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1115 Transformation Waiver Update

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The Health and Human Services Commission (HHSC) announces its intent to submit a “Fast Track” extension application to the Centers for Medicare & Medicaid Services (CMS) for the Texas Healthcare Transformation Quality Improvement Program (THTQIP) waiver under section 1115 of the Social Security Act. The extension request is for five years, which will provide the 1115 waiver authority through September 30, 2027.

The requested extension will allow Texas continued flexibility to pursue the goals of the existing 1115 waiver: 

  • Expand risk-based managed care to new populations and services;
  • Support the development and maintenance of a coordinated care delivery system;
  • Improve outcomes while containing cost growth; and
  • Transition to quality-based payment systems across managed care and providers. 

The extension will also create financial stability for Texas Medicaid providers, as HHSC works to transition the valuable work identified through Delivery System Reform Incentive Payment (DSRIP) innovations. The extension better aligns the DSRIP transition timeline with the overall goals to create a sustainable program. There are no significant policy changes requested under this extension application.

Under the "Fast Track" extension, CMS seeks to align the review process with timelines typically used for decisions on requests like a State Plan Amendment, or 90 days. 

Public Health Emergency

Responding to the public health emergency has put pressure on the state’s health-care system. Therefore, this application also requests that the Secretary exercise his authority under 42 CFR § 431.416(g) to waive certain notice procedures to expedite a decision. Approval of this “Fast Track” extension will sustain the achievements of the demonstration and support the needs of beneficiaries and Texans.

Visit here for more detailed information about the extension application

OPPORTUNITIES FOR PUBLIC COMMENT

1115 Waiver - Public Hearing

December 7, 2020 at 2:00 p.m., Central Time, by registering at the link below:

Members of the public throughout the state have an opportunity to provide comments through this webinar.

Register here to attend this webinar

HHSC Executive Council Meeting for Public Comment

December 8, 2020, at 2:00 p.m., Central Time

Register here to provide public comment.

Click here to attend the meeting

Written Comments

Written comments will be accepted until December 27, 2020, and can be emailed to Texas Medicaid Waivers.