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QIPP Year 5 Update

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The Texas Health and Human Services Commission (HHSC) has loaded managed care rates for state fiscal year (FY) 2022, effective September 1, 2021. These initial rates include the Quality Incentive Payment Program (QIPP), which the Centers for Medicare & Medicaid Services (CMS) has indicated it is willing to approve as proposed by the state. 

Updated October Timeline for Reporting and Payment

  • HHSC will issue the QIPP scorecard to managed care organizations (MCOs) between October 11 and October 15, 2021.
  • The September scorecard (issued in October) will presumptively indicate that all providers have met Component 1. This will be subject to verification and future recoupment.
  • The September scorecard (issued in October) will temporarily indicate Component 2 as “not met” for all providers but will be updated in the October scorecard (issued in November) based on provider performance.
  • MCOs will pay providers no later than 20 days after the date the MCO receives the QIPP scorecard.
  • QIPP providers will submit September Components 1 and 2 reporting by October 27, 2021, rather than the original deadline of October 6.
  • Providers that do not meet the October 27, 2021, deadline will be subject to recoupment and termination from the program.
  • The final quality metrics and performance requirements for QIPP program year 5 are available on the HHSC web site.

HHSC will provide reporting instructions and templates to QIPP providers in a separate communication. The November deadline for October provider submissions is November 4, 2021. HHSC continues to seek final approval of the QIPP program for fiscal year 2022. If you would like to track those discussions, please see our correspondence and updated preprints