DY 4 UC Commitments – Action Required

Dear RHP 6 Performing Providers,

 UC PROVIDERS and AFFILIATED IGT ENTITIES: ACTION REQUIRED. Please read this email just received from HHSC Rate Analysis:

Referenced “attached” files are available at these links:

 The purpose of this e-mail is to provide demonstration year 4 (DY 4) uncompensated care (UC) and intergovernmental transfer (IGT) data to all UC providers and Anchors for the UC payment to be processed in February 2016.  The attached file contains the maximum UC payment for this round of the DY 4 payment, the maximum IGT commitment for each provider and a request for the final IGT commitment from providers.  This is not the final DY 4 UC payment.  There will be a final DY 4 UC payment pending the resolution of Texas Children’s Hospital and Seattle Children’s Hospital vs. Burwell et al., Civil Action No. 14-2060, in the US District Court for the District of Columbia. HHSC is holding back 5 percent of the total DY 3 UC allocation to address possible changes to all hospitals’ HSLs pending the resolution of Texas Children’s Hospital and Seattle Children’s Hospital vs. Burwell et al., Civil Action No. 14-2060, in the US District Court for the District of Columbia.  Upon final resolution of this case, HHSC will make a final DY 4 UC payment based on the court decision.

 At this point, eligible providers and/or their government entities are asked to view the “2015 DY 4 UC IGT Commitment Amounts for Publication” tab of the attached workbook, locate their hospital and its associated “Maximum IGT for February 2016 DY 4 UC Payment (Prior to Haircut)” amount in Column K and complete the IGT commitment form by entering the IGT amount they are committing for the February 2016 DY 4 UC payment.  The commitment form must be returned to HHSC at  RAD_UC_Payments@hhsc.state.tx.us by close of business on January 25, 2016. 

Please determine the IGT amount you wish to commit up to the limit contained in Column K.  While you may commit to IGT the maximum amount in Column K, providers have the option to commit less than the maximum in order to ensure that they do not exceed their HSLs at the time of the UC interim and final reconciliations or if they do not have enough IGT available to fund the maximum amount.  Provider’s IGT commitments should take into consideration their own determinations of whether they might be paid above their HSLs at the time of the interim and final UC reconciliations.  Being paid above their HSLs would subject providers to recoupment at the time of the reconciliations.

 It is the responsibility for each provider to coordinate with their Government entities to determine the amount(s) that each Government entity is committing to. This is necessary to ensure that providers do not exceed their maximum IGT commitment. It is the responsibility of the provider receiving the payment to submit this form to HHSC by the designated due date.

 HHSC will impose a “haircut” to determine the actual DY4 UC payments upon receipt of their proposed IGT commitments. The size and distribution of the haircut will be dependent on amount the IGT commitments and the DY4 funds available.

 To ensure that all government entities receive this notification, HHSC strongly encourages anchors and providers to send this information to any government entity who is IGT’ing on their behalf. 

 Below are the pertinent dates associated with the DY4 UC payment:

  • January 25           DY4 UC IGT Commitment Due
  • January 27           DY4 UC IGT Notification sent to industry
  • February 4          Last date to transfer funds into TexNet
  • February 5           DY4 UC IGT Settlement Date
  • February 16        DY4 Transferring Entities (Big 6) Payment Date
  • February 29        Latest DY4 UC Payment Date

 To avoid having to revise your TexNet entries, do not enter your IGT amount into TexNet until you receive the final version of the calculation workbook from HHSC.  The final version, with the haircut, is expected to be released on January 27, 2016.

 If you have questions regarding the UC payment process, please send an email to RAD_UC_Payments@hhsc.state.tx.us