?
Answer:
The ANSA and CANS are not approved tools to use for measures M1-385 Assessment of Functional Status or QoL and M1-386 Improvement in Functional Status or QoL.
HHSC has not made any recommendations regarding the use of data collected through ANSA and CANS screening to other measures. Providers are strongly encouraged to prioritize measures in need of improvement that demonstrate delivery system reform and transformation of the healthcare system.
HHSC has updated the Category C Measure Specifications Part 2 (Hospital and Physician Practice Measures) and the posted specifications excel file to correct a few identified errors.
Please pull from bulletin board.
Most corrections are minor and
corrections are detailed in the posted change log.
The following significant correction was made:
D1-503 -Acute Composite (PDI 91) specifications have been corrected to clarify that the age range for both the numerator and denominator is ages 3 months - 17 years.
HHSC is working on additional guidance related to the inclusion of incarcerated populations in the DSRIP attributed population, and the payer-type assigned to pending Medicaid.
Category D
HHSC made a technical correction to the Measure Bundle Protocol related to Category D reporting for CMHCs
. Updates would allow Category D to incorporate potential changes to the measures reported by the Centers, since these measures are under internal and external review. The corrected version will be posted to the DSRIP Online Reporting System bulletin board and the waiver website.
HHSC is working on obtaining the data for Category D reporting.
PPV data will be provided the same way as the PPAs, PPCs and PPRs.
For LHDs, the data from the Behavioral Risk Factor Surveillance Survey (BRFSS) is based on calendar year 2016. When reporting, LHDs will provide qualitative information describing their activities in the areas included in Category D that took place any time during 2016 and through the reporting period.
It will be a similar approach for CMHCs, but finalization of the data is still in process.
Rules:
The DSRIP DY7-8 rule amendment 1 was published as proposed in the January 19, 2018, issue of the Texas Register, for an anticipated effective date of April 2018. HHSC is working on a second rule amendment to make the rules consistent with the DSRIP protocols approved by CMS.
Please also find attached the processes for 1) Requesting HHSC Pre-Review for Bundle I1 and Pre-Approval for Standardized Instruments, and 2) Requesting HHSC Approval of an Approximate Baseline.
DY7 Monitoring IGT:
Attached is the estimated DY7 Monitoring IGT.
The DY7 Monitoring IGT amounts are based on the total IGT funding per provider per IGT Entity applied to DY7 valuation. For example, if IGT Entity A and IGT Entity B funded Hospital Z at 60% and 40% for all DY6 Categories 1-4, then it was applied that IGT Entity A will fund 60% of Hospital Z's DY7 total provider valuation and IGT Entity B will fund the remaining 40% of Hospital Z's DY7 total provider valuation.
If IGT Entities change in entity or proportion funded in the RHP Plan Update submission, then HHSC will update the DY7 Monitoring IGT amounts to reflect the changes. The updated DY7 Monitoring IGT amount per IGT Entity will only decrease and will not increase based on the RHP Plan Update changes.
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